Emtricitabine Tenofovir alafenamide

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Emtricitabine Tenofovir alafenamide Brand Name– Descovy

What is Emtricitabine Tenofovir alafenamide

Emtricitabine Tenofovir alafenamide (Descovy) is indicated for use in combination with other antiretroviral agents to treat human immunodeficiency virus (HIV-1) infection in adults and pediatric patients who weigh at least 25 kg.

It is also indicated for pre-exposure prophylaxis to reduce the risk of sexually acquired HIV-1 in adults and adolescents who weigh at least 35 kg and are at high risk (excluding individuals at risk from receptive vaginal sex).

Similar to Truvada, Descovy contains two medications in a single tablet, emtricitabine (a nucleoside reverse transcriptase inhibitor) and tenofovir (an acyclic nucleotide reverse transcriptase inhibitor). However, Descovy contains a different tenofovir prodrug, tenofovir alafenamide, which provides lower concentrations in the bloodstream, but higher concentrations within the cells where HIV replicates.

As a result, Descovy is associated with few adverse reactions. The FDA-approved package labeling contains a Black Box Warning regarding the potential for acute exacerbations of hepatitis B in patients with HIV and HBV after treatment discontinuation.

Indications

  1. human immunodeficiency virus (HIV)
  2. human immunodeficiency virus (HIV) infection
  3. human immunodeficiency virus (HIV) prophylaxis

NOTE: HIV guidelines recommend consideration be given to avoiding use of tenofovir alafenamide-containing regimens in patients coinfected with tuberculosis and receiving a rifamycin

Side Effects

  1. abdominal pain
  2. angioedema
  3. bone fractures
  4. bone pain
  5. diarrhea
  6. Fanconi syndrome
  7. fatigue
  8. headache
  9. hepatic decompensation
  10. hepatic failure
  11. hepatitis B exacerbation
  12. hepatomegaly
  13. hypercholesterolemia
  14. hyperkalemia
  15. hypertriglyceridemia
  16. hypervolemia
  17. hypophosphatemia
  18. lactic acidosis
  19. myalgia
  20. nausea
  21. osteomalacia
  22. osteomyelitis
  23. osteopenia
  24. osteoporosis
  25. rash
  26. renal failure (unspecified)
  27. steatosis
  28. urticaria
  29. weakness
  30. weight gain

Monitoring Parameters

  • blood glucose
  • CBC with differential
  • CD4+ T cell count
  • hepatitis B serology
  • LFTs
  • plasma hepatitis C RNA
  • plasma HIV RNA
  • pregnancy testing
  • serum bilirubin (total and direct)
  • serum cholesterol
  • serum creatinine
  • serum lipid profile
  • urinalysis

Contraindications

  • alcoholism
  • autoimmune disease
  • Black patients
  • bone fractures
  • breast-feeding
  • females
  • Graves’ disease
  • Guillain-Barre syndrome
  • hepatic disease
  • hepatitis
  • hepatitis B and HIV coinfection
  • hepatitis B exacerbation
  • hepatitis C and HIV coinfection
  • hepatomegaly
  • hepatotoxicity or lactic acidosis
  • Hispanic patients
  • HIV serum status
  • human immunodeficiency virus (HIV) infection resistance
  • hypercholesterolemia
  • hyperlipidemia
  • hypertriglyceridemia
  • immune reconstitution syndrome
  • obesity
  • osteomalacia
  • osteoporosis
  • pregnancy
  • renal failure
  • renal impairment
  • sexually transmitted disease

Interactions

  • Abacavir; Dolutegravir; Lamivudine
  • Abacavir; Lamivudine, 3TC
  • Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
  • Acalabrutinib
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acyclovir
  • Adefovir
  • Alogliptin; Metformin
  • Amikacin
  • Aminoglycosides
  • Aminosalicylate sodium, Aminosalicylic acid
  • Amiodarone
  • Amlodipine; Celecoxib
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amphotericin B
  • Amphotericin B cholesteryl sulfate complex (ABCD)
  • Amphotericin B lipid complex (ABLC)
  • Amphotericin B liposomal (LAmB)
  • Aspirin, ASA
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Bacitracin
  • Barium Sulfate
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Boceprevir
  • Brigatinib
  • Cabozantinib
  • Canagliflozin; Metformin
  • Capmatinib
  • Carbamazepine
  • Carboplatin
  • Carvedilol
  • Celecoxib
  • Choline Salicylate; Magnesium Salicylate
  • Cidofovir
  • Cisplatin
  • Clarithromycin
  • Cobicistat
  • Colchicine; Probenecid
  • Conivaptan
  • Cyclosporine
  • Daclatasvir
  • Dapagliflozin; Metformin
  • Darolutamide
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dichlorphenamide
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diflunisal
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Dofetilide
  • Dolutegravir; Lamivudine
  • Doravirine; Lamivudine; Tenofovir disoproxil fumarate
  • Echinacea
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elexacaftor; tezacaftor; ivacaftor
  • Eliglustat
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enalapril; Felodipine
  • Ertugliflozin; Metformin
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Esomeprazole; Naproxen
  • Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestimate
  • Etodolac
  • Famotidine; Ibuprofen
  • Felodipine
  • Fenoprofen
  • Flibanserin
  • Flurbiprofen
  • food
  • Foscarnet
  • Fosphenytoin
  • Fostamatinib
  • Fostemsavir
  • Gadobutrol
  • Gadoversetamide
  • Ganciclovir
  • Gentamicin
  • Glecaprevir; Pibrentasvir
  • Glipizide; Metformin
  • Glyburide; Metformin
  • grapefruit juice
  • Hydrocodone; Ibuprofen
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Indomethacin
  • Interferon Alfa-2b; Ribavirin
  • Interferons
  • Isavuconazonium
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Ivacaftor
  • Kanamycin
  • Ketoconazole
  • Ketoprofen
  • Ketorolac
  • Lamivudine, 3TC
  • Lamivudine, 3TC; Zidovudine, ZDV
  • Lamivudine; Tenofovir Disoproxil Fumarate
  • Lansoprazole; Naproxen
  • Ledipasvir; Sofosbuvir
  • Linagliptin; Metformin
  • Lopinavir; Ritonavir
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • Magnesium Salicylate
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meloxicam
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Mifepristone
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nitisinone
  • Non-Ionic Contrast Media
  • Nonsteroidal antiinflammatory drugs
  • Obeticholic Acid
  • Omeprazole; Amoxicillin; Rifabutin
  • Orlistat
  • Osimertinib
  • Oxaliplatin
  • Oxaprozin
  • Oxcarbazepine
  • Pamidronate
  • Paromomycin
  • Phenobarbital
  • Phenytoin
  • Pirfenidone
  • Piroxicam
  • Plazomicin
  • Polymyxin B
  • Polymyxins
  • Posaconazole
  • Primidone
  • Probenecid
  • Ranolazine
  • Regorafenib
  • Ribavirin
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rifaximin
  • Rivaroxaban
  • Rofecoxib
  • Rolapitant
  • Salicylates
  • Salsalate
  • Sapropterin
  • Simeprevir
  • Sofosbuvir; Velpatasvir
  • Sofosbuvir; Velpatasvir; Voxilaprevir
  • St. John’s Wort, Hypericum perforatum
  • Streptomycin
  • Sulindac
  • Tacrolimus
  • Tafamidis
  • Tedizolid
  • Telithromycin
  • Temsirolimus
  • Testosterone
  • Tezacaftor; Ivacaftor
  • Ticagrelor
  • Tipranavir
  • Tobramycin
  • Tolmetin
  • Tolvaptan
  • Trandolapril; Verapamil
  • Trospium
  • Tucatinib
  • Valacyclovir
  • Valdecoxib
  • Valganciclovir
  • Valproic Acid, Divalproex Sodium
  • Vancomycin
  • Vemurafenib
  • Verapamil
  • Zoledronic Acid
  • Zonisamide

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