emtricitabine + rilpivirine hydrochloride + tenofovir alafenamide fumarate at a glance
Medicine class
Two nucleos(t)ide reverse transcriptase inhibitors combined with one non-nucleoside reverse transcriptase inhibitor.
Licensed population
Selected adults and adolescents aged at least 12 years and weighing at least 35 kg, subject to viral-load and resistance criteria.
Food
Take with food; a nutritional drink alone is not an adequate substitute.
Tablet handling
Swallow whole; chewing, crushing or splitting may give a bitter taste.
What is emtricitabine + rilpivirine hydrochloride + tenofovir alafenamide fumarate used for?
Licensed use:
HIV-1 treatment in adults and adolescents aged at least 12 years and weighing at least 35 kg, when viral load is no more than 100,000 HIV-1 RNA copies/mL and there are no known relevant resistance mutations to the NNRTI class, tenofovir or emtricitabine.
How does emtricitabine + rilpivirine hydrochloride + tenofovir alafenamide fumarate work?
Rilpivirine blocks HIV reverse transcriptase non-competitively. Activated emtricitabine and tenofovir metabolites act as false building blocks that terminate viral DNA chains, suppressing viral replication.
emtricitabine + rilpivirine hydrochloride + tenofovir alafenamide fumarate preparations and strengths
Tablet
Route: Oral
Strengths: 200 mg + 25 mg + 25 mg
How to take emtricitabine + rilpivirine hydrochloride + tenofovir alafenamide fumarate
Take by mouth with food exactly as prescribed. A nutritional drink alone does not replace food.
Swallow the film-coated tablet whole; do not chew, crush or split it.
Do not stop or restart treatment without consulting the HIV team, particularly if you also have hepatitis B.
emtricitabine + rilpivirine hydrochloride + tenofovir alafenamide fumarate side effects
Common or expected effects
- Feeling sick, vomiting, diarrhoea or abdominal discomfort
- Headache or dizziness
- Difficulty sleeping, abnormal dreams or sleepiness
- Depressed mood or depression
- Tiredness
- Reduced appetite
- Rash
- Changes in liver enzymes, blood-cell counts, cholesterol, triglycerides or other laboratory results
Get urgent medical advice
- Sudden swelling of the face, lips, tongue or throat, particularly with breathing or swallowing difficulty
- Severe rash with fever, swelling or liver problems
- New or worsening symptoms of infection or inflammation after starting HIV treatment
- Symptoms of worsening liver disease, especially after stopping treatment in someone with hepatitis B
emtricitabine + rilpivirine hydrochloride + tenofovir alafenamide fumarate in pregnancy
Discuss pregnancy promptly with the specialist HIV team and do not stop prescribed treatment without advice. Data for the complete combination are limited, and rilpivirine exposure falls during pregnancy, so closer viral-load monitoring may be needed. Use requires specialist assessment of benefits and potential risks.
emtricitabine + rilpivirine hydrochloride + tenofovir alafenamide fumarate while breastfeeding
The product information advises against breastfeeding because infant safety data are insufficient and some components may enter breast milk. Formula feeding is the safest option for preventing postnatal HIV transmission. Anyone considering breastfeeding should discuss this early with the specialist perinatal HIV team.
emtricitabine + rilpivirine hydrochloride + tenofovir alafenamide fumarate interactions
Check prescription, over-the-counter and herbal products because interactions can reduce treatment exposure, causing treatment failure and resistance.
Proton-pump inhibitors, including omeprazole and lansoprazole
Contraindicated because increased stomach pH substantially reduces rilpivirine absorption.
Carbamazepine, oxcarbazepine, phenobarbital or phenytoin
Contraindicated because enzyme induction can markedly reduce treatment exposure.
Rifampicin, rifabutin or rifapentine
Contraindicated because they can substantially lower antiretroviral concentrations.
Common questions about emtricitabine + rilpivirine hydrochloride + tenofovir alafenamide fumarate
Answers are fully visible for fast scanning and source review.
Is this a complete HIV treatment?
Yes. It is licensed as a complete HIV-1 regimen.
Does it cure HIV?
No. It suppresses HIV replication and helps reduce viral load, but does not remove HIV from the body.
Why must it be taken with food?
Food improves absorption of rilpivirine and tenofovir alafenamide. A nutritional drink alone is not enough.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.