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Mechanism

Tenofovir DF

Tenofovir DF converted into tenofovir and struggles with deoxyadenosine 5’ triphosphate and incooperated into viral DNA. Tenofovir DF worked as; Reverse transcriptase inhibitor; viral chain eliminator; viral production inhibitor

Efavirenz

By the way of reverse transcriptase enzyme which is sufficient for viral production Conversion occurs in formation of triphosphorylated form which is needed for efavirenz activity Inhibition of RT leads to intercede with development of DNA duplicates of viral RNA; occurs in cell division

Emtricitabine

Emtricitabine changed to Emtricitabine 5’ triphosphate which is fundamental for cell multiply Conflict occurs between this metabolite with deoxycytidine 5’ triphosphate and infused into viral DNA leads to chain obstruction.

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Brand : Trustiva
Ingredients : Tenofovir Disoproxil Fumarate + Emtricitabine+ Efavirenz
Strength : 300 mg + 200mg +600mg
Manufactured : Hetero
Package : 30 Tablets

SIDE EFFECTS

Adverse effects

The most common adverse effects; Lactic acidosis or hepatic steatosis, Nervous disorders, Renal impairment worsening, rash, Immune reconstitution syndrome, Liver injury, Bone defects, Fat redistribution, Severe acute exacerbation of hepatitis B

Common side effects

Nausea , fatigue, infections, sinusitis, dizziness, headache, respiratory problems, Nasopharyngitis, anxiety, depression, insomnia, elevation of creatine kinase, cholesterol, amylase, alkaline phosphatase, AST, ALT, blood glucose, decreased neutrophils, Diarrhea, vomiting

Precautions should be taken for following conditions

Patients should be examine correctly whether patient may suspected with HBV infection or not. The potency of Trustiva has not been monitored for chronic HBV infections The Trustiva treatment should be interrupt or discontinue while In lactic acidosis or hepatic steatosis To overwhelmed the problem by checking patients ECG, provides alternative medications.in case of QT extension While taking Trustiva at bed time the Neurological problems should be eliminated Trustiva should not be used in pregnancy condition.

Liver toxicity reduced by monitoring liver function test frequently and corrects the hepatic enzymes. Vitamin D supplements should be used for correct the bone defects Convulsion should be treated by using anti-convulsants medication Therapy should be stopped In case of immune reconstitution syndrome condition



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Drug interactions

Interaction of Trustiva with the substrates of CYP3A or CYP2B6: depletion of plasma concentration of these substrates. Interaction of Trustiva with the CYP3A inducers: elevation of clearance value of efavirenz results as depletion of plasma concentration Interaction of Trustiva with the drugs reducing renal functions: elevation of plasma concentration of Tenofovir DF & FTC.

Interaction of Trustiva with atazanavir: depletes atazanavir concentration and increases the tenofovir concentration. Interaction of Trustiva with Didanosine: increasing level of Didanosine Interaction of Trustiva with NNRTI: elevates the level of Efavirenz concentration

Interaction of Trustiva with anti-consultants, anti-coagulant, anti-depressants, or anti-fungals: depletes the concentration of these drugs Interaction of Trustiva with anti-infective, anti-mycobacterials, anti-malarial or CCB’s: depletes the effect of these drugs Interaction of Trustiva with lipid lowering agents, hormonal contraceptives or Immunosuppressant: depletes the effect of these drugs.


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