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You will need to discuss the benefits and risks of using Efavirenz/Emtricitabine/Tenofovir while you are pregnant. Severe acute exacerbations of hepatitis B have been reported in patients who have discontinued emtricitabine or tenofovir disoproxil fumarate. Osteomalacia and myopathy (both associated with proximal renal tubulopathy) have been reported during postmarketing experience with tenofovir. Exacerbations of hepatitis B have been reported in patients coinfected with HIV and hepatitis B after discontinuation of tenofovir. Efavirenz, emtricitabine, and tenofovir may cause lactic acidosis (a build-up of lactic acid in the body, which can be fatal). Do not take this medication with other medicines that also contain efavirenz, emtricitabine, tenofovir (Sustiva, Emtriva, Truvada, or Viread), or lamivudine (Combivir, Epivir, Epzicom, or Trizivir). Renal function should be evaluated prior to and during therapy with tenofovir. Efavirenz, emtricitabine, and tenofovir is not a cure for HIV or AIDS. Efavirenz, emtricitabine, and tenofovir can cause severe or fatal liver problems. The use of tenofovir has been associated with dose-related nephrotoxicity including cases of acute renal failure and Fanconi syndrome characterized by renal tubular injury with severe hypophosphatemia. Before taking lamivudine, tell your doctor if you have kidney disease, liver disease, a history of pancreatitis, or if you have used a medicine similar to lamivudine in the past, such as abacavir (Ziagen), didanosine (Videx), stavudine (Zerit), tenofovir (Viread), zalcitabine (Hivid), or zidovudine (Retrovir). There is a risk of passing the HIV infection or Efavirenz/Emtricitabine/Tenofovir to the baby. Efavirenz/emtricitabine/tenofovir is only recommended for use during pregnancy when there are no alternatives and benefit outweighs risk. Do not become pregnant while you take Efavirenz/Emtricitabine/Tenofovir and for 12 weeks after you stop taking it. MANAGEMENT: The use of tenofovir in patients who have recently received or are receiving treatment with other potentially nephrotoxic agents (e. However, elderly patients are more likely to have age-related kidney, liver, or heart problems which may require caution in patients receiving efavirenz, emtricitabine, and tenofovir. Hepatic function should be monitored closely with both clinical and laboratory follow-up for at least several months in patients who are co-infected with HIV and HBV and discontinue efavirenz/emtricitabine/tenofovir disoproxil fumarate. Additionally, renal impairment secondary to the use of these agents may reduce the clearance of tenofovir, which is primarily eliminated by renal excretion. Severe acute exacerbations of hepatitis B have been reported in patients who have discontinued emtricitabine or tenofovir disoproxil fumarate which are components of efavirenz/emtricitabine/tenofovir disoproxil fumarate. It is not known if Efavirenz/Emtricitabine/Tenofovir is found in breast milk. Both regimens were in combination with tenofovir/emtricitabine 300/200 once daily, as is standard. RenalRenal side effects associated with tenofovir have included renal insufficiency, renal failure, acute renal failure, Fanconi's syndrome, proximal tubulopathy, proteinuria, increased creatinine, acute tubular necrosis, nephrogenic diabetes insipidus, polyuria, and interstitial nephritis (including acute cases). Do not use efavirenz, emtricitabine, and tenofovir if you are pregnant. The risk may be greater in women, patients who are very overweight, or patients who have been taking nucleoside medicines (eg, emtricitabine, tenofovir) for a long time. Each tablet contains 600 milligrams (mg) of efavirenz, 200 mg emtricitabine and 300 mg of tenofovir disoproxil fumarate. Abacavir/lamivudine had additive to synergistic activity in cell culture in combination with the nucleoside reverse transcriptase inhibitors (NRTIs) emtricitabine, stavudine, tenofovir, zalcitabine, zidovudine; the non-nucleoside reverse transcriptase inhibitors (NNRTIs) delavirdine, efavirenz, nevirapine; the protease inhibitors (PIs) amprenavir, indinavir, lopinavir, nelfinavir, ritonavir, saquinavir; or the fusion inhibitor, enfuvirtide. Before taking stavudine, tell your doctor if you have kidney disease, liver disease, a history of pancreatitis, or if you have used a medicine similar to stavudine in the past, such as abacavir (Ziagen), didanosine (Videx), lamivudine (Epivir), tenofovir (Viread), zalcitabine (Hivid), or zidovudine (Retrovir). Keep using birth control to prevent pregnancy for at least 12 weeks after you stop taking efavirenz, emtricitabine, and tenofovir. Efavirenz and tenofovir are both excreted into the milk of lactating rats.



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