Paul A. Pham, Pharm.D. and John G. Bartlett, M.D.
Available formulation in Zambia: Capsule: 200 mg; Oral liquid: 10 mg/ml. TDF 300 mg/FTC 200 mg combination tab EFV 600 mg/TDF 300 mg/FTC 200 mg combination tab
- FTC/TDF plus EFV or NVP is now preferred firstline regimen due to long-term potency and favorable mutation pathway.
- Refrigerate FTC solution. Solution can be kept out at room temperature for 3 months only.
Zambia Information Author: Paul A. Pham, Pharm. D.
- Treatment of HIV infection in combination with other antiretroviral agents.
- Treatment of hepatitis B in HIV-HBV co-infected pts. or in HBV mono-infected patients.
| Emtriva ||Emtricitabine (FTC)||Gilead||Oral|
|$13.70 per cap
10 mg/mL (170mL)
|$97.00 (170 mL bottle)
| Truvada ||Emtricitabine (FTC)+ Tenofovir DF (TDF)||Gilead||Oral|
FTC200 mg/TDF 300 mg
|$38.34 per tab
|Atripla ||Emtricitabine (FTC)+ Tenofovir DF (TDF) + Efavirenz (EFV) ||Bristol-Myers Squibb / Gilead ||Oral |
FTC200mg/TDF300 mg/EFV 600 mg
|$55.11 per tab
*Prices represent cost per unit specified and are representative of "Average Wholesale Price" (AWP).
AWP Prices were obtained and gathered by Lakshmi Vasist Pharm D using the Red Book, manufacturer's
information, and the McKesson database.
^Dosage is indicated in mg unless otherwise noted.
Pill burden: 1 cap or tab once-daily.
- FTC 200 mg - 1 tab once-daily. with or without food.
- Can be administered as a co-formulated product with tenofovir DF (Truvada) 1 tab PO once-daily with or without food and TDF/EFV (Atripla) 1 tab once-daily. Evening dosing on an empty stomach recommended with initial Atripla therapy to decrease EFV-associated side effects.
200 mg q24hrs.
30-49 mL/min: FTC 200 mg every other day or TDF/FTC co-formulation (Truvada) 1 tab every other day;15-29 mL/min: FTC 200 mg every 3 days. TDF/FTC (Truvada) not recommended with GFR <30 ml/min. EFV/TDF/FTC co-formulation (Atripla) not recommended with GFR <50 ml/min.
<15 mL/min: 200 mg every 4 days. TDF/FTC (Truvada) and EFV/TDF/FTC co-formulation (Atripla) not recommended.
200 mg every 4 days post-HD (30% of dose removed with 3-hr HD). TDF/FTC (Truvada) not recommended with GFR <30ml/min . EFV/TDF/FTC co-formulation (Atripla) not recommended with GFR <50 ml/min).
No data. Consider dose reduction. TDF/FTC (Truvada) not recommended with GFR <30ml/min and EFV/TDF/FTC co-formulation (Atripla) not recommended with GFR <50 ml/min).
No data. Consider dose reduction.
- Generally well tolerated. For Atripla, see EFV for EFV-associated side effects and TDF for TDF-associated side effects
- Mild asymptomatic skin hyperpigmentation on the palm and/or soles noted in 3% of pts, with increased frequency in dark-skinned individuals.
- Asymptomatic and transient CPK elevation.
- Headache, diarrhea, nausea, asthenia, and rash that required discontinuation in approx. 1% of pts.
Not a substrate, inhibitor, or inducer of any CYP450 isoforms. No clinically significant drug interactions.
Lactic acidosis (categorized as NRTI class adverse effect, but not expected to occur frequently with FTC).
|Drug||Effect of Interaction||Recommendations/Comments
| AZT ||No significant drug interaction.||Use standard dose.
|Food||FTC AUC was not affected by food.||Administer FTC with or without food
| TDF ||Tenofovir Cmin was increased by 20%; AUC was unchanged.||Interaction not significant. Use standard dose.
- 184V: High-level resistance.
- T69ins: High-level resistance.
- Q151M complex: Unknown data, but low-level resistance likely.
- TAMs (41L, 210W, 215Y/F, 219Q/E, 44D, 67N, 70R, 118I): high level resistance with multiple TAMs.
- Pros: Activity against HBV; well tolerated; once-daily dosing; co-formulation with TDF; similar to 3TC with respect to activity, tolerability, and resistance profile
- Cons: Hyperpigmentation in some pts; less clinical data than for 3TC.