Tenofovir Disoproxil+Efavirenz+Emtricitabine

When should one not use Tenofovir Disoproxil+Efavirenz+Emtricitabine

• Tenofovir Disoproxil+Efavirenz+Emtricitabine should not be used by individuals who are allergic to its active substances or any listed excipients. It is also contraindicated for patients with severe liver impairment (CPT, Class C).
• Co-administration with certain medications such as terfenadine, astemizole, cisapride, midazolam, triazolam, pimozide, bepridil, or ergot alkaloids (e.g., ergotamine) is not recommended due to the risk of serious adverse reactions, including cardiac arrhythmias and respiratory depression.
• Co-administration with elbasvir/grazoprevir is contraindicated, as efavirenz can significantly reduce their plasma concentrations, leading to loss of therapeutic effect.
• Voriconazole should not be used with Tenofovir Disoproxil+Efavirenz+Emtricitabine since efavirenz decreases its plasma concentrations, while voriconazole increases efavirenz concentrations.
• Herbal preparations containing St. John's wort are not recommended due to the reduced clinical effects of efavirenz.
• Tenofovir Disoproxil+Efavirenz+Emtricitabine should not be administered to patients with a family history of sudden death, congenital QTc interval prolongation, symptomatic cardiac arrhythmias, clinically relevant bradycardia, congestive cardiac failure with reduced left ventricle ejection fraction, or severe electrolyte disturbances (e.g., hypokalemia or hypomagnesemia).

Common side effects of this drug are:

• Nausea
• Diarrhoea
• Rash
• Dizziness
• Headache
• Abnormal dreams
• Insomnia
• Vomiting
• Flatulence
• Sinusitis

Other General Warnings

• You are experiencing joint pain or difficulty in movement, as this may be a sign of osteonecrosis.
• You develop severe rash or symptoms like blistering or fever.
• You experience potential bone abnormalities and should consider alternative treatments if at high risk for fractures.
• You have liver or kidney disease
• You have a history of seizures and may require monitoring if on anticonvulsants.
• You experience severe depression, psychosis, or suicidal thoughts.
• You are taking medicines known to prolong the QTc interval, such as certain antiarrhythmics (Classes IA and III), neuroleptics, antidepressants, some antibiotics (macrolides, fluoroquinolones, imidazole, and triazole antifungals), non-sedating antihistamines, flecainide, certain antimalarials and methadone, as caution is advised.

How Does It Work?

Interactions with other medicines

• Do not take this medicine with other medications containing efavirenz, emtricitabine, tenofovir, or lamivudine.
• Avoid St. John's wort, grapefruit juice, and herbal remedies like Ginkgo biloba.
• Do not use with certain antifungals (voriconazole, itraconazole, posaconazole), some hepatitis C medicines, or certain heart rhythm drugs.
• Avoid combining with didanosine or strong TB drugs (rifampicin) unless closely managed by your doctor.
• Some antibiotics (such as clarithromycin), malaria medications, and seizure medications (including carbamazepine, phenytoin, and phenobarbital) may not work effectively or may increase side effects.
• Taking it with other kidney-toxic medicines (like some antibiotics, antifungals, or chemotherapy) can increase the risk of kidney damage.

Overdose

Missed a Dose