References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Eviplera is a once-daily single-tablet regimen for HIV, combining three medicines: rilpivirine (a non-nucleoside reverse transcriptase inhibitor) and emtricitabine plus tenofovir disoproxil fumarate (two nucleoside reverse transcriptase inhibitors). It’s been available in the UK for over a decade and is still used for people with suitable viral loads and no drug resistance concerns.
Here’s how Eviplera works, who it’s suitable for, and what to watch out for.
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How Eviplera Works
Each tablet contains three active ingredients that stop HIV from replicating inside CD4 cells:
| Ingredient | Class | Role |
|---|---|---|
| Rilpivirine 25mg | NNRTI | Blocks reverse transcriptase enzyme directly |
| Emtricitabine 200mg | NRTI | Stops viral DNA chain formation |
| Tenofovir DF 245mg | NRTI | Stops viral DNA chain formation |
Who Can Take It?
Eviplera is suitable for:
- Adults starting HIV treatment for the first time with a viral load below 100,000 copies/ml
- People switching from another successful regimen who have an undetectable viral load
- Those without known resistance to any of the three ingredients
It’s not usually recommended if your viral load is very high, if you have certain kidney problems, or if you need to take acid-reducing medications that interfere with rilpivirine absorption.
How to Take Eviplera
Take one tablet once a day with food. Food is important — Eviplera’s absorption drops significantly on an empty stomach, which can lead to treatment failure and resistance. A normal-sized meal (not a snack) is needed.
Side Effects
Most people tolerate Eviplera well. Possible side effects include:
- Headache
- Sleep problems and vivid dreams
- Mild mood changes
- Nausea (usually settles in the first few weeks)
- Kidney function changes (monitored with regular blood tests)
- Small reductions in bone density over time
Drug Interactions to Avoid
- Proton pump inhibitors (omeprazole, lansoprazole) — reduce rilpivirine absorption significantly
- H2 blockers (ranitidine, famotidine) — take 12 hours apart if needed
- Antacids — take 2 hours before or 4 hours after Eviplera
- Rifampicin and some anticonvulsants
- St John’s Wort
Read more: What is HIV? | HIV and the immune system | Nevirapine
Frequently Asked Questions
Do I really need to take Eviplera with food?
Yes. Taking it on an empty stomach cuts absorption by around 40%, which can let HIV replicate and cause drug resistance. Always take it with a proper meal.
Can I switch from Eviplera to something else?
Yes. If you experience side effects or have new drug interactions, your HIV team can switch you to a different regimen such as one containing a modern integrase inhibitor.
Is Eviplera still available in the UK?
Yes, though newer single-tablet regimens are more commonly prescribed for people starting treatment today. Eviplera remains a suitable option for many people who are already taking it successfully.
Related reading
- Efavirenz for HIV: An Older NNRTI Still in Use
- Dolutegravir: A Complete Guide to This HIV Medication
- Understanding Efavirenz in HIV Treatment
- Injectable HIV Treatment: Everything You Need to Know
- Are HIV Tests Accurate If You're on PrEP, PEP or ART?
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
