Emtricitabine/Tenofovir

Emtricitabine/Tenofovir (Generic Truvada) PrEP treatment was launched in 2012 and became available on the NHS in 2017.  It is a daily pill combining two drugs which, when taken before exposure to the human immunodeficiency virus (HIV), can help prevent the risk of infection if the body does come into contact with a carrier.  It is the first pharmacological option on the market for this purpose and is now used widely around the world for daily use.  In 2015, the World Health Organisation (WHO) recommended the drug for those who are at substantial risk of infection.

Emtricitabine/Tenofovir is safe to take as a daily tablet, whilst the risk of exposure to HIV is high.  Whilst studies are still being performed on the risks of long-term use of this medication, experts seem confident that, certainly, short-term use (in one study, up to 48 weeks) is perfectly safe.

Studies show that Emtricitabine/Tenofovir works 99% of the time if you take it every day without fail.  When taken on average 4 times a week, this drops to 96%.  The protection for taking 2 tablets per week drops substantially to just 76%, which shows that when taken as guided, it can have a very positive outcome for anyone in danger of catching the virus.  

Patients should note that the WHO has asserted that it takes 7 days from beginning the treatment before there are high enough levels of the drug in the bloodstream for full protection during possible anal transmission.  The US Centres for Disease Control and Prevention (CDC) state that 20 days is required for HIV exposure from the injection of drugs and for women who are at risk due to vaginal sex transmission.  

You should always read the patient leaflet, which comes with any medication, before beginning a new treatment and take your doctors advice for use.  If you have any queries or concerns, ask your GP or Click Pharmacy doctor before proceeding.

Emtricitabine/Tenofovir is taken by mouth once a day, with or without food.  You will be given the dosage most appropriate for you based on issues such as any current medical conditions, your response to treatment and your kidney function.  In some cases, the dosage is also based on a patients weight.

It is recommended that you take PrEP at the same time each day, thus keeping the level of drug in the blood steady and giving you as much protection as possible.  Taking more or less can be harmful and stop the medication from working as effectively.  If you wish to stop treatment, then speak to your doctor for advice on how to taper off.

Emtricitabine/Tenofovir is designed to stop the virus from being able to enter and overtake healthy cells within the body due to the presence of these drugs in the bloodstream.  It is an antiretroviral drug, or ARV, which works by inhibiting certain enzymes required by the virus to replicate itself and take a hold.  In this case, the reverse transcriptase enzyme is predominantly halted in its replication, along with the integral and protease enzymes.  Due to the virus’s ability to adapt itself and become resistant to drugs, a combination is used to keep it at bay.  By taking Emtricitabine/Tenofovir, the immune system is able to repair itself, thus preventing further longterm damage as the virus loses its hold on the body.

It is crucial you take an HIV test to determine whether or not you are HIV-negative before beginning PrEP.  If infected, the virus requires more than these two drugs to be stemmed.  You will also build up a resistance to both Emtricitabine and Tenofovir if you take PrEP whilst HIV positive without other medications making them ineffective and allowing the virus to become more established.

Taking PrEP after exposure will not protect you from developing the virus.  In this instance, you require Post Exposure Prophylaxis treatment or PEP.

Emtricitabine/Tenofovir is a prescription-only medication, so you will be asked to fill in a medical questionnaire for our doctors to assess before approving you for treatment.  Once approved, you will be given a prescription, and from there, you can purchase PrEP online via Click Pharmacy.  It will be sent quickly and discreetly direct to your chosen address by next day delivery where possible.  If you prefer, you may book a Skype or email appointment with one of our doctors to further discuss your medical situation.  The appointment will be private and totally confidential.

Once you have your prescription, you will be able to buy your medication again without redoing the health assessment.

The reason many people, both male and female, choose to take Emtricitabine/Tenofovir is that it works to protect them from the risks of HIV.   It has also been found in studies to have no significant side effects, and for anyone who does suffer from mild issues, they find that they clear up within the first month of taking the drug.

The CDC’s guidelines show that the drug is most commonly recommended for:

• men who have sex with men
• men and women who have regular sex with an HIV-positive partner
• sex workers
• those who inject drugs
• transgender women

It is becoming more and more widely known about, used and trusted and in the US, there is a 10-year initiative underway, rolling out the use of PrEP for those in high-risk situations.  According to the AVAC’s PrEP Watch database, as of January 2020, nearly 160,000 people in America were trusting PrEP to protect them from the risk of HIV, with numbers set to rise.

The active ingredients found in PrEP are emtricitabine and tenofovir which are both seen to inhibit the enzyme in the HIV virus which causes it to be able to establish itself within the body.

The following list are the inactive ingredients which make up this fixed-dose combination tablet:

• croscarmellose sodium
• lactose monohydrate
• magnesium stearate
• microcrystalline cellulose
• pregelatinized starch (gluten free).

If you are lactose intolerant, please let your GP or Click Pharmacy doctor know in advance of beginning this treatment.

A wide number of patients using this medication will not experience any side effects, and those that do find they are usually mild and stop after around 4 weeks of use.  It is important to note that if you have been prescribed PrEP, then any side effects from it will be outweighed by the risks of becoming infected with HIV.

Side effects may include:

• diarrhoea, stomach pains or bloating
• headaches and dizziness
• insomnia
• feelings of weakness within the body
• rash

If you wish to you, you can keep in contact with your doctor if you experience any such side effects.

• Less common but more serious side effects can include
• jaundice
• discoloured or itchy eyes
• stiffness in the joints
• lactic acidosis
• anaemia

If you experience any of these side effects, seek medical attention right away.  Also, if you are taking other medication, let you doctor know before beginning this treatment.

The dose of PrEP Emtricitabine/Tenofovir should always be according to the doctor’s prescribed amount. It depends on your kidney function, pre-existing medical conditions and treatment response. The dosage will also be different for children.

Do I need to get tested to take emtricitabine/tenofovir disoproxil?

Prior to starting emtricitabine/tenofovir disoproxil, some tests are required. These include:

• HIV test (If you’re already HIV positive, taking PrEP will create resistance against these drugs, which are also used to treat HIV)
• Renal function tests
• Hepatitis B test (if you are unvaccinated for Hepatitis B)
• Hepatitis C test (for homosexual men)

If you’ve had unprotected sex, you must wait 4 weeks to get an HIV test to make sure it is not false negative.

After starting emtricitabine/tenofovir, the following tests should be done

• Test for HIV after every 3 months
• Renal function tests once a year
• Hepatitis B and C tests (see above)

Emtricitabine/tenofovir disoproxil is contraindicated if you’re taking the following medication.

• Antiviral, antifungal or antibacterial medications such as aminoglycosides, vancomycin and ganciclovir
• Interleukin-2 (cancer chemotherapy)
• NSAIDs or Non-Steroidal Anti-Inflammatory Drugs to relieve any kind of pain
• Anti Hepatitis C drugs such as ledipasvir/sofosbuvir

Emtricitabine/tenofovir disoproxil affects kidneys. This is why this drug is not recommended for patients with severe kidney disease or those on dialysis.

Get in touch with your GP if you’re pregnant or breastfeeding before taking emtricitabine/tenofovir disoproxil. Make sure to also consult your GP if you are lactose intolerant, as this drug contains lactose.