garbage emtricitabine, rilpivirine, and tenofovir alafenamide (Oral route) em-trye-SYE-ta-been, ril-pi-VIR-een, ten-OF-oh-vir al-a-FEN-a-mide Oral route(Tablet) Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs. Severe acute exacerbations of hepatitis B have been reported in patients who are coinfected with HIV-1 and HBV and have discontinued products containing emtricitabine and/or tenofovir disoproxil fumarate, and may occur with emtricitabine/rilpivirine/tenofovir alafenamide. Hepatic function should be monitored closely in these patients. If appropriate, initiation of antihepatitis B therapy may be warranted . Overview Side Effects Interactions Pregnancy Reviews More Support Group Q & A Commonly used brand name(s) In the U.S. Odefsey Available Dosage Forms: Tablet Therapeutic Class: Antiretroviral Agent Pharmacologic Class: Nucleoside Reverse Transcriptase Inhibitor Slideshow 10 Serious Infections That Will Make You Shudder Uses For emtricitabine, rilpivirine, and tenofovir alafenamide Emtricitabine, rilpivirine, and tenofovir alafenamide combination is used to treat human immunodeficiency virus (HIV) infection. HIV is the virus that causes acquired immune deficiency syndrome (AIDS). emtricitabine, rilpivirine, and tenofovir alafenamide is usually given to patients who have not received any HIV treatment in the past. emtricitabine, rilpivirine, and tenofovir alafenamide will not cure HIV infection or AIDS. It works by lowering the amount of HIV in the blood and it will also help your immune system. This may help delay some of the medical conditions that usually result from AIDS or HIV disease. It will not keep you from spreading HIV to other people. emtricitabine, rilpivirine, and tenofovir alafenamide is available only with your doctor's prescription. Before Using emtricitabine, rilpivirine, and tenofovir alafenamide In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For emtricitabine, rilpivirine, and tenofovir alafenamide, the following should be considered: Allergies Tell your doctor if you have ever had any unusual or allergic reaction to emtricitabine, rilpivirine, and tenofovir alafenamide or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Pediatric Appropriate studies have not been performed on the relationship of age to the effects of emtricitabine, rilpivirine, and tenofovir alafenamide combination in children younger than 12 years or those weighing less than 35 kilograms (kg). Safety and efficacy have not been established. Geriatric Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of emtricitabine, rilpivirine, and tenofovir alafenamide combination in the elderly. Breast Feeding There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Interactions with Medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking emtricitabine, rilpivirine, and tenofovir alafenamide, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using emtricitabine, rilpivirine, and tenofovir alafenamide with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Carbamazepine Cisapride Dexamethasone Dexlansoprazole Esomeprazole Fosphenytoin Lansoprazole Omeprazole Oxcarbazepine Pantoprazole Phenobarbital Phenytoin Primidone Rabeprazole Rifampin Rifapentine St John's Wort Using emtricitabine, rilpivirine, and tenofovir alafenamide with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Aluminum Carbonate, Basic Aluminum Hydroxide Aluminum Phosphate Anagrelide Aripiprazole Arsenic Trioxide Buserelin Calcium Carbonate Carbamazepine Ceritinib Cimetidine Crizotinib Dabrafenib Dasabuvir Degarelix Delamanid Delavirdine Deslorelin Dihydroxyaluminum Aminoacetate Dihydroxyaluminum Sodium Carbonate Domperidone Donepezil Efavirenz Escitalopram Etravirine Famotidine Fluoxetine Gonadorelin Goserelin Histrelin Hydroxychloroquine Idelalisib Leuprolide Levofloxacin Magaldrate Magnesium Carbonate Magnesium Hydroxide Magnesium Oxide Magnesium Trisilicate Moxifloxacin Nafarelin Netupitant Nevirapine Nizatidine Ombitasvir Ondansetron Orlistat Oxcarbazepine Panobinostat Paritaprevir Pasireotide Pazopanib Phenobarbital Phenytoin Ranitidine Rifabutin Rifampin Rifapentine Sevoflurane St John's Wort Tacrolimus Tipranavir Triptorelin Vandetanib Using emtricitabine, rilpivirine, and tenofovir alafenamide with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Boceprevir Interactions with Food/Tobacco/Alcohol Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. Other Medical Problems The presence of other medical problems may affect the use of emtricitabine, rilpivirine, and tenofovir alafenamide. Make sure you tell your doctor if you have any other medical problems, especially: Bone fracture, history of or Depression, history of or Fanconi syndrome (kidney disease), history of or Heart rhythm problems (eg, QT prolongation) or Hepatitis B or C infection, history of or Kidney failure, history of or Osteomalacia (soft bones), history of or Osteoporosis (weak or brittle bones), history of Use with caution. May make these conditions worse. Proper Use of emtricitabine, rilpivirine, and tenofovir alafenamide Take emtricitabine, rilpivirine, and tenofovir alafenamide exactly as directed by your doctor . Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. Keep taking emtricitabine, rilpivirine, and tenofovir alafenamide for the full time of treatment , even if you begin to feel better. Do not stop taking it without checking first with your doctor. When your supply of the medicine is running low, contact your doctor or pharmacist ahead of time. Do not allow yourself to run out of the medicine. emtricitabine, rilpivirine, and tenofovir alafenamide comes with a patient information leaflet. Read and follow the instructions carefully. Ask your doctor if you have any questions. Take the tablet with food. If you take antacids that contain aluminum, magnesium, or calcium, take the antacid at least 2 hours before or 4 hours after you take emtricitabine, rilpivirine, and tenofovir alafenamide. If you take a stomach medicine for heartburn or ulcers such as cimetidine, famotidine, nizatidine, or ranitidine, take the heartburn medicine at least 12 hours before or 4 hours after you take emtricitabine, rilpivirine, and tenofovir alafenamide. Dosing The dose of emtricitabine, rilpivirine, and tenofovir alafenamide will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of emtricitabine, rilpivirine, and tenofovir alafenamide. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. For oral dosage form (tablets): For treatment of HIV infection: Adults and children 12 years and older weighing 35 kilograms (kg) or more One tablet once a day. Children younger than 12 years or weighing less than 35 kg Use and dose must be determined by your doctor. Missed Dose If you miss a dose of emtricitabine, rilpivirine, and tenofovir alafenamide, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Storage Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep the medicine in the original bottle that you were given at the pharmacy and keep it tightly closed. Precautions While Using emtricitabine, rilpivirine, and tenofovir alafenamide It is very important that your doctor check your progress at regular visits to make sure emtricitabine, rilpivirine, and tenofovir alafenamide is working properly. Blood and urine tests may be needed to check for unwanted effects. emtricitabine, rilpivirine, and tenofovir alafenamide does not decrease the risk of transmitting HIV infection to others through sexual contact or by contamination through blood. HIV may be acquired from or spread to others through infected body fluids, including blood, vaginal fluid, or semen. If you are infected, it is best to avoid any sexual activity involving an exchange of body fluids with other people. If you do have sex, always wear (or have your partner wear) a condom ( rubber ). Only use condoms made of latex or polyurethane and use them every time you have contact with semen, vaginal secretions, or blood. Also, do not share needles or equipment with anyone or use dirty needles. If you have any questions about this, check with your doctor. emtricitabine, rilpivirine, and tenofovir alafenamide should not be used together with dexamethasone (Decadron ), certain seizure medicines (such as carbamazepine, oxcarbazepine, phenobarbital, phenytoin, Dilantin , Tegretol , Trileptal ), medicines for tuberculosis (such as rifampin, rifapentine, Priftin , Rifadin , Rimactane ), certain stomach medicines (such as dexlansoprazole, esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole, Aciphex , Dexilant , Nexium , Prevacid , Prilosec ). or St. John's wort. The medicines in this combination tablet are also available as Atripla , Edurant , Emtriva , Stribild , Truvada , and Viread . Do not take the emtricitabine, rilpivirine, and tenofovir alafenamide combination with any of these medicines . emtricitabine, rilpivirine, and tenofovir alafenamide may cause a rare, but serious, unwanted effect called lactic acidosis (too much acid in the blood). Call your doctor right away if you have abdominal or stomach discomfort, a decreased appetite, diarrhea, fast, shallow breathing, a general feeling of discomfort, muscle pain or cramping, nausea, shortness of breath, sleepiness, or unusual tiredness or weakness. emtricitabine, rilpivirine, and tenofovir alafenamide may cause rare, but serious, liver problems. This is more common in patients with a history of hepatitis B or C infection or those who already have liver disease. Check with your doctor right away if you have clay-colored stools, dark urine, a decreased appetite, a fever, a headache, itching, nausea and vomiting, a skin rash, stomach pain or tenderness, swelling of the feet or lower legs, unusual tiredness or weakness, or yellow eyes or skin. emtricitabine, rilpivirine, and tenofovir alafenamide may cause serious types of allergic reactions, including skin reactions and drug reaction with eosinophilia and systemic symptoms (DRESS syndrome). Check with your doctor right away if you have blistering, peeling, or loose skin, large, hive-like swelling of the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs, severe acne or skin rash, sores or ulcers on the skin, or a fever or chills with emtricitabine, rilpivirine, and tenofovir alafenamide. Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you or anyone in your family has ever had a heart rhythm problem such as QT prolongation. Tell your doctor right away if you start to feel depressed or have thoughts about hurting yourself. Report any unusual thoughts or behavior that troubles you, especially if they are new or get worse quickly. emtricitabine, rilpivirine, and tenofovir alafenamide may cause you to have extra body fat. Tell your doctor if you notice changes in your body shape, such as an increased amount of fat in the upper back and neck, or around the chest and stomach area. You might also lose fat from your legs, arms, or face. Your immune system may get stronger when you start taking HIV medicines. Tell your doctor right away if you notice any changes in your health. Sometimes the immune system will start to fight infections that were hidden in your body, such as pneumonia, herpes, or tuberculosis. Autoimmune disorders such as Graves disease, polymyositis, and Guillain-Barré syndrome may also occur. emtricitabine, rilpivirine, and tenofovir alafenamide may cause your bones to get weak and brittle. This could increase your risk for broken bones (fractures). Ask your doctor about this if you have any concerns. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. emtricitabine, rilpivirine, and tenofovir alafenamide Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: More common Discouragement feeling sad or empty irritability lack of appetite loss of interest or pleasure mental depression thoughts of killing oneself tiredness trouble concentrating trouble sleeping Less common Body aches or pain burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings chest pain cough difficulty with breathing ear congestion fever or chills headache loss of voice runny or stuffy nose sneezing sore throat tightness in the chest unsteadiness or awkwardness unusual tiredness or weakness weakness in the arms, hands, legs, or feet Incidence not known Abdominal or stomach discomfort agitation bloating bloody or cloudy urine bone pain confusion constipation dark urine decreased appetite decreased urination diarrhea difficulty swallowing dizziness dry mouth fast heartbeat fast, shallow breathing frequent urination hostility increased thirst indigestion irritability large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs lethargy light-colored stools muscle pain or cramps muscle tenderness, wasting, or weakness nausea pain in the stomach, side, or abdomen, possibly radiating to the back rapid weight gain seizures skin rash, hives, itching sleepiness swelling of the face, ankles, hands, feet, or lower legs vomiting yellow eyes or skin Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common Abnormal dreams Less common Acid or sour stomach back pain belching difficulty with moving heartburn pain in the joints pain or tenderness around the eyes and cheekbones stomach discomfort or upset Incidence not known Lack or loss of strength Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. 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