Emtifovir

Introduction
Emtifovir belongs to a group of medicines called antiretrovirals. It is used to treat HIV (human immunodeficiency virus), the virus that can cause AIDS (acquired immunodeficiency syndrome). It helps to control HIV infection so your immune system can work better. Emtifovir is not a cure for HIV/AIDS and only helps to decrease the amount of HIV in your body. This helps to lower your risk of getting HIV-related complications and improves your lifespan. It may also be used to prevent HIV infection in some people at high risk. It may be prescribed alone or in combination with other HIV medicines. Your doctor will recommend the best medicines for you and will decide the doses that you need. Follow carefully the instructions for all the medicines that you are given. This medicine is best taken with food. Taking these medicines regularly at the right time greatly increases their effectiveness and reduces the chances of HIV becoming resistant to them. It is important not to miss doses and to keep taking them until your doctor tells you it is safe to stop. Common side effects of this medicine include nausea, diarrhea, headache, trouble sleeping, rash, and dizziness. These are usually not serious but inform your doctor if they bother you or do not go away. It can also increase the risk of bone loss (osteoporosis) if you take it for a long time. Exercise regularly and take calcium and vitamin D supplements as suggested by your doctor. Some people put on weight while taking medicines to treat HIV/AIDS. Before taking it, let your doctor know if you have any liver or kidney disease or bone problems. While using it, you may need regular blood tests to check your blood counts, liver function, and kidney function. Since this medicine may cause dizziness or sleepiness, do not drive if you experience these symptoms. Pregnant or breastfeeding women should consult their doctor before using this medicine. Do not have unprotected sex or share personal items like razors or toothbrushes if you are HIV positive. Talk to your doctor about safe ways like condoms to prevent HIV transmission during sex.

_
Uses of Emtifovir
HIV infection
Side effects of Emtifovir
Common
Diarrhea
Dizziness
Fatigue
Headache
Nausea
Rash
How to use Emtifovir
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Emtifovir is to be taken with food.
How Emtifovir works
Emtifovir is a combination of two anti-HIV medicines: Emtricitabine and Tenofovir disoproxil fumarate. They prevent HIV (virus) from multiplying, thereby reducing the amount of virus in your body. They also increase the CD4 cell (white blood cells that protect against infection) count in your blood.
Quick Tips
Tafero EM Tablet is a combination of two medicines which slows down or stops the progression of HIV infections.
It may also be used for preventing HIV and should be started within 72 hours of exposure to HIV.
Take it with food, as this increases the absorption of the medicine into the body.
Tafero EM Tablet may cause dizziness or sleepiness. Do not drive or do anything requiring concentration until you know how it affects you.
Skipping doses increases the risk of treatment failure. Make sure that you take all your doses at the correct time.
Always practice safe sex while taking Tafero EM Tablet. Do not share needles or personal items that can have blood or body fluids on them.
It may cause weakening of your bones. Exercise regularly and take calcium and vitamin D supplements as suggested by your doctor.
Brief Description
Indication
HIV-1 infection, Pre-exposure Prophylaxis HIV-1 infection
Administration
May be taken with or without food. Take consistently either always w/ or always w/o food.
Adult Dose
Oral HIV-1 infection, Pre-exposure Prophylaxis in combination with other antiretroviral agents Adult: 1 tablet once daily. Hepatic impairment Dose adjustment not necessary in moderate-to-severe hepatic impairment

_
Renal Dose
Renal impairment: Patient on haemodialysis: Not recommended. CrCl (ml/min) 30-49 1 tablet every 48 hr. <30 Not recommended. _ Contraindication Lactation. Not to be used for treatment of chronic hepatitis B virus (HBV) infection. Mode of Action Tenofovir disoproxil fumarate, a diester prodrug of tenofovir, is rapidly converted to tenofovir, an acyclic nucleoside phosphonate (nucleotide) analogue of adenosine 5'-monophosphate while emtricitabine is a synthetic nucleoside analogue of cytidine. Both emtricitabine and tenofovir inhibit HIV-1 reverse transcriptase, resulting in DNA chain termination. Precaution Lactic Acidosis/Severe Hepatomegaly With Steatosis. Liver impairment. Renal impairment; avoid in CrCl <30ml/min and in patients on dialysis. Pregnancy. Not to be used with other emtricitabine, tenofovir disoproxil fumarate or other cytidine analogues (e.g. lamivudine and zalcitabine) preparations. Increased risk for severe and potentially fatal hepatic adverse reactions in patients with HIV and hepatitis B or C virus co-infection treated with antiretroviral agents. If combination drug is discontinued in patients co-infected with HIV and HBV, monitor hepatic function for several months for acute exacerbation of hepatitis. Discontinue therapy if there is a rapid rise in aminotransferase concentrations, progressive hepatomegaly or steatosis, metabolic or lactic acidosis of unknown cause. Test for presence of chronic HBV before initiating therapy. Check CrCl before initiation of therapy and monitor renal function (CrCl and serum phosphate) every 4 wkly during the 1st year and then every 3 mthly (more frequently in patients at risk for renal impairment). Bone monitoring needed for patient with history of pathologic bone fracture or at risk of osteopenia. Monitor child exposed in utero to combination drug for possible mitochondrial dysfunction. Lactation: excretion in milk unknown/not recommended _ Side Effect >10% Diarrhea,Nausea,Fatigue,Headache,Dizziness,Depression,Insomnia,Abnormal dreams,Rash 1-10% Note: includes adverse effects grade 2-4 Diarrhea (9%),Nausea (9%),Fatigue (9%),Depression (9%),Sinusitis (8%),URI infections (8%),Dizziness (8%),Rash event (7%),Headache (6%),Nasopharyngitis (5%),Insomnia (5%),Vomiting (2%) Potentially Fatal: Lactic acidosis and severe hepatomegaly with steatosis.

_
Pregnancy Category Note
Pregnancy Data on the use during pregnancy from observational studies have shown no increased risk of major birth defects Available data from the Antiretroviral Regnancy Registry (APR) show no increase in the overall risk of major birth defects with first trimester exposure for emtricitabine (2.3%) or tenofovir DF (2.1%) compared with the background rate for major birth defects of 2.7% Pregnant women with HIV infection should continue antiretroviral drugs according to current guidelines during pregnancy to decrease maternal-fetal viral transmission (https://aidsinfo.nih.gov) Lactation Emtricitabine and tenofovir have been shown to be present in human breast milk HIV-1 infected women The CDC recommend that HIV-1 infected mothers not breastfeed their infants to avoid risking postnatal transmission of HIV-1 Because of the potential for HIV transmission (in HIV-negative infants); developing viral resistance (in HIV-positive infants); and adverse reactions in a breastfed infant similar to those seen in adults Instruct mothers not to breastfeed Women taking PrEP In HIV-uninfected women, consider the developmental and health benefits of breastfeeding and the mother’s clinical need of drug therapy for HIV-1 PrEP along with any potential adverse effects on the breastfed child from drug therapy and the risk of HIV-1 acquisition due to nonadherence and subsequent mother to child transmission Women should not breastfeed if acute HIV-1 infection is suspected because of the risk of HIV-1 transmission to the infant

_
Interaction
Decreased atazanavir concentration with tenofovir unless also co-administered with ritonavir. Increased serum concentration of both tenofovir and emtricitabine or co-administered drug if taken with drugs that are eliminated by active tubular secretion. Potentially Fatal: Increased risk of renal impairment with recent or concurrent use of nephrotoxic agents (e.g. aminoglycosides, amphotericin B, foscarnet, ganciclovir, pentamidine, vancomycin, cidofovir or interleukin-2); monitor renal function wkly if unavoidable. Increased didanosine levels and thereby increasing risk of pancreatitis and peripheral neuropathy, with a high treatment failure rate with concurrent use; avoid concurrent use. Do not use emtricitabine with lamivudine due to similar resistance profile. Increased risk of lactic acidosis with ?-interferon.

_