Combination of Emtricitabine and Tenofovir: What Side Effects to Expect?

Individuals who have relationships with HIV-infected people and belong to a risk group of getting the virus eventually have strong protection now. Taking special meds for pre-exposure prophylaxis can save people from being infected. Read more about how they work and how they are safe for a human body.

Now, a lot of public health officials set an ambitious goal to eliminate HIV infections. Their plan relies on use of the two powerful antiretroviral substances – tenofovir and emtricitabine.

For more than 10 years, they have been used as a part of medication therapy which suppresses HIV in individuals who already have the virus. In 2012, they became the first substances for use in people who are HIV-negative in order to prevent getting the infection.

🔍Drug Information

Emtricitabine and tenofovir disoproxil fumarate are active components approved by the FDA to treat HIV infections [1]. They can be used to cure HIV-positive people and to be taken for pre-exposure prophylaxis (PrEP) in individuals who are HIV-negative and have high risks to get the infection [2]. People at this risk group are those who:

  • have sexually transmitted diseases;
  • have an HIV-positive sexual partner;
  • do not use condoms;
  • live in prison/jail;
  • have drug or alcohol dependence;
  • exchange sex for food, drugs, or money.

When these substances are used for PrEP, this means that they are taken by healthy people. As tenofovir and emtricitabine are always present in the blood, they are able to fight off HIV infections, if a person occasionally gets this virus. These components stop the virus from replicating inside the immune cells in the human body [3].

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📝What Adverse Reactions May Occur?

Along with all the positive characteristics, these strong substances may cause undesired effects in users. Some of these negative reactions don’t require medical assistance and may go away during therapy as a user’s body adjusts to the drug.

Inform your physician if you experience any side effects or if they continue and bother you. Your GP will tell you about the ways to reduce or prevent these reactions.

📋Common Side Effects of Emtricitabine and Tenofovir

For people who use these components for PrEP, the most typical emtricitabine tenofovir side effects are included in the following list. They are usually mild and disappear within a few days or a week [4].

If they are bothersome, inform your health care provider:

  • headaches;
  • nausea;
  • diarrhea;
  • cough;
  • trouble sleeping;
  • depression;
  • fatigue;
  • fever;
  • runny nose;
  • body aches;
  • nasal or ear congestion;
  • vomiting;
  • respiratory infections;
  • dizziness;
  • sore throat.

These symptoms may also be reported if tenofovir and emtricitabine are combined with other antiretroviral medicines. This data was proven by clinical trials, in which both substances were used by patients within 96-144 weeks [5].

Taken by HIV-positive people, these components also cause decreased weight and abdominal pain.

📋Severe Consequences

If you experience any serious side effects, report to your GP as soon as possible. These symptoms include:

  • breathing difficulties;
  • irregular or fast heartbeat;
  • vision changes;
  • allergic reactions (rash, hives, swelling of your face, itching, etc.);
  • bone pain;
  • tingling feelings in your feet or hands;
  • chest pain;
  • burning of the mouth or face;
  • passing of gas;
  • joint swelling or pain;
  • anxiety;
  • back pain.

These symptoms require urgent medical help.

📋Rare Adverse Reactions While Taking This Medication

Rare side effects include such conditions as:

  • severe kidney problems. Decreased kidney function occurs only in 1% of users. Your therapist may need to perform some blood tests to check your renal system and change the medicine dosage. If your kidneys do not work well, the therapy can be canceled. The symptoms of kidney injury are muscle pains, changes in the amount of the urine or its trouble passing, vomiting, nausea, fatigue, and others;
  • severe liver problems. The risk to cause this disorder is very low. Your doctor may perform several tests and prescribe a dosage adjustment. Hepatotoxicity is a kind of hepatic dysfunction with causes of liver enlargement and the formation of fat deposits. The symptoms of liver injury are dark yellow urine, light-colored stool, skin discoloration, loss of appetite, nausea, stomach aches, and others;
  • bone loss. Emtricitabine and tenofovir can cause decrease of bone growth in children or bone mass in adults. This disorder occurs in 1.7% of patients. People with bone fracture are recommended taking calcium supplements and vitamin D to prevent this issue. The main symptoms include bone pain and thinning or softening of bones;
  • lactic acidosis. This disease causes a buildup of acid in the blood which can become life-threatening. Women and obese people are more prone to get this condition. Usually, lactic acidosis is treated in the hospital. The main symptoms are weakness, tiredness, trouble breathing, feeling cold (especially in your legs and arms), dizziness, stomach pain, fast heartbeat, muscle cramps, confusion, and others;
  • immune reconstitution syndrome. Treatment with tenofovir and emtricitabine can cause a rapid improvement in the functions of the patient’s immune system. Sometimes, this causes a body to fight older infections that people had in the past. This may seem as if they caught a new infection with a high level of inflammation. These disorders can reappear as a new fungal infection, pneumonia, or tuberculosis. Therapists usually prescribe antifungal treatment and antibiotics [6].

These side effects are not typical. Predisposed patients with poor health conditions (like liver disease) may develop these reactions in 1-2% of cases.

💊How to Take Emtricitabine and Tenofovir Disoproxil Safely?

Proven by numerous human trials, emtricitabine and tenofovir can reduce risks of getting HIV by 92% if they are used for PrEP. Statistical analysis indicates that the medicines may be effective up to 99% if taken exactly as instructed [7]. The proper use of these drugs is the key to positive treatment results. If people take them less frequently than prescribed or do not take them at all, they may get infected.

These antiviral preparations are used only after you have visited your doctor and had a prescription. The doctor may offer you tests for liver function, sexually transmitted diseases, and blood tests which are a necessary condition for getting a prescription. Only people with a confirmed HIV-negative status can take tenofovir and emtricitabine for PrEP. Once in three months, these tests should be done again [8].

The tablets are taken every day without skipping. Try to swallow a pill at the same time. This helps keep the same amount of drug ingredients in the blood. Don’t chew or split a tablet.

Patients with certain health issues like kidney or liver diseases, bone problems, hepatitis, and pregnant women should take the drug under medical control or have a special dosage adjustment [9].

If you take any antiviral or antifungal agents, hepatitis C or B drugs, HIV pills, pain-killers, or tablets to treat bone diseases, inform your therapist. These medications may interact with tenofovir and emtricitabine and cause adverse reactions [10].

The branded versions of these medicines are very expensive, while generic alternatives are available at a fraction of the cost. Several companies have begun to market generics through online pharmacies. These tablets are produced in India and can be ordered without prescription.

Therefore, HIVPrEP is here to give you all the information you need about generic alternatives of emtricitabine/tenofovir.


  1. Emtricitabine/tenofovir disoproxil fumarate: Dosage, Side Effects. AIDSinfo. Retrieved 20 March 2019.
  2. Medscape. Emtricitabine-tenofovir DF: dosing, indications, interactions, side effects, and more. Retrieved 11 May 2015.
  3. Truvada: Uses, Dosage, Side Effects – Retrieved 20 September 2018.
  4. Truvada: Dosage, Adverse Effects, Uses, Interactions, and More by Retrieved 26 January 2019.
  5. Emtricitabine/Tenofovir (Truvada) for HIV Prophylaxis. The American Academy of Family Physicians. Retrieved 13 September 2008.
  6. Emtricitabine/Tenofovir. Wikipedia. Retrieved 17 February 2019.
  7. Truvada: Side Effects, Interactions, Warning, Dosage & Uses. online medical resource.
  8. Truvada: Dosage, Side Effects, Interactions, Uses, and More by HealthLine Media. Retrieved 26 January 2019.
  9. Highlights of prescribing information by Gilead Sciences, Inc. Retrieved May 2018.
  10. Internet-based pre-exposure prophylaxis with generic tenofovir DF/emtricitabine in London. The National Center for Biotechnology Information. Retrieved 1 October 2017.
Logan Morris

Expert in pharmaceutical practice and antiviral medicine, founder of HIVPrEP. Main goal is to popularize HIV topics and create awareness for global masses on how to prevent the disease and how to use HIV medication safely.

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