Emtricitabine and Tenofovir (Oral)

 

Emtricitabine and tenofovir (Truvada), when combined with other medicines, slows the progression of the HIV virus and may add years to individuals diagnosed with HIV-1.

Overview

It is well-known that the Human Immunodeficiency Virus (HIV) could progress to Acquired Immunodeficiency Virus (AIDS).

However, many strides have been made to control the virus due to the dedication of medical specialists across the world.

Emtricitabine and Tenofovir are prescribed with other drugs to help prevent the HIV virus from multiplying in the body. It is indicated for both adults and children who are over the age of 12 years old. However, there are some weight limitations. Users of this combo treatment must weigh at least 17 kg or 37 lbs.

Comprehensive Prevention Plan

In addition to treating HIV infections, Emtricitabine and Tenofovir are additionally prescribed as a preventative treatment for in high-risk adults as a part of a comprehensive prevention plan. This prevention tactic is otherwise known as pre-exposure prophylaxis.

Examples of High-Risk Patients Include:

  • Drug Users
  • Couples With One HIV-Positive Partner
  • Heterosexual Adults (Male and Female) Who Choose to Forgo Condoms
  • Homosexual and Bisexual Males With Recent STDs
  • Individuals Who Are Incarcerated

Note: The medicine may not prevent transmission in all patients and an HIV negative status must be confirmed prior to prescribing the drug.

Occupational Exposure

Healthcare workers who regularly encounter HIV positive patients may be prescribed Truvada. The medicine provides an extra layer of protection against transmission, especially for healthcare workers utilizing needles or handling bodily fluids.

While Emtricitabine and Tenofovir tablets help to treat the underlying infection, it is important to note that it's not a cure or direct treatment for HIV or AIDS.

Here's What Emtricitabine and Tenofovir Do:

1. Prevents the Reproduction of the Human Immunodeficiency Virus
2. Delays Immune Weakening Effects
3. Postpones Severe Health Issues Associated with HIV
4. Decreases the Risk of Developing AIDS
5. Lowers Chances of HIV Related Ailments (Cancer, Pneumonia, More)

Emtricitabine and Tenofovir are only available with a doctor's prescription. It is sold under the U.S. brand name Truvada as a syndicated drug containing both medicines.

A Brief Overview of HIV

In the 1980s, HIV/AIDS became a popular topic in the news and medical communities, though scientists have traced the virus' origins to the 1930s.

At the time, there was a lot of stigma surrounding HIV. There wasn't much information to go on, and for the most part, infected patients quickly succumbed to the virus' attacks on the immune system.

Today, HIV/AIDS is still widely considered to be a global pandemic, with some 36 million people living with the infection. However, medical researchers have come a long way.

Multidrug therapies, including the use of Truvada, have helped patients maintain a relatively normal life including a long-life expectancy rate.

More than 15 years after the first case was identified in the United States, the median life expectancy of someone with HIV was 39 years. Currently, this number has doubled to roughly 70 years, when the person has been classified as being in:

  • Optimal Health
  • Receiving Multidrug Therapies

The use of Truvada along with other medicines, therefore, plays a significant role in this advancement of life expectancy.

Medical researchers know that the same virus that causes HIV leads to AIDS. However, AIDS is a more aggressive form of the virus where the immune system declines at an exponential rate. Truvada, when combined with other therapies, helps stop the progression of the virus to AIDS.

Of noteworthiness, Truvada the combination of Emtricitabine and Tenovir is included in the World Health Organization's list of Essential Medicines.

Conditions Treated?

  • Human Immunodeficiency Virus, HIV Prevention

Type Of Medicine?

  • Antiretroviral Agent, HIV Antiviral, HIV Nucleoside Analog Reverse Transcriptase Inhibitor

Side Effects

Truvada may cause several side effects to occur. Follow the directions outlined by your medical provider to reduce the chances of side effects.

Most side effects subside with time as the body adjusts to the treatment. If your symptoms persist, be sure to consult your healthcare provider.

Common Side Effects Of Truvada

The most commonly reported side effects of Truvada include:

  • A Bloated Stomach
  • Abnormal Heartbeat
  • Aggression
  • Appetite Loss
  • Blood in The Urine
  • Cramps
  • Dehydration
  • Depression
  • Excess Gas
  • Feeling Confused
  • Feeling Constipated
  • Feeling Dizzy
  • Feeling Irritated
  • Feeling Weak
  • Fevers or Chills
  • Headaches
  • Heartburn
  • High Blood Pressure
  • Involuntary Twitching
  • Itching
  • Jaundice
  • Lesions or Blisters on or Beneath the Skin
  • Lethargy
  • Low Energy
  • Low Urine Output
  • Mood Swings
  • Nausea or Vomiting
  • Pain in the Abdomen
  • Pain in the Back or Side
  • Pain in the Bones
  • Spots, Rashes, or Pimples on the Skin
  • Sudden Weight Gain
  • Swollen Eyelids
  • Trouble Breathing
  • Weight Loss
  • Welting or Hives

Rare Side Effects of Truvada

Truvada may also cause these rare side effects in some patients:

  • A Burning Sensation in the Facial Area
  • A Jabbing Sensation or Pain
  • A Sense of Hopelessness
  • A Tingling Sensation Throughout the Body
  • Blindness or Vision Changes
  • Blurred Vision
  • Burping
  • Flu-Like Symptoms, Including Sneezing, Coughing or Sore Throat
  • Limpness
  • Pain in the Chest
  • Seizures
  • Sudden Clumsiness
  • Unconsciousness
  • Vision Loss

Dosage

The dosage tables outlined below are average amounts that are generally prescribed. However, it should not replace the orders provided by your healthcare provider.

HIV Infection Treatment Dosage Amounts:

Adults Weighing 35 kg or More:

Take 1 Pill | 1X Daily. The Pill is a Combo of:

  • 200 mg Emtricitabine and 300 mg Tenovir

Children Weighing 35 kg or More

Take 1 Pill | 1X Daily. The Pill is a Combo of:

  • 200 mg Emtricitabine and 300 mg Tenovir

Children Weighing 17 kg to less than 35 kg

Take 1 Pill | 1X Daily. The Pill is a Combo of Either:

  • 100 mg Emtricitabine and 150 mg Tenovir for Children Who Weigh >17-<22 kg
  • 133 mg Emtricitabine and 200 mg Tenovir for Children Who Weigh >22-<28 kg
  • 167 mg Emtricitabine and 250 mg Tenovir for Children Who Weigh >22-<35 kg

Children Weighing Under 17 kg

Varies based on the Discretion of the Medical Provider

Pre-Exposure Prophylaxis Dosage Amounts for HIV Prevention in High-Risk Patients

Adults: Take 1 Pill | 1X Daily. The Pill is a Combo of

  • 200 mg Emtricitabine and 300 mg Tenovir

Adults: Take 1 Pill | 1X Daily. The Pill is a Combo of

  • The Doctor's Discretion

As seen in the dosage tables, the prescribed amounts are largely based on the patient's age and weight. The dosage is also guided by a full medical assessment of the patient.

Other factors that medical providers consider when writing the dosage are the medication's strength, the length of treatment, and the number of times of per day needed. Truvada can be taken with or without foods  no significant differences have been shown to occur with either choice.

Dosage for Occupational Exposure  Healthcare Workers

Take 1 Pill | 1X Daily. The Pill is a Combo of:

  • 200 mg Emtricitabine and 300 mg Tenovir

Note: The timeline for treatment for healthcare workers is 28 days or 4 weeks.

Missed Doses

For missed doses, take Truvada as soon as you remember to do so. If the next day is close, skip the missed dose and resume the normal schedule. Truvada doses should never be doubled as doing so could cause serious negative effects to occur.

Overdose

If you take more than the recommended dose of Truvada, contact 911 right away. Also, contact the American Association of Poison Control Centers at 1-800-222-1222.

Interactions

Negative interactions have been found when Truvada is used in conjunction with certain medicines, substances, or when specific underlying conditions exist. Read more below for details:

Drug Interactions

The following list of drugs is not suggested for concomitant use with Truvada:

  • Atazanavir
  • Atripla
  • Combivir
  • Compler
  • Darunavir
  • Didanosine
  • Dutrebis
  • Emtriva
  • Epivir
  • Epivir-HBV
  • Epzicom
  • Genvoya
  • Hepsera
  • Ledipasvir
  • Lopinavir
  • Odefsey
  • Orlistat
  • Ritonavir
  • Stribild
  • Tipranavir
  • Triumeq
  • Trizivir
  • Viread

Overview of Drug Classes and Examples

To provide better insight on drug classes that may cause contraindications with Truvada, tell your doctor if you take:

  • Bowel Disorder Drugs
  • Chemotherapy Drugs
  • Injectable Antibiotics
  • NSAIDS Tylenol, Aleve, Advil
  • Osteoporosis Medications Taken Intravenously
  • Prescriptions to Prevent Organ Transplant Rejection

Pre-Existing Conditions

Certain underlying ailments could also affect the way Truvada works. On the other hand, this drug may cause specific medical conditions to become worse.

Tell your doctor if you any of the below ailments before starting treatment with Truvada:

  • A History of Kidney or Liver Disease
  • A Pre-Exposure to HIV
  • Bone Fractures of Osteoporosis
  • Hepatitis Infections

Warnings

Truvada includes a comprehensive guide with each refill. Patients are urged to read these instructions each time the medicine is replenished at the pharmacy to determine if new updates are added.

Follow All Prescriptions Orders

To reduce the risk of side effects and to ensure the medicine works optimally, it's essential that patients follow all instructions provided by their healthcare provider.

This means taking the right dosage every day and for as long as it is prescribed.

Do not stop using the medicine even if you feel better - unless it advised by your medical provider.

Truvada is not a replacement for other treatments. In most cases, it is prescribed as a supplementary medicine to keep the HIV infection under control. Patients are therefore advised to take all medicines prescribed for best results.

Get Refills on Time

Truvada is most efficient when it there is a continuous supply maintained in the bloodstream. It is therefore of utmost importance to keep on schedule with the dosage requirements and to get refills on time. Ask your pharmacist for the best way to keep track.

Follow-Up Appointments

Extra care is provided to patients who are using Truvada. Users of this medicine can expect frequent follow-up visits at their medical provider where blood or urine samples are taken to determine if the medicine is working as it should.

Allergies

Truvada may cause serious allergic reactions to occur. Be sure to tell your doctor if you a history of allergies to any other medicines, as well as foods, dyes, and/or preservatives.

Lactic Acidosis

Truvada sometimes causes excess amounts of acid to form in the bloodstream, which could subsequently cause liver toxicity. This condition is otherwise known as lactic acidosis. People who are more susceptible to lactic acidosis include:

  • Long-Time Users of Antiviral Drugs
  • Overweight Patients
  • Women

Some of the warning signs of lactic acidosis include:

  • Appetite Loss
  • Diarrhea
  • Drowsiness
  • Feeling Nauseous
  • Jaundice
  • Labored Breathing
  • Lethargy
  • Pain and Cramps in the Muscles
  • Pain or Discomfort in the Stomach

If any of these symptoms occur, consult your medical provider right away.

Hepatitis B

Truvada is not indicated for the treatment of Hepatitis B. Patients who have been diagnosed with both HIV and Hepatitis B and have also been prescribed Truvada need to be examined post-treatment for several months to determine if Hepatitis B has progressed or become worse.

Kidney Issues

You should not take Truvada in conjunction with NSAIDs or other antiviral medicines. Doing so increases the risk of developing kidney problems, according to medical studies.

Weight Changes

In some cases, Truvada may cause significant weight changes to occur. Fat deposits have been recorded in Truvada users in target regions such as the stomach, upper back, neck, and chest. Additionally, the medicine could cause fat loss in the arms, legs, and face.

Hidden Infections May Appear

Truvada essentially strengthens the body's immune system responses and in some cases, new users may report the development of new infections.

However, this is likely due to infections that have laid dormant for a while and are now being fought by a stronger immune system.

Some examples of these dormant viruses or autoimmune disorders include but aren't limited to:

If you notice new infections after starting Truvada, consult your healthcare provider.

Use in Seniors

Due to seniors' propensity to have underlying health issues relating to the kidney, heart, or liver, adjusted doses of Truvada may be needed for safe measure.

Transmission of HIV

If you take Truvada, this not does reduce the risk of passing on HIV to sexual partners.

Safe Sex Practices

Practicing safe sex is the best way to reduce the chances of transmission. Healthcare specialists suggest wearing a latex or polyurethane condom every time you have sex as the HIV infection can be spread through many bodily fluids including:

  • The Blood
  • Vaginal Fluids
  • Semen

In addition to sexual activity, HIV can also be spread by sharing used needles, razors, and toothbrushes.

Breastfeeding

If your doctor has prescribed Truvada to prevent or treat HIV and you have recently given birth, do not breastfeed your baby. The medicine does not prevent HIV transmission through breastmilk.

Dietary Changes

No significant dietary changes are indicated when taking Truvada. However, you should always consult with your medical provider to determine if any dietary or lifestyle habits influence the drug's effectiveness. For example, tell your doctor if you smoke tobacco products or drink alcohol, as these could cause negative interactions to occur.

Pre-Exposure Prophylaxis

As mentioned earlier in this guide, Truvada is sometimes used to prevent HIV transmissions in high-risk adults. The program is otherwise known as pre-exposure prophylaxis. Nevertheless, there are some precautions to take note of:

1. Verify HIV Status' A medical provider will verify if the patient is HIV negative before prescribing Truvada. In some cases, the virus may not be detected in newly infected patients.

2. Regular Tests' Periodic testing is generally completed on partners taking Truvada once every 12 weeks. Other STD tests are generally performed for gonorrhea or syphilis.

Signs of HIV ' Some of the telltale signs of an HIV infection include:

  • Heavy Sweating During the Nighttime
  • Lymph Nodes That Feel Swollen
  • Pain or Cramps in the Muscles or Joints
  • Rashes on the Skin
  • Severe Headaches
  • Spikes in Temperature

If these symptoms arise, contact your healthcare provider right away.

Using Other Drugs

Due to the possibility of negative drug interactions with Truvada, it is important to consult a healthcare provider before starting any new drugs, including prescription or over-the-counter medicines.

Storage

Truvada should be stored in the original container dispensed by your pharmacy. After each use, ensure the cap is tightly sealed to preserve the integrity of the medicine.

Truvada should be stored at a room temperature of 20-25°C (68-77°F). Avoid placing the medicine in areas that have high levels of heat or humidity, such as the kitchen or bathroom for example. The medication should also be kept out of the reach of children.

If you stop taking Truvada for any reason, be sure to discard of the medicine safely. The take-back program offered by most pharmacies features a safe way to discard of leftover prescriptions, including Truvada.

The take-back program essentially reduces the chances of drugs ending up in the unsuspecting hands of children and/or pets.

Summary

Truvada is used in conjunction with other medications to slow the progression of HIV, the same virus that causes AIDS.

Truvada syndicates two drugs - Emtricitabine and Tenovir - into one pill. Though not a cure, it helps patients enjoy a longer lifespan and a better quality of life.

The medicine works by decreasing the replication of the human immunodeficiency virus in the body and strengthening the immune system's fight responses.

It is indicated for both adults and children over the age of 12 years old. Patients must weigh more than 17 kg or 37 pounds to safely use this medicine.

In addition to treating HIV positive patients, the medicine is moreover employed as a preventative measure for adults considered to be at a high risk of acquiring HIV.

Truvada should be taken exactly as directed by a medical provider. As an antiretroviral agent, it is generally prescribed for the long-term: patients typically take one pill by mouth once per day.

If patients discontinue use, even for a short period of time, the HIV infection may become harder to manage. As a result, it is best to keep a consistent supply of Truvada on hand at all times. To accomplish this, refills must be completed before the medication runs out.

An insert label is included with all Truvada prescriptions. Occasionally, new updates are added. When you pick up a new refill, be sure to reread the label to determine if new precautions have been included. For example, Truvada could possibly cause lactic acidosis as well as liver damage to occur. The insert label outlines the telltale signs of this condition and advises you to contact 911 if the symptoms occur.

HIV is still a global epidemic. However, with the use of Truvada along with other medicines, HIV positive patients can enjoy the benefits of better health and a longer life expectancy.

For example, patients who test positive for HIV can now live for 70 years or more thanks to antiviral medicines like Truvada. The key, however, is following the treatment plan provided by healthcare professionals, including meeting all testing and follow-up appointments to determine if the medicine is working as intended.

The virus which was once considered to be a death sentence is now a manageable ailment.