Efavirenz, Emtricitabine and Tenofovir (Oral)

Efavirenz, emtricitabine and tenofovir are antiviral agents decreasing the amount of HIV in the body, delaying the development and reproduction of the virus.

Overview

There is no cure or prevention for HIV infection and, without therapy, it can lead to acquired immune deficiency syndrome (AIDS). Treatments with anti-retroviral (ARV) efavirenz, emtricitabine and tenofovir have been effective in slowing down the progression of this disease. This trio helps the immune system, but the medicine also triggers side effects of existing ailments or unknown underlying health disorders.

ARVs block the HIV lifecycle. Both work to prevent viral replication in infected cells containing the HIV enzyme. Efavirenz belongs to a class of medications called non-nucleoside reverse transcriptase inhibitors (NNRTIs). Emtricitabine and tenofovir are nucleoside reverse transcriptase inhibitors (NRTIs).

Treatment does not the stop the spread of HIV to other individuals. You need to continue taking your medicine and learn about precautions to prevent spreading the disease, for example, practice safe and covered sexual activities. Do not share personal items exposed to body fluids or blood, for example, needles, syringes, toothbrushes or razors.

Before scheduling or undergoing any surgery or dental work, talk with your doctors and tell them about the medicines you are taking now. Some medications may affect the results of certain medical lab tests.

Conditions Treated

  • HIV
  • Prevention of infection after exposure

Type Of Medicine

  • Antiretroviral agent

Side Effects

Efavirenz, emtricitabine and tenofovir are prescriptions used to block the HIV virus from causing mutated cells. Although we rely on medications for treatment, they also cause unwanted side effects. Before you take this medication, talk to your doctor, since medicines contain different active ingredients, prompting harmful reactions. If you have questions about which side effects are more likely to occur due to an existing condition, ask your doctor.

You may experience side effects not listed, depending on your health and lifestyle routines. If you recognize other effects, check with your doctor. The effects are listed as most common, least common and rare.

Your doctor will be talk to you about which side effects are most prevalent with your individual condition. Most individuals experience some of these listed, but not all. If you experience side effects that aren't listed here, tell your physician or health care specialist. If the effect persists or reaches a level of discomfort beyond your tolerance, there are methods to help prevent or relieve the reaction. The severity of each effect varies from person to person depending on your health, the current phase of your disorder and your age.

Taking this medicine will strengthen your immune system. If any of the effects persist, it could be a sign of a hidden infection becoming active. Keep your doctor updated about any changes in your health.

Most common

  • Diarrhea
  • Dizziness
  • Unusual tiredness

Some side effects appear at the start of treatment and fade away as your body adjusts to the medication. Be sure to share all of your health, medical and family history with your doctor. Your medical history provides valuable information for the doctor. The doctor will decide if this medicine is the best form of treatment for you.

Not all side effects need medical attention, but if you are unsure, contact your doctor. Do not stop taking the medicine or change the dose without your doctor's approval. In order to manage this disorder, you need to learn how your body responds and what induces the effect.

Least common

  • Color changes in urine and stools
  • Fever
  • Headache
  • Jaundice
  • Loss of appetite
  • Muscle aches
  • Nausea and vomiting
  • Rash
  • Skin blistering
  • Sore throat
  • Stomach pain
  • Swelling

As individuals, we are unique and how we respond to medications varies - the effects involve discomfort and pain. For some individuals, dynamics in lifestyles, genetics and unknown factors contribute to certain side effects. The severity depends on the individual's health condition, age and term of exposure.

If any of these effects occur and cause stress, seek medical attention for your own comfort. Some effects are rare and may be caused with the introduction of new medications. There are instances where adjustments to existing medicines or an underlying health condition could trigger side effects.

Let your doctor know how you are feeling the more the doctor knows about how your body is responding to the medicine, the more they can make a difference in maintaining your health for the long-term.

Rare

  • Insomnia
  • Irritability
  • Loss of interest
  • Sadness
  • Sleepiness
  • Trouble concentrating

Precautions

This medicine can affect the liver, prompting a condition known as lactic acidosis (build-up of lactic acid in the blood). Another health condition increasing the risk of this is being overweight. Although this is more prevalent in women, it should act as a caution for everyone. If you have been taking these medicines for a long time, you are at a higher risk of developing liver problems.

If you have been treated for liver problems, have a family history of liver complications or experience these these effects, tell your doctor. You may have sensitivity to this medicine, triggering an adverse reaction.

  • Dark urine
  • Irregular heartbeats
  • Jaundice
  • Severe muscle pain not an ache
  • Trouble breathing
  • Unusual bleeding or bruising

Dosage

Efavirenz, emtricitabine and tenofovir are prescribed in fixed dose tablets. The doses will vary depending on the severity of your condition, other health circumstances or your own tolerance to this medication. Take the medicine as instructed by your doctor and keep taking it, even if you feel better. The virus can build resistance when there's a lapse in taking your medication, affecting the treatment of HIV infections.

For HIV infection treatment

Adult

A single tablet contains 600 mg of efavirenz, 200 mg of emtricitabine and 300 mg of tenofovir.

  • 1 tablet daily, swallow the tablet whole with a glass of water.
  • Taken on an empty stomach at bedtime.

Adolescent: 12 years of age or older, weighing at least 88 pounds.

  • 1 tablet daily, swallow the tablet whole with a glass of water.
  • Taken on an empty stomach at bedtime.

Children younger than 12 years of age should not use this medicine. A doctor will decide the dosage.

Your doctor will check how you respond to this medicine, so be sure to keep up with your office visits, along with lab tests for ongoing evaluations of your health. It's important that you understand the risks of this condition and how the medicine works at managing this disease.

Do not change the dose or the frequency prescribed by the doctor. The dose of medicine depends on the strength prescribed. The time intervals between doses and the duration of treatment are based on your body's response, your health and the stage of the condition.

Do not share your medicine with anyone else.

Missed dose

If you miss a dose, take it as soon as possible to keep the medication levels in your body working against the infection. If you take this medicine during the day, side effects may intensify for you. It's critical to keep taking the medication to prevent interruptions in treatment, which could result in harmful consequences.

If you are near the time for taking the next dose, skip the missed dose and continue with your scheduled dose. Do not double the dose under any circumstances. If you do, contact your doctor immediately.

Interactions

In some circumstances, medicines like efavirenz, emtricitabine and tenofovir work well together to manage the condition. There are some situations where different medicines interact with each other and cause other disorders, or prompt serious effects to existing health conditions. Your doctor may change the frequency or the administering time to reduce or prevent the reactions. Your doctor may adjust the doses of different drugs to treat the present conditions.

Some side effects are inconsistent due to the frequency that we take them and whether they result from prescribed or over the counter (OTC) drugs. Your doctor will watch how these medicines work with efavirenz, emtricitabine and tenofovir:

  • Aminoglycoside antibiotic
  • Arthritis medicine
  • Blood pressure medicine
  • Blood thinners
  • Nonsteroidal anti-inflammatory drugs
  • Statin medicine

Talk with your doctor about your daily routines certain foods, health supplements and herbal remedies can affect your response to this medication. Lifestyle choices surrounding alcohol, tobacco, other drugs, OTC medications and prescriptions will change the effectiveness of efavirenz, emtricitabine and tenofovir.

There are health situations where using multiple medications is necessary and doctors are may be concerned about the interactions changing the results and increasing the risks. Prescribed medicines are based on doses. When medicines share similar compounds, it could cause a severe interaction, intensifying the side effect for you. There's a second concern when you are taking multiple medicines: the chemical quantities could change the outcome of treatment.

Based on a full examination of your health and the condition treated with this medicine, your doctor will decide if any of the medicines you are taking now could cause harm. It may be necessary to change some medicines or adjust the doses for better health results.

If you are taking any of the medicines listed, or other prescription or non-prescription medications not listed, tell your doctor. There are other mediations not listed that interact with this condition. Your doctor will check your medications to be sure this medicine is safe for you.

  • Acyclovir
  • Alfuzosin
  • Amifampridine
  • Amiodarone
  • Amisulpride
  • Amitriptyline
  • Amprenavir
  • Anagrelide
  • Apomorphine
  • Aripiprazole
  • Arsenic Trioxide
  • Artemether
  • Asenapine
  • Astemizole
  • Atazanavir
  • Atorvastatin
  • Atovaquone
  • Avanafil
  • Axitinib
  • Azithromycin
  • Bedaquiline
  • Bepridil
  • Bexarotene
  • Boceprevir
  • Bosutinib
  • Bupropion
  • Buserelin
  • Carbamazepine
  • Carbamazepine
  • Caspofungin
  • Chloroquine
  • Chlorpromazine
  • Cidofovir
  • Ciprofloxacin
  • Cisapride
  • Citalopram
  • Clarithromycin
  • Clomipramine
  • Clozapine
  • Cobimetinib
  • Crizotinib
  • Cyclobenzaprine
  • Cyclosporine
  • Dabrafenib
  • Daclatasvir
  • Darunavir
  • Dasatinib
  • Degarelix
  • Delamanid
  • Desipramine
  • Deslorelin
  • Dexamethasone
  • Didanosine
  • Dienogest
  • Diltiazem
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Dolutegravir
  • Domperidone
  • Donepezil
  • Doxepin
  • Doxorubicin
  • Dronedarone
  • Droperidol
  • Ebastine
  • Elbasvir
  • Enzalutamide
  • Eribulin
  • Erythromycin
  • Escitalopram
  • Estradiol
  • Ethinyl Estradiol
  • Ethynodiol
  • Etonogestrel
  • Etravirine
  • Famotidine
  • Felbamate
  • Fentanyl
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Formoterol
  • Fosamprenavir
  • Foscarnet
  • Fosphenytoin
  • Galantamine
  • Ganciclovir
  • Gatifloxacin
  • Gemifloxacin
  • Ginkgo Biloba
  • Gonadorelin
  • Goserelin
  • Granisetron
  • Grazoprevir
  • Halofantrine
  • Haloperidol
  • Histrelin
  • Hydrocodone
  • Hydroxychloroquine
  • Hydroxyzine
  • Ibutilide
  • Idelalisib
  • Ifosfamide
  • Iloperidone
  • Imipramine
  • Indinavir
  • Itraconazole
  • Ivabradine
  • Ketoconazole
  • Lapatinib
  • Ledipasvir
  • Leuprolide
  • Levofloxacin
  • Linagliptin
  • Lopinavir
  • Lumefantrine
  • Maraviroc
  • Medroxyprogesterone
  • Mefloquine
  • Mesoridazine
  • Mestranol
  • Methadone
  • Methotrimeprazine
  • Metronidazole
  • Mifepristone
  • Mizolastine
  • Moricizine
  • Moxifloxacin
  • Nafarelin
  • Naloxegol
  • Nelfinavir
  • Netupitant
  • Nevirapine
  • Nifedipine
  • Nilotinib
  • Norfloxacin
  • Norgestimate
  • Octreotide
  • Ofloxacin
  • Olanzapine
  • Olaparib
  • Ondansetron
  • Orlistat
  • Ospemifene
  • Paliperidone
  • Panobinostat
  • Papaverine
  • Paritaprevir
  • Paroxetine
  • Pasireotide
  • Pazopanib
  • Pentamidine
  • Perphenazine
  • Phenobarbital
  • Phenytoin
  • Pimavanserin
  • Pimozide
  • Pipamperone
  • Piperaquine
  • Pitolisant
  • Ponatinib
  • Posaconazole
  • Pravastatin
  • Probucol
  • Procainamide
  • Prochlorperazine
  • Proguanil
  • Promethazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinine
  • Ranolazine
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rilpivirine
  • Risperidone
  • Ritonavir
  • Saquinavir
  • Sertindole
  • Sertraline
  • Sevoflurane
  • Simeprevir
  • Simvastatin
  • Sirolimus
  • Solifenacin
  • Sonidegib
  • Sorafenib
  • Sotalol
  • Sparfloxacin
  • St John's Wort
  • Sulpiride
  • Sultopride
  • Sunitinib
  • Tacrolimus
  • Tamoxifen
  • Telaprevir
  • Telavancin
  • Telithromycin
  • Terfenadine
  • Tetrabenazine
  • Thioridazine
  • Thiotepa
  • Tipranavir
  • Tizanidine
  • Tolterodine
  • Tolvaptan
  • Toremifene
  • Trazodone
  • Trimipramine
  • Triptorelin
  • Ulipristal
  • Vandetanib
  • Vardenafil
  • Velpatasvir
  • Vemurafenib
  • Venetoclax
  • Venlafaxine
  • Vilanterol
  • Vilazodone
  • Vinflunine
  • Voriconazole
  • Vorinostat
  • Warfarin
  • Ziprasidone
  • Zotepine
  • Zuclopenthixol

The list of medicines with possible interactions is lengthy; it reflects the range of potential risks and the likelihood of unexpected side effects when treating conditions with multiple drugs. The presence of other medical disorders increases the risk of probable complications. If you have a family history of, or have been treated for, any of these ailments, tell your doctor.

There are clinical tests and actual incidents of individuals taking these medications, while unaware of the following underlying conditions, where taking this medicine could worsen the condition:

  • Allergic reactions to efavirenz
  • Bone problems
  • Depression
  • Hepatitis B infection
  • Kidney or liver disease
  • Seizure history

9

Sometimes, abnormal and harmful effects occur when taking this medicine. It may cause anatomical, functional damages, irreversible physical changes or increase the individual's susceptibility to other chemicals and medicines. The highest level of concern is an increased risk of adverse effects leading to mortality.

Here's a list of significant effects related to drug interactions requiring a dose change, additional monitoring or an alternative therapy.

  • Central Nervous System¬†: symptoms appear during the first or second days of treatment interfering with the control of one's body and mind functions.
  • Fat redistribution: treatment may cause accumulation of body fat, such as abdominal obesity, lipodystrophy and wasting syndrome (sunken facial features), dorsocervical fat (back hump) or Cushing syndrome.
  • Hepatotoxicity: risk of developing acute or chronic liver damage, including patients with no pre-existing hepatic disease or identifiable risks. Individuals with an existing condition will find it worsens.
  • Loss of bone mineral density: HIV patients are susceptible to bone loss, so doses of calcium and vitamin D are recommended. Individuals with a history of fractures or osteoporosis are at higher risks.
  • Psychiatric effects: efavirenz has been associated with depression, suicide, paranoia and aggression. Individuals with mental illness or drug abuse history should be monitored.
  • QT prolongation: heart rhythm problems inherited and caused by medications like efavirenz or health conditions. Rapid heartbeats can cause fainting, seizures or fatal incidents.
  • Renal toxicity: Tenofovir may cause acute renal failure. Your doctor may consider changing your medication.

Warnings

The US Food and Drug Administration's division of antiviral products have limited the number of HIV treatment regimen drugs to help reduce toxicity. Although there have been successful developments for the treatment of HIV, there are warnings for both industry professionals and consumers pertaining to effects and risks when using this medicine as therapy.

FDA Warning

Sometimes, the individual and doctors are unaware of the existence of hepatitis B. When taking this medicine, side effects and health conditions worsen. Individuals with hepatitis B need to stop taking it. Before you stop or if you recognize changes in your health or no signs of improvement, talk with your doctor first.

  • Follow-up visits are necessary when hepatitis B therapy stops.
  • This medicine is not approved to treat hepatitis B.
  • Your doctor will test for hepatitis B before prescribing this medication.

The FDA is actively working on preventions for HIV transmission, supporting and enforcing public safety at all times by:

  • Ensuring that the nation's blood supply is safe.
  • Certifying that the quality of materials meet the standard for devices and supplies involved with health care services.
  • Overseeing industry and public health guidelines for the prevention and therapy of HIV infection.
  • Implementing device sterilization and disinfection reprocesses of medical devices used in health services to prevent transmission of HIV.

Pregnancy

Using this medicine if you are pregnant can harm the unborn child. If you become pregnant during treatment, contact your doctor at once. During treatment, be sure to use birth control to prevent pregnancy. Birth control pills alone will not prevent pregnancy, so you need to keep taking the pills and use a secondary form, such as contraceptive creams, condoms or diaphragms.

If you have completed treatment and wish to conceive, talk to your doctor. You may need to avoid getting pregnant for a minimum of 12 weeks after treatment.

Do not breastfeed - this medication will pass to the infant.

Geriatrics

Elderly adults have the same HIV risk factors as younger individuals. Due to age and the natural digression with health, this group is more susceptible to the side effects caused by the medication during treatment. Also, older adults are more likely to suffer from heart disease, diabetes and other health ailments, which can increase the complications of HIV treatment.

The largest risk for the group is the lack of knowledge about this disease. Recognizing the symptoms and seeing a doctor for diagnosis before the infection becomes fatal is critical.

Pediatrics

Recent clinical data shows ARV drugs are effective for pediatrics. There are warnings with severe precautions for administering this medicine to children younger than 12 years of age. Adolescents weighing less than 88 pounds may be at a higher risk for complications.

Talk to your doctor in all situations involving treatment. You need to understand this drug therapy and the impact to your child's health.

Other conditions

If you have known allergies, before starting this treatment, tell your doctor. If you suffer from kidney, liver or heart diseases this drug may have serious reactions for you. If you have a history of seizures, mental health or substance abuse, it's critical that your doctor knows about your past and your current reactions to medicines.

Transmitting HIV Infection

HIV does not survive outside of the body. The exposure involves access to the body's blood. A small amount of blood, sometimes invisible to the human eye, can change a life.

Blood infections were more common during earlier years through transfusions, organ or tissue transplants. Today, testing and stricter guidelines have lowered the risk and the incidents.

Contact with HIV-infected blood or body fluids can transmit the infection through open wounds or broken skin.

Storage

Keep this medicine out of reach of children and pets. Store it in a closed container at room temperature and away from heat, moisture and direct light. Do not freeze this medication.

Dispose of any unused portions or outdated medicines. Do not dispose of it by flushing it down the toilet or in the household trash. Your doctor or pharmacist can help you with the disposal to prevent any accidents.

Summary

Successful treatment and HIV survival rates have increased, but there are still many warnings and unknown factors for treating this condition. The best outcome happens when a constant level of these drugs are present in the body. A combination of existing health ailments and your response to treatment will affect the outcome. This medicine has fixed doses of efavirenz, emtricitabine and tenofovir  your doctor needs to decide if this therapy is right for you.