Truvada is a combination antiretroviral medication used for the treatment of HIV-1 infection. It contains two active ingredients: emtricitabine (FTC) and tenofovir alafenamide (TAF).
Precautions for Administration of Truvada
Contraindication Screening
Emtricitabine and Tenofovir Disoproxil Fumarate Tablets are contraindicated in patients who are allergic to emtricitabine or tenofovir.
Concurrent use with dofetilide or rifampicin is prohibited, as it may lead to severe drug interactions.
For patients with concurrent hepatitis B virus (HBV) infection, sudden discontinuation of the medication may cause severe acute exacerbation of hepatitis B. Therefore, HBV screening should be performed before starting the medication.
Baseline Assessment Items
Renal function tests: Including serum creatinine, estimated creatinine clearance (CLcr), urine glucose, and urine protein.
Liver function tests: Especially for patients with concurrent HBV infection.
Bone mineral density assessment: Long-term use may affect bone metabolism.
Pregnancy screening: Women of childbearing age need to confirm their pregnancy status.
Precautions for Concurrent Medication Use
Antiarrhythmic drugs (e.g., dofetilide).
Anticonvulsant drugs (e.g., carbamazepine, phenobarbital).
Antituberculosis drugs (e.g., rifampicin, rifabutin).
Drugs containing polyvalent cations (e.g., aluminum/magnesium-containing antacids, calcium/iron supplements).
Nephrotoxic drugs (e.g., non-steroidal anti-inflammatory drugs).
Aluminum/magnesium-containing antacids or calcium preparations should be administered 2 hours after taking Truvada on an empty stomach, while calcium or iron supplements can be taken concomitantly with the medication.
Key Monitoring Points for Administration of Truvada
Routine Monitoring Items
Renal function: Check serum creatinine and estimated creatinine clearance at least every 6 months.
Urinalysis: Monitor changes in urine glucose and urine protein.
Liver function: Especially for patients with concurrent HBV infection.
HIV viral load: The main indicator for evaluating treatment efficacy.
CD4 cell count: Reflects the status of immune function.
Monitoring for Special Populations
Patients with concurrent hepatitis B infection: After discontinuation of the medication, liver function should be closely monitored for at least several months, and antiviral treatment for hepatitis B should be administered if necessary.
Pregnant women: The benefits and risks should be weighed, and the patient should be registered in the Antiretroviral Pregnancy Registry. Breastfeeding by mothers with HIV infection is not recommended.
Elderly patients: Since they may have impaired renal function, enhanced monitoring of renal function is required.
