Emtriva

Emtriva is very well tolerated. The most common side effects (rarely reported) may include headache, diarrhea, and nausea. Prior to initiation, people should be tested for hepatitis B virus (HBV) infection. Severe exacerbations of hepatitis B have been reported in people co-infected with hepatitis B who have discontinued Emtriva (because emtricitabine also treats HBV).

Monitor liver enzymes closely in people co-infected with hepatitis B and, if appropriate, initiation of anti-hepatitis B therapy may be warranted upon Emtriva discontinuation. Call your health care provider right away if you develop any of the following signs or symptoms of hepatitis: yellowing of the skin or whites of the eyes; dark or tea-colored urine; pale-colored bowel movements; nausea or vomiting; loss of appetite; or pain, aching, or tenderness on the right side below the ribs. Rare skin discoloration (darkening of the skin on the palms and the soles) can occur and was more frequent in children, but is generally mild and not medically concerning.

Do not take with Cimduo or Temixys, Descovy, Epivir, Epivir-HBV, Hepsera, or Truvada, used for the treatment of hepatitis B. No other significant drug interactions are predicted. Emtriva may be used with hepatitis C drugs such as Epclusa, Harvoni, or Zepatier, depending on the other components in the HIV regimen. Tell your provider or pharmacist about all medications, herbals, and supplements you are taking or thinking of taking, prescribed or not.

This drug is used almost exclusively as part of combination tablets. Emtriva (emtricitabine) is similar to Epivir (lamivudine)—both treat HIV and HBV and have the same resistance profile, meaning that if your virus is resistant to one drug, it will be resistant to the other. If your HIV develops resistance to Epivir or Emtriva, it does not mean that your HBV is also resistant to them.

Both Descovy and Truvada (both contain Emtriva) are currently recommended by DHHS HIV treatment guidelines for first-time therapy for most people. Emtriva is also found in several single-tablet regimens (Atripla, Biktarvy, Complera, Genvoya, Odefsey, Stribild, and Symtuza). Sometimes, drug resistance that the virus develops against emtricitabine makes the virus reproduce at a slower rate. This drug resistance can also improve the antiviral activity of Retrovir (zidovudine, or AZT—very rarely taken today) and Viread or Vemlidy (tenofovir), and for that reason, some providers continue Emtriva treatment in combination with other antiretrovirals after resistance develops. Emtriva oral solution should be kept in the refrigerator. If kept at room temperature, the oral solution should be used within three months. The capsule is small, which is an advantage for people with difficulty swallowing.

Dr. Melanie Thompson:

Emtricitabine, commonly called FTC, is frequently coformulated with other HIV medications in the Gilead stable. In fact, Gilead bought Triangle Pharmaceuticals, the initial developer of FTC, just to acquire FTC for this purpose in 2003. Its resistance pattern is the same as for 3TC, and resistance arises easily without a strong backbone. Initially thought to be slightly more potent than 3TC, this has never been shown to make a clinical difference, and the two drugs are treated as interchangeable for treatment by guidelines panels. 

FTC has activity against hepatitis B, and a hepatitis flair could occur if the drug is stopped in people with HBV.

Activist Bridgette Picou:

Emtriva is found in many STRs (Biktarvy and Genvoya, for example) and it is similar to lamivudine. It is well tolerated and considered safe, especially where dose adjustment is necessary due to decreased kidney function. Emtriva can also be used to treat hepatitis B, so you should know your hepatitis status or get tested before starting or stopping Emtriva.