How It Works
HIV is a virus that replicates by spreading through the body and damaging the immune system, leaving individuals vulnerable to other serious infections. Emtricitabine and tenofovir disoproxil fumarate works by stopping the virus from making copies of itself. Limiting the spread of HIV in the body helps protect and preserve the immune system. When used for PrEP, the medication helps prevent the virus from establishing a permanent infection after potential exposure.
It is important to understand that while this medication helps manage the symptoms of HIV and limits the spread of the virus within the body, it is not a cure for HIV or AIDS. Even while taking this therapy, it may still be possible to transmit HIV to others, which is why it is often part of a broader health strategy that includes safe sex practices. Additionally, this medication does not prevent other sexually transmitted infections (STIs) such as gonorrhea, chlamydia, or herpes.
| Quick Facts | |
|---|---|
| Common Brands | Truvada |
| Drug Class | HIV Combination Antiretroviral Therapy (ART), Nucleoside Reverse Transcriptase Inhibitor (NRTI) |
| Generic Status | Generic for Truvada |
| Availability | Prescription only |
Dosing
Emtricitabine and tenofovir disoproxil fumarate comes in oral tablets containing 200 mg of emtricitabine and 300 mg of tenofovir disoproxil.
- HIV treatment: The recommended dose is one tablet taken by mouth once daily.
- HIV prevention (PrEP): The recommended dose is one tablet taken by mouth once daily.
Providers may prescribe a different dose if you have kidney problems. Tablets should be swallowed whole — do not cut, crush, or chew them. If you miss a dose, take it as soon as you remember, unless it is almost time for the next dose; in that case, skip the missed dose and continue with your regular schedule. Never take double doses of emtricitabine and tenofovir disoproxil fumarate.
Note: Dosing information is educational only. Your prescribing physician will determine your specific dose based on your individual health needs. Always follow your healthcare provider’s instructions for exact dosing.
Uses
FDA-Approved Uses
Emtricitabine and tenofovir disoproxil fumarate is FDA-approved to:
- Treat HIV-1 infection in combination with other antiretroviral agents
- Prevent HIV-1 infection from sex (Pre-Exposure Prophylaxis or PrEP)
Off-Label Uses
You may see emtricitabine and tenofovir disoproxil fumarate prescribed for uses that are not “FDA-approved.” This is a very common and legal practice called “off-label” prescribing, where a doctor uses their clinical judgment to prescribe a drug for a different (but well-researched) purpose.
There are currently no common off-label uses for this medication.
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Side Effects
Like all medications, emtricitabine and tenofovir disoproxil fumarate can cause side effects. Some common side effects may improve over time as your body adjusts to the medication. Other side effects may be serious and require medical attention.
Common Side Effects
- Diarrhea
- Nausea
- Fatigue
- Headache
- Dizziness
- Depression
- Trouble sleeping (insomnia)
- Abnormal dreams or nightmares
- Rash
Serious Side Effects
Serious side effects are rare, but it’s important to know what to look for if they do occur. Stop using emtricitabine and tenofovir disoproxil fumarate and call your doctor immediately if you experience:
- Severe allergic reactions: Symptoms include swelling of the face, lips, tongue, or throat; difficulty breathing or swallowing; racing heart; severe rash or itching; fever.
- Lactic acidosis: Emtricitabine and tenofovir disoproxil fumarate may cause a dangerous buildup of lactic acid in the blood. Symptoms include difficulty breathing, drowsiness, muscle pain, general malaise, and stomach pain.
- Liver damage (hepatotoxicity): Symptoms include yellowing of the skin or eyes (jaundice), dark-colored urine, light-colored stools, loss of appetite, weakness, fever, and stomach pain.
- Kidney damage: This medication can affect kidney function. Symptoms include swelling in the feet or ankles, decreased urination, confusion, nausea, and shortness of breath.
- Bone problems: Long-term use of emtricitabine and tenofovir disoproxil fumarate may lead to reduced bone mineral density (osteopenia) or osteoporosis, increasing the risk of fractures and bone pain.
- Immune system changes: Your immune system may get stronger when you start taking emtricitabine and tenofovir disoproxil fumarate and start fighting latent infections. Symptoms vary by infection but may include fever, swollen lymph nodes, confusion, coughing up blood, headache, weakness, and vision or skin problems.
Call your doctor immediately if you experience any concerning or prolonged symptoms.
Pharmacist Tips
Do Not Skip Doses
Missing doses can allow the virus to become resistant to the medication, making it harder to treat. Using an app or alarm can help you remember your daily dose.
Take With or Without Food
You can take emtricitabine and tenofovir disoproxil fumarate with or without food. However, if you experience an upset stomach or nausea, taking the tablet with food may help.
Get Regular Bloodwork
It’s recommended to monitor your kidney and liver function before and during treatment. If you are taking emtricitabine and tenofovir disoproxil fumarate for PrEP, you must be tested for HIV at least every 3 months to ensure you remain HIV-negative.
Maintain Bone Health
Since this medication can affect bone density, ask your healthcare provider what you can do to strengthen your bones, such as taking calcium or vitamin D supplements.
Avoid Certain Pain Relievers
To protect your kidneys, it is recommended to avoid taking high doses of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) or naproxen (Aleve) while on this medication. If you use these medications, talk to your healthcare provider.
Store at Room Temperature
The tablets should be kept in a cool, dry place at room temperature (68°F to 77°F) with the container tightly closed.
Practice Safe Sex
If you are taking emtricitabine and tenofovir disoproxil fumarate for PrEP), it’s recommended to use condoms and be aware of your partner’s HIV status to lower your risk of infection from HIV and other STIs.
Drug Interactions
Certain medications and substances can interact with emtricitabine and tenofovir disoproxil fumarate, potentially altering how it works or increasing the risk of side effects. For example:
- Hepatitis C medications: Drugs such as Epclusa or Harvoni can increase the levels of emtricitabine and tenofovir disoproxil fumarate in your body, potentially worsening side effects like fatigue and nausea.
- Pain relievers (NSAIDs): Taking NSAIDs like ibuprofen or naproxen can increase the risk of kidney injury when combined with emtricitabine and tenofovir disoproxil fumarate.
- Other antiretrovirals: Do not take this medication with adefovir or other drugs containing emtricitabine, tenofovir, or lamivudine.
- Antibiotics and antiviral medications: Combining emtricitabine and tenofovir disoproxil fumarate with like acyclovir, valacyclovir, aminoglycoside antibiotics (like gentamicin), atazanavir, didanosine, and lopinavir/ritonavir may affect kidney function.
Always give your doctor and pharmacist a complete list of all your medications, vitamins, and supplements to check for potential interactions.
FAQs
Is emitricitabine and tenofovir disoproxil fumarate (Truvada) the same thing as PrEP?
Truvada (emtricitabine and tenofovir disoproxil fumarate) is a medication used for PrEP (pre-exposure prophylaxis). PrEP is the strategy of taking medication to prevent HIV. Truvada is also used to treat existing HIV infections in combination with other medicines.
Does Truvada cure HIV?
No, it does not cure HIV or AIDS. It helps control the infection by stopping the virus from replicating, which keeps the immune system healthy.
How effective is Truvada at preventing HIV if I miss a dose?
Missing doses can significantly weaken your protection against the virus and increase the risk of infection. For HIV treatment, missing doses can cause the virus to change form and become resistant to the medication. It is important to take it every day.
Can I take emitricitabine and tenofovir disoproxil fumarate (Truvada) just on the days I have sex?
It is recommended to take the medication every day to treat or prevent HIV infection. For PrEP, Truvada works best after being taken daily for a few weeks.
Does emitricitabine and tenofovir disoproxil fumarate protect against other STDs like chlamydia or gonorrhea?
No. This medication does not protect against sexually transmitted infections (STIs) such as herpes, gonorrhea, or chlamydia. You should continue to practice safe sex and use condoms.
Why do I need to get tested for Hepatitis B before starting Truvada?
It is strongly recommended to test for Hepatitis B because stopping this medication suddenly can cause a serious worsening of Hepatitis B infection in people who have both HIV and Hepatitis B. If you have Hepatitis B, your liver function must be monitored closely if you stop taking the drug.
How long does it take for emitricitabine and tenofovir disoproxil fumarate to become effective after starting?
For HIV prevention (PrEP), the medication works best after you have taken it every day for a few weeks.
Can I drink alcohol while taking Truvada?
It is currently unknown if drinking alcohol significantly affects emtricitabine and tenofovir disoproxil fumarate.
Is emitricitabine and tenofovir disoproxil fumarate safe to take during pregnancy or breastfeeding?
It is not known if this medication harms an unborn baby, so you should tell your provider if you plan to become pregnant. The drug does pass into breast milk. Women with HIV should not breastfeed to avoid transmitting the virus to the baby. If taking it for PrEP, consult your healthcare provider.
What is the difference between Truvada and Descovy?
Both are combination medications containing emtricitabine, but they use different forms of tenofovir. Truvada contains tenofovir disoproxil fumarate (TDF), while Descovy contains tenofovir alafenamide (TAF). Also, Descovy is not approved for PrEP in individuals at risk of HIV from receptive vaginal sex.
Can I take ibuprofen or aspirin with Truvada?
Ask your healthcare provider. Taking high doses of NSAIDs like ibuprofen (Advil) or naproxen (Aleve) can increase the risk of kidney damage when taken with this medication.
Does emitricitabine and tenofovir disoproxil fumarate interact with hormone therapy for transgender individuals?
Emitricitabine and tenofovir disoproxil fumarate (Truvada) is not known to interact with hormone therapy. If you have concerns, talk to your healthcare provider.
Is emitricitabine and tenofovir disoproxil fumarate used for anything other than HIV prevention?
Yes, it is also used for treating HIV infection when taken in combination with other antiretrovirals.
Comparable Medications
Emtricitabine and Tenofovir Disoproxil Fumarate, Descovy (Emtricitabine + Tenofovir Alafenamide), Cimduo (Lamivudine + Tenofovir Disoproxil Fumarate), Biktarvy (Bictegravir + Emtricitabine + Tenofovir Alafenamide), or Truvada/Isentress (Raltegravir)?
There are several medications that your doctor can prescribe in place of emtricitabine and tenofovir disoproxil fumarate. Here are a few possible alternatives below.
Descovy (emtricitabine + tenofovir alafenamide)
A combination pill used for treating HIV-1 infection and HIV-1 pre-exposure prophylaxis (PrEP) in at-risk individuals (with the exception of those at-risk from receptive vaginal sex).
Cimduo (lamivudine + tenofovir disoproxil fumarate)
A combination pill used for treating HIV-1 infection.
Biktarvy (bictegravir + emtricitabine + tenofovir alafenamide)
A combination pill used for treating HIV-1 infection.
Isentress (raltegravir)
An antiviral pill used for treating HIV-1 infection.
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Important: Information on this page is for educational purposes only. Prescribing decisions are made by independent, licensed providers. TelyRx operates technology-enabled pharmacies and a telehealth platform that connects patients with board-certified licensed providers. Prescriptions, when provider-approved and issued, are filled and shipped by TelyRx-affiliated pharmacies. We do not employ physicians or make prescribing decisions. Learn more about our editorial standards here.