Emtricitabine

Aka: Emtricitabine, Truvada, FTC, Emtriva, Coviracil

1. See Also
   1. Anti-Retroviral Therapy
   2. Nucleoside Reverse Transcriptase Inhibitor
2. Preparations
   1. Emtricitabine (Emtriva, Coviracil)
   2. Emtricitabine with Tenofovir (Truvada)
3. Mechanism
   1. Nucleoside Reverse Transcriptase Inhibitor
4. Adverse Effects: Emtricitabine alone
   1. See nRTI for adverse effects attributed to the class
   2. Minimal specific adverse effects and well tolerated
   3. Hyperpigmentation of palms and soles
   4. Hepatitis B infection flares on withdrawal of medication
5. Adverse Effects: Emtricitabine with Tenofovir (Truvada)
   1. See Tenofovir
   2. Renal Failure
6. Protocol: HIV Prevention
   1. Indication
      1. HIV Prevention in high risk adults (e.g. HIV partner)
   2. Contraindications
      1. Creatinine Clearance <60 ml/min
   3. Dosing
      1. Truvada one tablet daily
   4. Efficacy
      1. Prevents one case of HIV in 44 men who have sex with men each year
   5. Monitoring
      1. HIV Test
         1. Prior to starting (confirm HIV negative status)
         2. Repeat HIV Test every 3 months
      2. Serum Creatinine
         1. Onset (avoid starting if Creatinine Clearance <60 ml/min)
         2. Repeat 3 months after starting
         3. Repeat every year
      3. STD Screening
         1. Repeat every 6 months
   6. Precautions
      1. Compliance is critical (must take daily to prevent HIV resistance)
      2. Does not replace safe sex practices (Condoms)
      3. Very expensive ($14,000 per year)
      4. Risk of Renal Failure, liver toxicity, Osteoporosis
   7. References
      1. (2012) Presc Lett 19(8): 44
      2. Baeten (2012) N Engl J Med 367:399-410
7. References
   1. (2009) Treat Guidel Med Lett 7(78): 11-22
   2. Reust (2011) Am Fam Physician 83(12): 1443-51