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Precautions and warnings with emtricitabine and tenofovir should be reviewed before starting treatment, including possible side effects and information on who should not take the drug. For example, tell your healthcare provider about all existing medical conditions you have before taking the medication. Precautions and warnings with emtricitabine and tenofovir also extend to people with liver disease, kidney problems, or hepatitis B.

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

You should talk with your healthcare provider prior to taking emtricitabine and tenofovir disoproxil fumarate (Truvada®) if you have:
  • Hepatitis B
  • Kidney disease, including kidney failure (renal failure)
  • Liver disease, such as liver failure or cirrhosis
  • Osteoporosis or other bone problems
  • Any allergies, including allergies to food, dyes, or preservatives.
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 Emtricitabine and Tenofovir

Warnings and precautions to be aware of prior to taking emtricitabine and tenofovir include the following:
  • Stopping this medication may make a hepatitis B infection worse. This could lead to liver failure. If you stop taking this medication and have hepatitis B, you will need to be monitored for several months to make sure your infection is not getting worse.


  • In rare cases, 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.
  • 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 emtricitabine and tenofovir from the blood, and the medication can damage the kidneys. Let your healthcare provider know if you have any kidney problems. For people with poor kidney function, this medication can be used at reduced or less frequent doses for treating HIV, but should not be used at all for HIV prevention. In addition, people with kidney problems may be at a higher risk for kidney damage due to the drug.


  • Emtricitabine and tenofovir can decrease bone density, which increases the risk of osteoporosis and broken bones. Your healthcare provider should check your bone density while you are taking the drug, especially if you have had a broken bone in the past. Ask your healthcare provider if you should take calcium and vitamin D during treatment, as this may help strengthen your bones.


  • When you first start taking HIV medications and your immune system begins to recover, a group of problems known as immune reconstitution syndrome may occur. Your immune system may start aggressively reacting to any infections you may have and may cause extreme inflammation. There have even been cases of autoimmune disorders (such as Graves' disease, polymyositis, and Guillain-Barré syndrome) possibly caused by this problem.


  • When used for HIV prevention instead of treatment, this medication should be used only in people who definitely do not have HIV. Frequent HIV testing (at least every three months) is recommended during treatment. When used for HIV prevention, safer sex practices are essential, since the drug does not completely eliminate the risk for contracting HIV. 


  • 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 emtricitabine and tenofovir exactly as prescribed. Missing doses may increase the chance of the virus becoming resistant to HIV medications.
  • Emtricitabine and tenofovir can interact with a number of different medications (see Drug Interactions With Emtricitabine and Tenofovir).
  • Emtricitabine and tenofovir is considered a pregnancy Category B medication. This means that it is probably safe for use during pregnancy, although the full risks are not known (see Truvada and Pregnancy).
  • It is not known if emtricitabine and tenofovir passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Truvada 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.
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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