Brand name: Emtriva

Common name: emtricitabine, FTC

Class: nucleoside analog (also called nucleoside reverse transcriptase inhibitor, NRTI or nuke)

Standard dose: One 200 mg capsule once-a-day, with no food restrictions (may be taken with or without food). The dosing frequency needs to be adjusted for people who have decreased kidney function. Take missed dose as soon as possible, but do not double up on your next dose.

AWP: $308.45 / month

Manufacturer contact: Gilead Sciences, www.gilead.com, 1 (800) GILEAD5 (445–3235)

AIDS Treatment Information Service: 1 (800) HIV–0440 (448–0440)

Potential side effects and toxicity: Most common side effects include headache, diarrhea, nausea and rash. Skin discoloration observed as a darkening of the skin on the palms and the soles of the feet can occur and usually does not cause any symptoms. Rare but potentially fatal toxicity with all NRTIs is pancreatitis (inflammation of the pancreas), hepatomegaly with steatosis (enlarged, fatty liver) and lactic acidosis (accumulation of lactate in the blood and abnormal acid-base balance). Lactic acidosis has been seen in patients taking NRTIs but is more common and more severe in women, people who are obese and people who have been taking nukes for a long time; and more common in people with liver disease, but can occur in people without a history of liver damage. People with lactic acidosis may experience persistent fatigue, abdominal pain or distension, nausea/vomiting, and difficulty breathing or shortness of breath; and enlarged, fatty liver. Pancreatitis can be life-threatening and may cause pain in the stomach and back, along with nausea, vomiting and blood in the urine. Your physician will check for pancreatitis by checking for increased levels of amylase and lipase in the blood. Risks for pancreatitis include: higher than recommended doses of NRTIs, advanced HIV, and alcohol use. Children should be monitored carefully for pancreatitis.

Potential drug interactions: No significant drug interactions observed in clinical trials.

Tips: Emtriva (FTC) is called a “me-too” drug because of its similarity to Epivir (3TC); both drugs are associated with the M184V mutation (which suggests drug resistance). However, Emtriva remains in blood cells in excess of the 24-hour dosing interval. It also remains inside of the cell longer with a steady state intracellular mean half-life of the active drug of 39 hours.

Due to cross-resistance, Epivir (3TC) and Emtriva (FTC) can lower the levels of Hivid, and should be avoided. Emtriva has demonstrated efficacy against HBV but is not currently approved to treat HBV. Worsening of hepatitis B (HBV) in people co-infected with HIV/HBV has occurred when Emtriva was discontinued. Patients co-infected with HIV/HBV who stop taking Emtriva should be closely followed by their physician. Available in a co-formulation with Viread, Truvada.