emtricitabine, rilpivirine, and tenofovir (Oral route)
em-trye-SYE-ta-been, ril-pi-VIR-een hye-droe-KLOR-ide, ten-OF-oh-vir dye-soe-PROX-il FUE-ma-rate
Potentially fatal lactic acidosis and severe hepatomegaly with steatosis has been reported with use of tenofovir disoproxil fumarate in combination with other antiretrovirals. The emtricitabine, rilpivirine hydrochloride, and tenofovir disoproxil fumarate combination is not approved for treatment of chronic hepatitis B virus (HBV) infection, and patients infected with both HIV-1 and HBV have reported severe exacerbations of HBV after discontinuing emtricitabine or tenofovir disoproxil fumarate. Closely monitor hepatic function and initiate anti-hepatitis B therapy if necessary .
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
Therapeutic Class: Antiretroviral Agent
Pharmacologic Class: Nucleoside Reverse Transcriptase Inhibitor
Uses For emtricitabine, rilpivirine, and tenofovir
Emtricitabine, rilpivirine, and tenofovir combination is used to treat human immunodeficiency virus (HIV) infection. HIV is the virus that causes acquired immune deficiency syndrome (AIDS). emtricitabine, rilpivirine, and tenofovir is usually given to patients who have not received any HIV treatment in the past, in adult patients who have an amount of HIV in the blood (viral load) that is equal to 100,000 copies/mL or less, or in certain adult patients who have a viral load that is less than 50 copies/mL.
emtricitabine, rilpivirine, and tenofovir will not cure HIV infection or AIDS. It works by lowering the amount of HIV in the blood. The medicine will also help your immune system. This may help delay problems that usually result from AIDS or HIV disease. It will not keep you from spreading HIV to other people. People who receive emtricitabine, rilpivirine, and tenofovir may continue to have some of the problems usually related to AIDS or HIV disease.
emtricitabine, rilpivirine, and tenofovir is available only with your doctor's prescription.
Before Using emtricitabine, rilpivirine, and tenofovir
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For emtricitabine, rilpivirine, and tenofovir, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to emtricitabine, rilpivirine, and tenofovir or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Emtricitabine, rilpivirine, and tenofovir combination is not recommended for children. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of emtricitabine, rilpivirine, and tenofovir combination in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving emtricitabine, rilpivirine, and tenofovir combination.
|All Trimesters||B||Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.|
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with Medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking emtricitabine, rilpivirine, and tenofovir, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using emtricitabine, rilpivirine, and tenofovir with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- St John's Wort
Using emtricitabine, rilpivirine, and tenofovir with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aluminum Carbonate, Basic
- Aluminum Hydroxide
- Aluminum Phosphate
- Arsenic Trioxide
- Calcium Carbonate
- Dihydroxyaluminum Aminoacetate
- Dihydroxyaluminum Sodium Carbonate
- Eslicarbazepine Acetate
- Magnesium Carbonate
- Magnesium Hydroxide
- Magnesium Oxide
- Magnesium Trisilicate
Using emtricitabine, rilpivirine, and tenofovir with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Interactions with Food/Tobacco/Alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of emtricitabine, rilpivirine, and tenofovir. Make sure you tell your doctor if you have any other medical problems, especially:
- Bone problems or
- Depression, history of or
- Kidney disease, mild to moderate or
- Liver disease (eg, hepatitis B or C infection)—Use with caution. May make these conditions worse.
- Kidney disease, moderate to severe—Should not be used in patients with this condition.
Proper Use of emtricitabine, rilpivirine, and tenofovir
Take emtricitabine, rilpivirine, and tenofovir exactly as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.
emtricitabine, rilpivirine, and tenofovir comes with a patient information leaflet. Read and follow the instructions carefully. Ask your doctor if you have any questions.
Keep taking emtricitabine, rilpivirine, and tenofovir for the full time of treatment, even if you begin to feel better. Do not stop taking it without checking first with your doctor. When your supply of the medicine is running low, contact your doctor or pharmacist ahead of time. Do not allow yourself to run out of the medicine.
It is best to take emtricitabine, rilpivirine, and tenofovir with food.
If you are taking antacids that contain aluminum, magnesium, or calcium, take the antacid at least 2 hours before or 4 hours after emtricitabine, rilpivirine, and tenofovir.
If you are taking a stomach medicine for heartburn or ulcers, such as cimetidine, famotidine, nizatidine, ranitidine, Axid®, Pepcid®, Tagamet®, or Zantac®), take the heartburn medicine at least 12 hours before or 4 hours after emtricitabine, rilpivirine, and tenofovir.
The dose of emtricitabine, rilpivirine, and tenofovir will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of emtricitabine, rilpivirine, and tenofovir. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For oral dosage form (tablets):
- For treatment of HIV infection:
- Adults—One tablet once a day with food.
- Children—Use is not recommended.
- For treatment of HIV infection:
If you miss a dose of emtricitabine, rilpivirine, and tenofovir, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Wait until your next regularly scheduled dose if it has been more than 12 hours since you missed your last dose.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep the bottle tightly closed. Keep the medicine in the original bottle that you were given at the pharmacy.
Precautions While Using emtricitabine, rilpivirine, and tenofovir
It is very important that your doctor check your progress at regular visits to make sure emtricitabine, rilpivirine, and tenofovir is working properly. Blood and urine tests may be needed to check for unwanted effects.
emtricitabine, rilpivirine, and tenofovir does not decrease the risk of transmitting HIV infection to others through sexual contact or by contamination through blood. HIV may be acquired from or spread to others through infected body fluids, including blood, vaginal fluid, or semen. If you are infected, it is best to avoid any sexual activity involving an exchange of body fluids with other people. If you do have sex, always wear (or have your partner wear) a condom (“rubber”). Only use condoms made of latex or polyurethane and use them every time you have contact with semen, vaginal secretions, or blood. Also, do not share needles or equipment with anyone or use dirty needles. If you have any questions about this, check with your doctor.
emtricitabine, rilpivirine, and tenofovir should not be used together with adefovir (Hepsera®), dexamethasone (Decadron®), lamivudine (Combivir®, Epivir®, Epivir-HBV®, Epzicom®, Trizivir®), certain seizure medicines (such as carbamazepine, oxcarbazepine, phenobarbital, phenytoin, Dilantin®, Tegretol®, Trileptal®), medicines for tuberculosis (such as rifampin, rifapentine, Priftin®, Rifadin®, Rimactane®), certain stomach medicines (such as dexlansoprazole, esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole, Aciphex®, Dexilant®, Nexium®, Prevacid®, Prilosec®). or St. John's wort.
The medicines in this combination tablet are also available as Atripla®, Edurant®, Emtriva®, Stribild®, Truvada®, and Viread®. Do not take the emtricitabine, rilpivirine, and tenofovir combination with any of these medicines.
emtricitabine, rilpivirine, and tenofovir may cause a rare, but serious, unwanted effect called lactic acidosis (too much acid in the blood). Call your doctor right away if you have more than one of these symptoms: abdominal or stomach discomfort, a decreased appetite, diarrhea, fast, shallow breathing, a general feeling of discomfort, muscle pain or cramping, nausea, shortness of breath, sleepiness, or unusual tiredness or weakness.
emtricitabine, rilpivirine, and tenofovir may cause rare, but serious, liver problems. This may occur in patients with a history of hepatitis B infection. Check with your doctor right away if you have more than one of these symptoms: clay-colored stools, dark urine, a decreased appetite, fever, headache, itching, nausea and vomiting, skin rash, stomach pain or tenderness, swelling of the feet or lower legs, unusual tiredness or weakness, or yellow eyes or skin.
Serious skin reactions can occur with emtricitabine, rilpivirine, and tenofovir. Check with your doctor right away if you have blistering, peeling, or loose skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills with emtricitabine, rilpivirine, and tenofovir.
emtricitabine, rilpivirine, and tenofovir may cause serious types of allergic reactions, including anaphylaxis and drug reaction with eosinophilia and systemic symptoms (DRESS syndrome). Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, lightheadedness or dizziness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth with emtricitabine, rilpivirine, and tenofovir.
Tell your doctor right away if you start to feel depressed and have thoughts about hurting yourself. Report any unusual thoughts or behavior that troubles you, especially if they are new or get worse quickly.
emtricitabine, rilpivirine, and tenofovir may cause your bones to get thin. This could increase your risk for broken bones (fractures). Ask your doctor about this if you have any concerns.
emtricitabine, rilpivirine, and tenofovir may increase the risk of kidney problems. To lower this risk, avoid other medicines that can be harmful to the kidneys such as aminoglycoside antibiotics, certain other antiviral medicines, and NSAID pain medicines.
emtricitabine, rilpivirine, and tenofovir may cause you to have extra body fat. Tell your doctor if you notice changes in your body shape, such as an increased amount of fat in the upper back and neck, or around the chest and stomach area. You might also lose fat from your legs, arms, or face.
Your immune system may get stronger when you start taking HIV medicines. Tell your doctor right away if you notice any changes in your health. Sometimes the immune system will start to fight infections that were hidden in your body, such as pneumonia, herpes, or tuberculosis. Autoimmune disorders such as Graves disease, polymyositis, and Guillain-Barré syndrome may also occur.
Before you have any medical tests, tell the medical doctor in charge that you are taking emtricitabine, rilpivirine, and tenofovir. The results of some tests may be affected by emtricitabine, rilpivirine, and tenofovir.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
emtricitabine, rilpivirine, and tenofovir Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:More common
- feeling sad or empty
- lack of appetite
- loss of interest or pleasure
- mental depression
- thoughts of killing oneself
- trouble concentrating
- trouble sleeping
- Body aches or pain
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- chest pain
- difficulty with breathing
- ear congestion
- fever or chills
- loss of voice
- runny or stuffy nose
- sore throat
- tightness in the chest
- unsteadiness or awkwardness
- unusual tiredness or weakness
- weakness in the arms, hands, legs, or feet
- Abdominal or stomach discomfort
- bloody or cloudy urine
- bone pain
- broken bones, especially the thigh bone
- changes in behavior
- dark urine
- decreased appetite
- decrease in the amount of urine
- difficulty with swallowing
- dry mouth
- fast heartbeat
- fast, shallow breathing
- frequent urination
- general tiredness and weakness
- increased thirst
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- light-colored stools
- muscle pain or cramps
- muscle tenderness, wasting, or weakness
- nausea or vomiting
- numbness or tingling in the hands, feet, or lips
- pain in the stomach, side, or abdomen, possibly radiating to the back
- rapid weight gain
- skin rash, hives, itching
- swelling of the face, ankles, hands, feet, or lower legs
- upper right stomach pain
- yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- Abnormal dreams
- Acid or sour stomach
- back pain
- difficulty with moving
- pain in the joints
- pain or tenderness around the eyes and cheekbones
- stomach discomfort or upset
- Lack or loss of strength
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
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