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Precautions and Warnings With Efavirenz, Emtricitabine, and Tenofovir

Talk to your healthcare provider about precautions and warnings with efavirenz, emtricitabine, and tenofovir to help ensure safe treatment. You should know that the medication may cause psychiatric problems, make hepatitis B worse, or change body fat distribution. Precautions and warnings with efavirenz, emtricitabine, and tenofovir also include the possibility of drug interactions, so tell your healthcare provider about all medicines you are taking before starting treatment.

Efavirenz, Emtricitabine, and Tenofovir: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking efavirenz, emtricitabine, and tenofovir disoproxil fumarate (Atripla™) if you have:
 
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
You should also be sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 

Specific Precautions and Warnings With Efavirenz, Emtricitabine, and Tenofovir

Warnings and precautions to be aware of prior to taking efavirenz, emtricitabine, and tenofovir include the following:
 
  • The medication can cause psychiatric problems, including anxiety, depression, aggressiveness, and suicidal thoughts or behavior. Tell your healthcare provider immediately if you are experiencing any psychiatric side effects of efavirenz, emtricitabine, and tenofovir.
     
  • Efavirenz, emtricitabine, and tenofovir can cause dizziness, drowsiness, and problems with concentration. Make sure you know how the HIV medicine affects you before driving, operating heavy machinery, or consuming alcoholic beverages.
     
  • Efavirenz, emtricitabine, and tenofovir often causes harmless skin rashes. However, if you have a rash with blisters, loss of skin, a fever, or mouth sores, be sure to tell your healthcare provider immediately, as this may be a sign of a life-threatening reaction to the medication.
     
  • If you have liver disease (especially hepatitis), your healthcare provider should monitor your liver function (using regular blood tests) to make sure efavirenz, emtricitabine, and tenofovir is not causing further liver damage. Also, you may need a lower dosage, since the liver helps to remove the medicine from the blood.
Because some cases of serious liver damage associated with this medication occurred in people without previous liver problems (or other risk factors for liver damage), some healthcare providers choose to monitor liver function in all people taking this medication. 
  • Efavirenz, emtricitabine, and tenofovir may increase the risk of seizures. Make sure your healthcare provider knows if you have epilepsy or a history of seizures prior to taking the medication.
     
  • Stopping this medication may make a hepatitis B infection worse. This may become quite serious. You should be tested for hepatitis B before taking this medication. If you have hepatitis B and stop taking this medication, your healthcare provider should monitor your liver very carefully for several months. 

 

  • In rare cases, efavirenz, emtricitabine, and tenofovir can cause a condition called lactic acidosis and hepatic steatosis. It is caused by damage to the liver and can be very dangerous. You are at higher risk for this side effect if you have liver disease.

 

  • Efavirenz, emtricitabine, and tenofovir can change the distribution of fat on your body. You may gain fat in areas that are not typical for you, such as in the abdomen or at the back of the neck (a "buffalo hump"), and may lose weight in other areas.
     
  • The kidneys help remove efavirenz, emtricitabine, and tenofovir from the blood, and the drug can damage the kidneys. Let your healthcare provider know if you have any kidney problems, as you may need a lower dose of efavirenz, emtricitabine, and tenofovir, and you may be at a higher risk for kidney damage due to the drug.
     
  • The medication can decrease bone density, which increases the risk of osteoporosis and broken bones. Your healthcare provider should check your bone density while taking efavirenz, emtricitabine, and tenofovir, especially if you have had a broken bone in the past. Ask your healthcare provider if you should take calcium and vitamin D while treatment, as this may help strengthen your bones.
     
  • Efavirenz, emtricitabine, and tenofovir is not a cure for HIV or AIDS. If you have HIV or AIDS, you should always use safer sex practices, whether or not you are taking medications.
     
  • As with all HIV medications, it is important that you take efavirenz, emtricitabine, and tenofovir exactly as prescribed. Missing doses may increase the chance of the virus becoming resistant to HIV medications.
     
  • Efavirenz, emtricitabine, and tenofovir can interact with a number of different medications (see Drug Interactions With Efavirenz, Emtricitabine, and Tenofovir).
     
  • Efavirenz, emtricitabine, and tenofovir is considered a pregnancy Category D medication. This means that it is probably not safe for use during pregnancy, although the full risks are not known (see Atripla and Pregnancy).
     
  • This medication passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking efavirenz, emtricitabine, and tenofovir (see Atripla and Breastfeeding). It is important to understand that the HIV virus can be transmitted through breast milk and that breastfeeding is usually not recommended in women with HIV or AIDS.
     

Info on Efavirenz, Emtricitabine, and Tenofovir

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