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Drug Interactions between emtricitabine / rilpivirine / tenofovir and Symfi

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

lamiVUDine emtricitabine

Applies to: Symfi (efavirenz / lamivudine / tenofovir) and emtricitabine / rilpivirine / tenofovir

Using lamiVUDine together with emtricitabine is generally not recommended. Combining these medications is not expected to substantially enhance activity against HIV. In fact, there is reason to believe that overall effectiveness may diminish due to possible antagonistic effects pertaining to how these medications are activated in the body. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Major

efavirenz rilpivirine

Applies to: Symfi (efavirenz / lamivudine / tenofovir) and emtricitabine / rilpivirine / tenofovir

Using efavirenz together with rilpivirine can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

lamiVUDine efavirenz

Applies to: Symfi (efavirenz / lamivudine / tenofovir) and Symfi (efavirenz / lamivudine / tenofovir)

Efavirenz may cause liver problems, and using it with other medications that can also affect the liver such as lamiVUDine may increase that risk. You should avoid or limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark colored urine, light colored stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. Talk to your doctor or pharmacist if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

efavirenz tenofovir

Applies to: Symfi (efavirenz / lamivudine / tenofovir) and emtricitabine / rilpivirine / tenofovir and Symfi (efavirenz / lamivudine / tenofovir)

Efavirenz may cause liver problems, and using it with other medications that can also affect the liver such as tenofovir may increase that risk. You should avoid or limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark colored urine, light colored stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. Talk to your doctor or pharmacist if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

efavirenz emtricitabine

Applies to: Symfi (efavirenz / lamivudine / tenofovir) and emtricitabine / rilpivirine / tenofovir

Efavirenz may cause liver problems, and using it with other medications that can also affect the liver such as emtricitabine may increase that risk. You should avoid or limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark colored urine, light colored stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. Talk to your doctor or pharmacist if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Drug and food interactions

Moderate

efavirenz food

Applies to: Symfi (efavirenz / lamivudine / tenofovir)

Taking efavirenz with food increases the amount of medicine in your body, which may increase the frequency of side effects. You should take efavirenz once a day on an empty stomach, preferably at bedtime. Taking it at bedtime may make some side effects such as dizziness, trouble sleeping, drowsiness, trouble concentrating, and/or unusual dreams less bothersome. However, these symptoms may be more severe if efavirenz is used with alcohol or mood-altering (street) drugs. You should avoid driving or operating hazardous machinery until you know how the medication affects you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

rilpivirine food

Applies to: emtricitabine / rilpivirine / tenofovir

Food significantly increases the absorption of rilpivirine. You should take each dose of rilpivirine with a meal. Taking it on an empty stomach may lead to inadequate blood levels and reduced effectiveness of the medication. Grapefruit juice can also increase the absorption of rilpivirine and should preferably be avoided.

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Minor

tenofovir food

Applies to: emtricitabine / rilpivirine / tenofovir and Symfi (efavirenz / lamivudine / tenofovir)

Information for this minor interaction is available on the professional version.

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Nnrtis

Therapeutic duplication

The recommended maximum number of medicines in the 'NNRTIs' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'NNRTIs' category:

  • emtricitabine/rilpivirine/tenofovir
  • Symfi (efavirenz/lamivudine/tenofovir)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.