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Brand Name: Truvada

Common Name: emtricitabine and tenofovir

Class: fixed dose combination—nucleoside/nucleotide analogs (also called nucleoside or nucleotide reverse transcriptase inhibitors, NRTIs or nukes)

Standard Dose: One tablet (300 mg Viread and 200 mg Emtriva) once a day, no food restrictions (may be taken with or without food). Dosing frequency needs to be adjusted for people with decreased kidney function. Take missed dose as soon as possible, but do not double up on your next dose.

AWP: $867.99 / month

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

AIDSInfo:1 (800) HIV–0440 (448–0440), www.aidsinfo.nih.gov

Potential side effects and toxicity:

See Viread and Emtriva. Overall, fairly well tolerated, however, individuals may experience the following: nausea, headache, diarrhea, rash, vomiting, abdominal distension/pain and gas, and anorexia (loss of appetite).

Potential drug interactions:
See Viread and Emtriva. The levels of Videx EC and Videx (ddI) are increased by 44–60% when given at the same time as Viread. Therefore, a dose reduction to 250 mg for Videx is recommended for people who weigh more than 60 kg (132 pounds); there is no recommendation for those who weigh less than this. See Tips. Viread decreases the concentration levels of Reyataz. In addition, Reyataz (and Kaletra) increases Viread concentrations. The reasons for these interactions are not fully understood. Higher Viread concentrations could increase the risk of Viread-associated adverse events, including renal disorders. The FDA suggests that patients receiving Reyataz and Viread should be monitored for Viread-associated adverse events. When taken with Viread, it is recommended that Reyataz 300 mg is given with Norvir 100 mg (all as a single daily dose with food). Reyataz without Norvir should not be taken with Viread.
Tips:

Remember, Truvada is two drugs in one pill, so see the pages for those drugs, Emtriva and Viread. Currently, U.S. HIV treatment guidelines recommend Truvada over Epzicom as a preferred agent for the NRTI component of an HIV regimen. The combination of Viread with either Epivir or Emtriva has shown potent virologic suppression with Sustiva and was not worse than Combivir. The kidney toxicity must be monitored before and during treatment with Truvada. And Truvada may not be a good option for patients with underlying kidney problems. Epzicom is not on the preferred list on the U.S. treatment guidelines due to the risk of hypersensitivity reactions even though it has demonstrated potency when compared to Combivir.

Doctor
Truvada is the convenient (one pill a day), potent, and generally well-tolerated conformation of tenofovir plus emtracitabine. On the basis of Gilead 934 and other studies, Truvada is now a preferred NRTI backbone regimen for use in triple combination ART for naïve patients. Attributes and disadvantages of Truvada can be found in the discussion of the individual drugs as well as in the Atripla and Combivir discussions. Both tenofovir and FTC are active against hepatitis B virus, which is an attribute for co-infected patients where hepatitis B monotherapy is discouraged.—Keith Henry, MD
Activist
Another dual-nuke combo pill, Truvada has been gaining ground during the past couple of years as a strong backbone for both treatment naïve as well as many experienced patients. Although the same issues that are mentioned for its component parts ring true (potential kidney dysfunction and drug-drug interactions), Truvada is well-tolerated and is easy to take (once daily dosing). Its biggest competitor in the market is Epzicom, and the companies have been dueling back and forth for favor with the community and the docs. Ultimately treatment decisions need to be made on an individual basis, so all the tit for tat among the companies really isn’t going to make that much difference in the end.—Cathy Olufs
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