Truvada (Emtricitabine, Tenofovir Disoproxil Fumarate)

Dosage

Truvada is to be taken orally, once per day, as directed by your doctor. It can be taken with or without food. Prescribed dosage is dependent on the severity of your condition, your kidney function, and how you respond to treatment. If this medication is prescribed to children, the dosage is also dependent on weight.

When treating HIV infection, Truvada is taken alongside other HIV medications. If taken with didanosine enteric-coated tablets, it is best if both are taken on an empty stomach or with only a light meal. Take both on an empty stomach if you are taking the didanosine buffered tablets.

It is important that you follow the instructions of your doctor carefully when taking this medication. Do not skip any doses, change the dosage, or stop taking it without first talking to your doctor. This can lead to an increased viral load, increased viral resistance, or cause unwanted side effects. Laboratory tests may be required to monitor your kidney and liver function, blood counts, bone density, or viral load.

Storage

This medication should be stored in its original packaging until it is time to take it. Store in a location that will not exceed 25°C, out of direct sunlight and away from moisture. Keep out of reach of children and pets. Do not consume expired medication. Dispose of expired or surplus medication responsibly, following the instructions of your doctor or pharmacist. Do not flush medication down the toilet or sink. Do not share this medication with anyone else, even if they have the same condition as you.

Side Effects

Common Side Effects

All medications come with a risk of side effects. It is important to recognise that your doctor has determined your risk of side effects is outweighed by the potential benefit this medication can provide. Side effects will differ between individuals and it is possible that you will not experience any at all. Common side effects associated with Truvada include:

• Diarrhea
• Headaches
• Dizziness
• Difficulty sleeping
• Back pain
• Skin colour changes on palms or soles of feet

If you experience these symptoms and they concern you, or they worsen or do not resolve on their own, contact your healthcare provider.

Treating HIV will allow your immune system to become stronger over time. As this happens, it will begin to fight off existing infections, which may lead to development of disease symptoms. Further, if your immune system becomes overactive, you may experience symptoms. This can happen at any time after starting HIV treatment. Contact your doctor right away if you experience any of the following:

• Unexplained weight loss
• Severe lethargy
• Persistent muscle aches/weakness
• Persistent severe headaches
• Joint pain
• Numbness or tingling of the limbs or extremities
• Changes in vision
• Symptoms of infection (fever, cough, difficulty breathing, swollen lymph nodes)
• Signs of overactive thyroid (irritability, nervousness, heat intolerance, fast or irregular heart rate, bulging eyes, abnormal growth in the neck)
• Signs of Guillain-Barre syndrome (unsteadiness, coordination loss, dysphagia, trouble speaking or chewing, difficulty moving eyes)

Severe Side Effects

Occasionally, Truvada use can be associated with severe side effects that should be taken seriously. Seek medical help right away if you experience severe mood or mental changes (depression, anxiety), or signs of kidney failure (changes in urine output, blood present in urine).

There is a risk of developing liver and blood issues when taking Truvada. Lactic acidosis can be fatal. Seek medical assistance immediately if you develop liver related symptoms such as persistent nausea or vomiting, appetite loss, severe abdominal pain, yellowing of the skin or eyes, dark urine, rapid or deep breathing, drowsiness, or unusual weakness.

Truvada contains tenofovir, which can increase the risk of bone loss. Your doctor may prescribe calcium or vitamin D supplements to reduce this risk. People at high risk for bone loss will likely have their bone mineral density monitored while taking this medication. Contact your doctor immediately if you experience bone pain or easily broken bones.

A severe allergic reaction to this medication is rare, but not impossible. Seek medical assistance immediately if you experience symptoms of an allergic reaction such as rash, itching, facial swelling, severe dizziness, or difficulty breathing.

This is not an exhaustive list of side effects. If you experience any abnormalities while taking Truvada that concern you, contact your doctor for assistance.

Warnings & Precautions

Allergies

Before starting Truvada, ensure your doctor is aware of your complete family and personal medical history. Do not take this medication if you are allergic to any of its ingredients. Tell your doctor if you have a history of allergic reactions to other medications.

Medical History

Ensure your doctor knows your medical history, especially of pancreatitis, liver problems such as hepatitis BC, or cirrhosis, alcohol use, bone disease or osteoporosis, or kidney problems.

Dizziness

Truvada can cause dizziness. It is best if you avoid operating heavy machinery (including driving) until you know how this medication affects you. Alcohol and marijuana use can exacerbate the dizziness associated with Truvada, so limit consumption of both.

Surgery

Prior to surgery, ensure all medical personnel involved in your care are aware of all medications you take regularly, including prescription and non-prescription.

Pregnancy

This medication should only be used by pregnant people when it is absolutely necessary. Your doctor should discuss the risks and benefits with you. Treating HIV infection can reduce the risk of transmission to the baby.

Breast Feeding

Truvada has shown to pass into breast milk. It is not advised to take this medication while breast feeding, to minimise the risk to the nursing infant. Active HIV infection can also be transmitted to an infant via breast feeding, so this is not recommended also.

Interactions & Contraindications

When two or more medications are taken concurrently, they can interact with one another, changing how one or more medications function in the body or leading to unwanted side effects. It is therefore important that drug interactions are minimised. Keep a comprehensive list of all the medications you take on a regular basis, including prescription, non-prescription, and herbal supplements, and share this with your doctor. Do not stop, start, or change the dosage of any medication without first consulting your doctor.

Some medications that may cause negative interactions include adefovir, orlistat, and other medications that can lead to kidney damage (aminoglycosides).

One of the components of Truvada, tenofovir, can reduce the effectiveness of atazanavir. If you are taking both of these medications at the same time, you may need to take another medication (ritonavir) to prevent this interaction.

It is not advised to take other HIV medications that contain similar ingredients to Trudava. Check the labels on all medication before taking it, and ask your doctor or pharmacist if you are unsure.