What is Truvada?
Truvada is an antiviral medicine very popular for fighting HIV infections. The two main active substances in the medicine, tenofovir and emtricitabine will inhibit the enzyme that causes the body to develop new HIV viruses. This will keep the virus from expanding. Please consider that HIV is an STD and when under this condition, the white blood cells are affected, making the defenses weak. HIV virus can be spread through contaminated blood, sperm, and vaginal fluid, but also through the use of contaminated injection needles or medical devices. Sadly, a pregnant woman with HIV can also infect her baby during childbirth or breastfeeding. If not stopped in time through medication, HIV may evolve into AIDS which will lead the body not to have an active immune system. In sum, the body will no longer defend itself against viruses and bacteria; even a small infection can be life-threatening. Truvada will inhibit the growth of the virus in the blood, keeping the level of the white blood cells, protecting the body’s natural defenses.
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Buy Truvada With an Online Prescription
An online doctor consultation means filling out a medical questionnaire. A registered EU doctor assesses your medical questionnaire and analize whether Truvada is suitable and safe for you to buy. After approval, a prescription is issued and send to the registered EU pharmacy. You will receive your discretely shipped Truvada pills within 3 business days.
Active ingredients: 1 film-coated tablet containing 200 mg emtricitabine and 300 mgtenofovir disoproxil fumarate equivalent to 245 mg tenofovir disoproxil;
Excipients: croscarmellose sodium, lactose monohydrate, magnesium stearate, cellulose microcrystalline, pregelatinized starch, Opadry II Light Blue Y-30-10671-A;(indigo carmine (E 132) aluminum lacquer; hypromellose; lactose, monohydrate; titanium dioxide (E 171); triacetin) ͘
The drug is prescribed in combination antiretroviral therapy for the treatment of HIV-infected people adults from 18 years old͘.
Hypersensitivity to the active substances or to any of the excipientsContraindicated for children - (under 18 years).
͘Method of administration and dose
Treatment should be started by a doctor who has experience in the treatment of HIV infection.
- Adults- The recommended dose of Truvada is one orally taken tablet. once a day͘ Truvada meal intake is recommended to optimize the absorption of tenofovir͘Even light food improves the absorption of tenofovir from the combined tablet (see section "Pharmacokinetics") ͘
- Elderly patients͘- There is no data available to make recommendations for dosing for patients over 65 years of age͘ However, no adjustment is needed the recommended daily dose for adults unless there is evidence of renal failure͘.
- Renal impairment͘- Emtricitabine and tenofovir are excreted in the urine and exposure to emtricitabineand tenofovir increases in patients with impaired renal function͘ Limited data availableon the safety and efficacy of Truvada for patients with moderate and severe renal impairmentinsufficiency (creatinine clearance <50 ml / min), and safety data with minor renalinsufficiency (creatinine clearance 50-80 ml / min) not yet evaluated Therefore for patients with renal insufficiency can be applied to Truvada only if the potential benefit of treatments considered to outweigh the risks͘ There may be a risk to patients with renal failure careful monitoring of kidney function is required (see section "Application Features") ͘For patients with creatinine clearance of 30 and 49 ml/min, adjusting the interval between these dosage adjustments have not been confirmed in clinical settings studies, therefore, the clinical response of these patients should be closely monitored the sections "Application Features" and "Pharmacokinetics").
- Minor renal impairment (creatinine clearance 50-80 ml/min)- ͘ Take 1 tablet 1 time per day (see section "Application Features") ͘
- Moderate renal impairment (creatinine clearance 30-49 ml / min)- ͘ Recommended Truvadaevery 48 hours (see section "Application Features") ͘
- Patients with severe renal impairment (creatinine clearance <30 ml/min)- and patients who underwent hemodialysis Truvada is not recommended for patients with severe renal impairment disorders (creatinine clearance <30 ml/min) and patients requiring hemodialysis since the combination tablet cannot achieve the required dose reduction.
- Hepatic impairment͘- No dose adjustment required͘ If patients with concomitant HIV infection and viral hepatitis B (HBV) discontinue use of Truvada, careful care should be taken monitoring for signs of exacerbation of hepatitis (see section "Application Features").
- ͘Application method- If patients have difficulty swallowing, Truvada can be ground in approximately 100 ml of water, orange or grape juice and take immediately if the patient misses the next dose of Truvada, and from the time of proper administration no more than 12 hours have elapsed, the patient should receive the food preparation as soon as possible continue to follow the usual schedule of administration. ͘If the patient has missed taking another dose of the drug Truvada, and since proper administration has passed more than 12hours, that is, it is almost time to take the next dose of the drug, the patient should not be taken missed dose, and you should continue to take the drug as usual a patient has a vomiting within 1 hour after taking Truvada, he or she will another tablet should be taken͘. If vomiting has occurred in a patient more than 1 hours after taking the drug, there is no need to take another tablet of the drug.
- Adverse reactions- In an open-label randomized clinical trial (GS-01-934, see sectionPharmacodynamics) are the most common adverse reactions likely to be associated with emtricitabine and/or tenofovir disoproxil fumarate were nausea (12%) and diarrhea (7%). ͘The safety profile of emtricitabine and tenofovir disoproxil fumarate in this study corresponded to previous experience with these substances when applied separately to the other antiretroviral drugs͘. Patients receiving tenofovir disoproxil fumarate have had rare cases renal failure, renal failure, and proximal renal tubulopathy-including Fanconi syndrome), which sometimes leads to bone anomalies (infrequently contributes to fractures) ͘Patients receiving Truvada are advised to monitor kidney function. Lactic acidosis, severe hepatomegaly with fatty liver and lipodystrophy associated with tenofovir disoproxil fumarate and emtricitabine (see section Features" application).
Description of selected adverse reactions
- Renal insufficiency͘- Because the drug Truvada may cause dysfunction kidneys, it is recommended to monitor kidney function (see section "Application Features").
- ͘Interaction with didanosine͘- Concomitant administration of tenofovir disoproxil fumarate and didanosine not recommended because it leads to a 40-60% increase in the effect of didanosine, which may increase the risk of didanosine-related adverse reactions (see section 4)."Interaction with other medicinal products and other types of interaction") ͘ Rarely reported cases of pancreatitis and lactic acidosis, sometimes with fatal consequences͘.
- Lipids, lipodystrophy, and metabolic disorders͘- Combination antiretroviral therapy was associated with metabolic abnormalities such as hypertriglyceridemia, hypercholesterolemia, insulin resistance, hyperglycemia, and hyperlactatemia. Combination antiretroviral therapy has been associated with the redistribution of body fat in HIV-infected patients (lipodystrophy), including loss of peripheral and facial subcutaneous fat, increased intra-abdominal and intestinal fat, breast hypertrophy and fat accumulation in the dorsal cervical region (bovine hump).
- Immune reactivation syndrome͘- in HIV-infected patients with severe immune deficiency at the time the introduction of combination antiretroviral therapy ( CART ) may have an inflammatory response to asymptomatic or residual opportunistic pathogens.
- Osteonecrosis͘- Cases of osteonecrosis have been observed in patients with advanced risk factors disease or combined combination antiretroviral therapy for a long time(C RT) сто The frequency of occurrence of the specified phenomenon is unknown.
- Lactic acidosis and severe hepatomegaly with fatty degeneration͘- About lactic acidosis, commonly associated with fatty liver degeneration has been reported with use nucleoside analogs Treatment with nucleoside analogs should be discontinued symptomatic hyperlactatemia and metabolic or lactic acidosis, gradually increasing hepatomegaly or rapid increase in aminotransferase levels.
Other special populations͘
- Elderly patients͘- The use of Truvada has not been studied in patients over 65 years of age͘Elderly patients are more likely to have decreased renal function, therefore, during treatment care should be taken in the care of elderly patients.
- Patients with renal insufficiency͘- Because tenofovir disoproxil fumarate may lead to nephrotoxicity, it is recommended to carefully monitor the renal function of all patients with renal insufficiency who take Truvada (see sections on “How to use and doses, "Features of administration" and "Pharmacokinetics").
- Patients with concomitant HIV / hepatitis B or type C͘ infection- In Study GS-01-934 only a limited number of patients were infected with hepatitis B virus at the same time (n = 13)or hepatitis C virus (n = 26) ͘ Side effects profile of emtricitabine and tenofovir fumarate disoproxil in patients co-infected with HIV / hepatitis B virus or HIV /hepatitis C virus type was similar to that observed in HIV-infected patients without concomitant infection͘ However, as expected in this patient population, there is an increase in the level aspartate transaminase (AST) and alanine aminotransferase (ALT) were observed more frequently than in the general population of HIV infected people.
- Exacerbation of hepatitis after cessation of treatment͘- After cessation of treatment in HIV-Clinical and laboratory signs emerged in infected patients with combined HBV infection exacerbation of hepatitis.
If an overdose has occurred, the patient should be monitored for signs of toxicity. If necessary, standard supportive measures should be used treatment Up to 30% of emtricitabine dose and approximately 10% tenofovir dose can be removed byhemodialysis͘ It is unknown whether emtricitabine or tenofovir is excreted by peritoneal dialysis.
Use during pregnancy or breastfeeding
- Pregnancy- The small amount of data on pregnant women (300-1000 consequences of pregnancy) indicates the absence malformation or toxicity to the embryo/neonate associated with emtricitabine andtenofovir disoproxil fumarate͘ Animal studies of emtricitabine and tenofovir fumarate disoproxil do not show reproductive toxicity͘ Therefore, use of Truvadapossible during pregnancy, if necessary.
- Breast-feeding- Emtricitabine and tenofovir have been found in human milk͘ There is insufficient information on effects of emtricitabine and tenofovir on neonates/infants ͘ Therefore, Truvada should not apply during breastfeeding͘As a rule, it is recommended that HIV-positive women do not breast-feed their children what circumstances to prevent the transmission of HIV to the child.
- Children- It is contraindicated to apply Truvada to patients under the age of 18, as safety and the effectiveness of the drug is not established for this age group͘.
Features of application
- Concomitant use with other medicinal products- Truvada should not be used concomitantly with other medicinal products containing emtricitabine, tenofovirdisoproxil fumarate or other cytidine analogs such as lamivudine (see section "Interaction with other medicines and other types of interaction͘) ͘ Truvada should not be given at the same time asadefovir dipivoxil͘.
- Concomitant administration of diisopropyl fumarate and didanosine tenofovir- No͘ Co-administration of tenofovir disoproxil fumarate and didanosineleads to a 40-60% increase in systemic exposure to didanosine, which may increase didanosine-related adverse events͘ Reported infrequent, sometimes lethal,cases of pancreatitis and lactate acidosis не Co-administration of tenofovir disoproxil fumarate and didanosine at a dose of 400 mg per day was associated with a significant decrease in CD4 cell count, possibly through intercellular interactions that increase phosphorylated (ie active). Didanosine Reduced Dosage - 250 mg didanosine with tenofovirdisoproxil fumarate was associated with a high incidence of virologically unsuccessful treatment with several combinations tested͘.
- Triple nucleoside therapy- High-frequency reports have been reported virological treatment failure and the emergence of early-stage resistance if tenofovir disoproxilfumarate was combined with lamivudine and abacavir, as well as lamivudine and didanosine 1 time there is a close structural similarity between lamivudine and emtricitabine, and the similarity of the pharmacokinetics and the pharmacodynamics of the two substances is, therefore, the same problem may be observed if Truvada is used with a third nucleoside analog.
- Opportunistic Infections͘- In patients receiving Truvada or any other antiretroviral therapy, the development of opportunistic infections and other complications of HIV may continue infections, and therefore, they should remain under the close clinical supervision of physicians who have experience in treating patients with HIV-related diseases.
- HIV transmission- Patients should be informed of what has not been proven antiretroviral treatment, including Truvada, prevents the risk of HIV transmission to other patients by sexual intercourse or by contact with the blood preventive measures͘.
- Renal disorders͘- Emtricitabine and tenofovir are mainly excreted by the kidneys combinations of glomerular filtration and active tubular secretion͘ Reportedrenal failure, renal impairment, increased creatinine, hypophosphatemia and proximal tubulopathy (including Fanconi syndrome) with tenofovir fumarate disoproxil in clinical practice. It is recommended that creatinine clearance be calculated in all patients prior to initiation of treatment labor and kidney function monitoring (creatinine clearance and serum phosphate levels)every four weeks for the first year and then every three months for at-risk patients impaired renal function, including patients who have previously had renal symptoms at the time of receipt dipefoxil adefovir may require more frequent renal function testing.
Truvada contains lactose monohydrate͘. Therefore, patients with such rare hereditary problems; as galactose intolerance, Lapp lactase deficiency or disorder glucose-galactose absorption should not be taken with this preparation. The ability to influence the speed of response when driving or working with other mechanisms.
No studies have been performed on the effects on the ability to drive and use mechanisms, However, patients should be informed that dizziness may occur during treatment with both emtricitabine and tenofovir disoproxil fumarate. Interaction with other medicinal products and other types of interactions.
Because Truvada contains emtricitabine and tenofovir disoproxil fumarate, any interactions, occurring separately with these substances may also occur with Truvada͘ Interaction studies were conducted only in adults͘Steady-state pharmacokinetics of emtricitabine and tenofovir were not affected emtricitabine and tenofovir disoproxil fumarate were used together unlike the use of each drug separately.