MEDWATCH:  Truvada® (Emtricitabine and Tenofovir DF) By  Stuart Katsh, MS, RD

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Pharmacologic Classification

• Combination Antiretroviral Agents: Nucleoside Reverse Transcriptase Inhibitor (NRTI) (emtricitabine) and Nucleotide Reverse Transcriptase Inhibitor (Tenofovir DF)

Indication

• This combination antiviral agent is used with other antiviral agents for the treatment of HIV infection

• Truvada® is orally administered as 1 tablet a day with: 
• 200 milligrams (mg) of emtricitabine and
• 300 of Tenofovir DF

Dosage

• The recommended dose is one tablet daily, in combination with other antiretroviral agents.

• Truvada® has not been studied in those patients under 18 or more than 65 years old

• Test tube (in vitro) studies indicate that neither Tenofovir DF nor emtricitabine inhibit cytochrome P450 liver enzymes.

• Dosage adjustment in renal insufficiency: As Truvada® is excreted renally, it should not be used in patients with a creatinine clearance (CrCl) of less than 30 mL/min and in end-stage-renal disease requiring dialysis.

 

 

Note: Use of the separate components may allow for appropriate dose adjustments in those patients with CrCl of less than 30 mL/min.
 
 

Dosing in Renal Disease:

CrCl (mL/min) Dose
>50                   1 tab q24h
30-49                1 tab q48h
<30        not recommended
 
 
 
 

Most patients taking Truvada® experience no side effects. Rare side effects include: bone disorders, decreased appetite, diarrhea, flatulence, headache, hepatic dysfunction, nausea, renal failure, severe disease of the pancreas, stomach pain, unusual tiredness or weakness, vomiting and weight loss. Other adverse medication reactions include: lactic acidosis with hepatic steatosis (rare but potentially life-threatening toxicity with use of NRTIs), rash, and skin discoloration.