Emtricitabine Tenofovir disoproxil fumarate Brand Name– Truvada
What is Emtricitabine Tenofovir disoproxil fumarate
Emtricitabine Tenofovir disoproxil fumarate (Truvada) is used for the treatment of human immunodeficiency virus (HIV) infection and for pre-exposure prophylaxis to reduce the risk of sexually acquired HIV-1 in adults and adolescents (weighing 35 kg or more) at high risk.
Emtricitabine is a nucleoside reverse transcriptase inhibitor (NRTI) and tenofovir is an acyclic nucleotide analog (i.e., nucleotide reverse transcriptase inhibitor).
Each is active against HIV and when combined exhibit synergistic antiretroviral activity in HIV-infected cells. While it belongs to the same nucleoside series as lamivudine (3TC), emtricitabine has consistently been more potent against HIV in vitro than lamivudine.
Due to the similarities between the 2 drugs, emtricitabine will not likely be effective in individuals who display antimicrobial resistance to lamivudine. While emtricitabine and tenofovir also exhibit activity against hepatitis B virus (HBV), only tenofovir is indicated for this use; the combination product carries a boxed warning that severe, acute exacerbations of hepatitis B have been reported in HBV-infected patients after discontinuation of emtricitabine; tenofovir disoproxil fumarate (DF).
Decreases in bone mineral density (BMD) have been reported with tenofovir therapy in children; therefore, use of tenofovir is only recommended as part of a preferred regimen in adolescents in Tanner stage 4 or 5. Tenofovir may be considered in children in lower Tanner stages as alternative treatment or in special circumstances.
Emtricitabine; tenofovir DF was the first medication approved for pre-exposure prophylaxis, in combination with safe sex practices, for uninfected individuals at high risk of contracting HIV
Indications
- human immunodeficiency virus (HIV)
- human immunodeficiency virus (HIV) infection
- human immunodeficiency virus (HIV) prophylaxis
NOTE: HIV guidelines recommend consideration be given to avoiding use of tenofovir disoproxil fumarate-containing regimens in patients with renal disease and osteoporosis.
Side Effects
- abdominal pain
- abnormal dreams
- angioedema
- anorexia
- anxiety
- arthralgia
- asthenia
- back pain
- bone fractures
- bone pain
- chest pain (unspecified)
- cough
- depression
- diabetes insipidus
- diarrhea
- dizziness
- dyspepsia
- dyspnea
- elevated hepatic enzymes
- Fanconi syndrome
- fatigue
- fever
- flatulence
- glycosuria
- headache
- hematuria
- hepatic decompensation
- hepatic failure
- hepatitis B exacerbation
- hepatomegaly
- hyperamylasemia
- hyperbilirubinemia
- hypercholesterolemia
- hyperglycemia
- hypertriglyceridemia
- hypoglycemia
- hypokalemia
- hypophosphatemia
- infection
- insomnia
- interstitial nephritis
- lactic acidosis
- maculopapular rash
- myalgia
- myasthenia
- myopathy
- nausea
- neuritis
- neutropenia
- osteomalacia
- osteopenia
- osteoporosis
- pancreatitis
- paresthesias
- peripheral neuropathy
- pharyngitis
- polyuria
- proteinuria
- pruritus
- rash
- renal failure (unspecified)
- renal tubular necrosis
- rhabdomyolysis
- rhinitis
- sinusitis
- skin discoloration
- skin hyperpigmentation
- steatosis
- vesicular rash
- vomiting
- weakness
- weight loss
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/BUN
- serum lipid profile
- serum phosphate
- urinalysis
Contraindications
- alcoholism
- autoimmune disease
- bone fractures
- breast-feeding
- children
- females
- Graves’ disease
- Guillain-Barre syndrome
- hepatic disease
- hepatitis B and HIV coinfection
- hepatitis B exacerbation
- hepatitis C and HIV coinfection
- hepatotoxicity or lactic acidosis
- HIV serum status
- human immunodeficiency virus (HIV) infection resistance
- hypophosphatemia
- 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
- Bacitracin
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Bepridil
- Bismuth Subsalicylate
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Boceprevir
- Brigatinib
- Cabozantinib
- Canagliflozin; Metformin
- Capmatinib
- Carboplatin
- Carvedilol
- Celecoxib
- Choline Salicylate; Magnesium Salicylate
- Cidofovir
- Cisplatin
- Clarithromycin
- Clofarabine
- Colchicine
- Colchicine; Probenecid
- Colistimethate, Colistin, Polymyxin E
- Conivaptan
- Cyclosporine
- Dapagliflozin; Metformin
- Darolutamide
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dextromethorphan; Quinidine
- Dichlorphenamide
- Diclofenac
- Diclofenac; Misoprostol
- Didanosine, ddI
- Diflunisal
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Dofetilide
- Dolutegravir; Lamivudine
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Dronedarone
- Echinacea
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elexacaftor; tezacaftor; ivacaftor
- Eliglustat
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Ertugliflozin; Metformin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Esomeprazole; Naproxen
- Etodolac
- Etravirine
- Famotidine; Ibuprofen
- Fenoprofen
- Flurbiprofen
- food
- Foscarnet
- Fostamatinib
- Ganciclovir
- Gentamicin
- 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
- Iohexol
- Iopamidol
- Iopromide
- Ioversol
- Isosulfan Blue
- Istradefylline
- Itraconazole
- Ivacaftor
- Kanamycin
- Ketoconazole
- Ketoprofen
- Ketorolac
- Lamivudine, 3TC
- Lamivudine, 3TC; Zidovudine, ZDV
- Lamivudine; Tenofovir Disoproxil Fumarate
- Lansoprazole; Naproxen
- Lapatinib
- Ledipasvir; Sofosbuvir
- Linagliptin; Metformin
- Lopinavir; Ritonavir
- Lumacaftor; Ivacaftor
- Magnesium Salicylate
- Meclofenamate Sodium
- Mefenamic Acid
- Mefloquine
- Meloxicam
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Mifepristone
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nelfinavir
- Neratinib
- Non-Ionic Contrast Media
- Nonsteroidal antiinflammatory drugs
- Ombitasvir; Paritaprevir; Ritonavir
- Orlistat
- Osimertinib
- Oxaliplatin
- Oxaprozin
- Pamidronate
- Paromomycin
- Piroxicam
- Plazomicin
- Polymyxin B
- Polymyxins
- Posaconazole
- Probenecid
- Propafenone
- Quinidine
- Ranolazine
- Regorafenib
- Ribavirin
- Rifaximin
- Ritonavir
- Rofecoxib
- Rolapitant
- Salicylates
- Salsalate
- Sapropterin
- Saquinavir
- Simeprevir
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Sorafenib
- Streptomycin
- Sulindac
- Tacrolimus
- Tafamidis
- Tedizolid
- Telaprevir
- Telithromycin
- Temsirolimus
- Testosterone
- Tezacaftor; Ivacaftor
- Ticagrelor
- Tipranavir
- Tobramycin
- Tolmetin
- Tolvaptan
- Trandolapril; Verapamil
- Trospium
- Tucatinib
- Valacyclovir
- Valdecoxib
- Valganciclovir
- Vancomycin
- Vemurafenib
- Verapamil
- Zoledronic Acid
- Zonisamide
