How Does Truvada Interact with Other Substances?

There are several Truvada drug interactions you should be aware of. At HIVPrEP, we give you only informative resources. A doctor can further help you with detailed information depending on the outcome of your health (after a complete body checkup).

Truvada for PrEP does not help you from the risk of contracting HIV infection alone. It must be used with other safe sex practices like using polyurethane or latex condoms to reduce the chance of obtaining HIV.

Truvada is in the list of WHO essential medicines making it one of the basic meds needed in everyday life [1]. Prior to using this drug, it’s advisable to read all the information regarding its usage, precautions & effects, as well as interactions with foods, other diseases, and other drug substances.

There are several Truvada drug interactions you should be aware of. At HIVPrEP, we give you only informative resources. A doctor can father help you with detailed information depending on the outcome of your health (after a complete body checkup).

🔍What You Should Know Before Taking Truvada

Truvada is a brand-name medication formed from a combination of two antiviral medicines (tenofovir-DF and emtricitabine (FTC)). It’s the ultimate remedy used to treat and prevent HIV/AIDS.

It doesn’t cure HIV. It’s designed to serve two purpose – to reduce the HIV-1 infection from multiplying in the body as well for PrEP for persons with HIV-negative status. You must test HIV-negative prior to starting to use this drug. Don’t use Truvada for PrEP if you’re HIV-positive, only use it when you’ve fully affirmed your HIV status.

Prior to using Truvada, it’s advisable to always visit a doctor for a complete health examination (checkup). Let your doctor know all the medicines you’re using and while you’re under this medication, don’t mix any other medicine without your doctor’s recommendation.

💊How Does This Medication Interact with Other Drugs?

Like any other drug, Truvada has its benefits and drug interactions leading to adverse negative effects. This article covers the main drug interactions. According to drugs.com, more than 250 drugs are known to interact with tenofovir-DF/emtricitabine (FTC). These drugs have varying effect from minor, moderate, to major interactions.

Drug interactions affect how Truvada function or alter how those drugs perform leading to acute effects that may harm your health (leading to fatal consequences). Knowing how these drugs interact with Truvada is the first precaution and responsibility to avoid side effects that may arise.

The main indicator is to attempt to put your health safe if you’re using medications for other diseases (disease interactions). Major drug interactions are common in patients with the following disease [2]:

  • liver disease (for hepatitis B);
  • bone toxicity;
  • kidney disease;
  • hepatotoxicity;
  • osteopenia;
  • hemodialysis;
  • hepatitis C;
  • erectile dysfunction;
  • renal dysfunction.

There are other diseases that may be affected by Truvada. To ensure you remain safe, list to your doctor all meds you’re using including prescription and OTC meds, vitamins, and herbal products. It’s also important to inform your therapist or doctor if you’ve had any disease you think may be affected by Truvada including the ones listed above.

Using pharmacologic boosters – those which inhibit CYP3A such as ritonavir and cobicistat can lead to notable drug interactions and there must be supervised or monitoring when administered in combinations other HIV/AIDS (like Truvada) [3].

Here are some of the most frequently checked drug interactions of you should know apart from what your doctor prescribed to you based on the outcome of your health status.

Truvada and Isentress Combination

As an INSTI, Isentress is prescribed to treat HIV-1 infection by controlling the virus from multiplying in the body as well as occupational exposure. It is known to interact with more than 120 drugs. Truvada, on the other hand, is used to treat HIV-1 infection (by controlling its viral replication) as well as used for pre-exposure prophylaxis (PrEP).

There is no available information on drug interactions between Truvada and Isentress when used together. In fact, this combination is well tolerated and effective in most cases [4].

Depending on your health. Isentress is known to cause some effect on people with kidney, muscle disorder, or liver disease. Do not coadminister it with Truvada without your doctor’s recommendation if you’re diagnosed with these diseases.

Does It Interact with Tivicay?

Tivicay (dolutegravir), an INSTI, is used to treat HIV infection. More than 260 meds are known to interact with Tivicay, some with minor effects while 131 of these drugs cause a severe effect that may harm your health.

Dolutegravir and Truvada (tenofovir) are known to have minor interactions with food ( which are clinically irrelevant). Coadministering both of these meds doesn’t cause harm nor need a change in therapy.

Tivicay in combination with Truvada has no effect on your body. There is no available information on the effect of the two-drug combination. As a precaution, do not use both of these drugs if you’re diagnosed with hemodialysis, hepatitis, or liver impairment disease as each drug is known to contribute to the effect of these diseases.

Truvada and Valtrex Interactions

There is a major drug interaction between Valtrex (valacyclovir) and Truvada. Individually, tenofovir and valacyclovir may cause kidney complications and combining both meds may increase that risk.

A doctor may suggest to give you an alternative medication that achieves the same results with no drug interactions. Whenever you feel symptoms of kidney problem (such as vomiting, loss of appetite, swelling, shortness of breath, muscle cramps, weakness, dizziness, bone pain, nausea, tiredness, fluid retention, etc.), consult your doctor.

What About Viagra and Cialis?

Viagra (tadalafil) and Cialis (sildenafil) are PDE5 inhibitors used to treat male impotence, there is no known effect if you combine either of the pills with Truvada. There are no serious problems known to be triggered when using ED and Truvada at the same time.

Sildenafil and tadalafil have moderate interactions with some foods like grapefruits and its products resulting in higher levels of sildenafil in your body as well as delaying the time it takes for the med to function.

Tadalafil may decrease blood pressure. Combining tadalafil with alcohol may seriously increase this effect. Grapefruits (juice and its products) may also raise the blood levels leading to negative effects of tadalafil which may harm your health.

Can You Combine Ibuprofen and Truvada?

Ibuprofen prescribed for reducing fever and treat pain (or inflammation) resulting from several conditions such as headache, menstrual cramps, back pain, toothache, among others.

Tenofovir and ibuprofen may affect the kidney and combining both of them may further cause severe kidney problems. Your doctor or health specialist may be able to prescribe other same alternatives that do not interact with Truvada. If it’s necessary to use ibuprofen, you may require a dose adjustment and continual monitoring.

If you experience adverse effects, it’s important to first talk to a doctor or a specialist before stopping the medications.

📋Is It Safe to Mix Truvada and Vitamins?

Yes, it safe to mix both as there are no adverse drug interactions between Truvada and vitamins. Your doctor may give you tailored precautions prior to using vitamins in combination with Truvada.

Vitamins have their own drug interactions as well as side effects which are important to know prior to starting this medication. For example, multivitamins can lower the dolutegravir (Tivicay) effectiveness (used as ARV) and it’s best to administer dolutegravir 6 hours after using multivitamins or 2 hours prior to using multivitamins.

There is not enough evidence on Truvada (as an anti-HIV drug) interact with vitamins. Taking vitamins in large quantities may be dangerous and may lead to adverse effects.

For example:

  • taking vitamin A in large quantities can cause liver problems as well as bone damage. It’s associated with other effects like vomiting and headache. Taking a dose of 1.5 mg or more may boost the risk of osteoporosis. A pregnant woman or who is planning to be pregnant is advised not to take vitamin A in large quantities – it may harm your fetus;
  • higher dosage of vitamin B3 continuously during a long period may lead to liver damage;
  • higher usage of vitamin B6 may cause nerve damage;
  • large dosage of vitamin C can cause stomach pain and diarrhoea which may lead to kidney stones.

This is not a detailed list. When medicating with Truvada, don’t take vitamins in large quantities. A doctor should give you the recommended dosage of vitamin to avoid unwelcome side effects that may harm your health.

Interactions with Essential Oils

Essential oils contain organic compounds such as phenylpropanoids, terpenoids, and polyphenols which can contribute to our body immune defenses resulting in our improved health. Them most commonly checked essential oil are those from grapefruit oil and other citrus oils but research shows that these oils have much lower likeliness of causing serious interaction with Truvada.

Essential oils (for example lavender, eucalyptus, tea tree oil, peppermint, patchouli, etc.) has no indications to interact with Truvada. You may continue to use these oils while under Truvada medication.

🌿What About Herbs?

Most patients with HIV use vitamins and other food supplements to strengthen their immune system. Before using any mineral, vitamins or herbal supplement, talk to your doctor first. There are some risks involves especially when used in large amounts.

Nutritional supplements can slow HIV progression although there is no reliable research benefit associated with this. Some herbal medicines can interact with HIV meds lowering its effectiveness in fighting the virus.

There are very few known potential herbal interactions with Truvada.

Some interactions include:

  • African potato herb affects NNRTIs and protease inhibitors causing inadequate anti-HIV drug getting into the blood;
  • garlic supplements decrease the anti-HIV drug blood concentrations by affecting (or even stopping) the proper processing of protease inhibitors;
  • St John’s Wort is known to lower or impact blood levels of all NNRTIs and protease inhibitors so should not be used when administering Truvada or any other anti-HIV pills;
  • sutherlandia is an herb known to interact with NNRTIs and protease inhibitors.

There are other herbals that have the potential to interact with Truvada including horny goat weed. Your doctor can give you more information on any herbs you’re using.

🍏Food Interactions

We eat various kinds of foods which may contain an active substance that might interact with the medication we take. Various drug interaction with foods is common and your medical specialist can give you detailed information on how to safely take foods with Truvada.

Truvada is favorable to most foods. Although there are minor drug interactions, it doesn’t cause any serious harm or needs a change in therapy. In case you suspect a certain food causes some effects, call your doctor for immediate advice. Fatty meals are known to slow down the absorption rate of tenofovir in the body which means more time is needed for it to be effective.

🥃Can I Take Alcohol with This Drug?

Higher consumption of alcohol raises the risk of developing a wide range of cancer-related diseases, stroke and cardiovascular disease. This condition is increased in patients living with HIV and they’re more likely to be in a state of mortality and physiologic frailty [5].

Drug interactions with alcohol is common as it’s known to alter body processes affecting the functionality of some drugs. There is no evidence if taking alcohol in small amounts has effects on Truvada. If possible, quit drinking alcohol in order to increase your health and strengthen your immune system.

📝Other Most Frequent Checked Truvada

Aspirin is another drug commonly tested for drug interactions with HIV/AIDS meds. It’s used to treat various conditions including aseptic necrosis, kawasaki disease, pain, juvenile rheumatoid arthritis (meloxicam is also used to treat this condition), controlling of thromboembolism in atrial fibrillation and more. Aspirin and its drug variations have no known effect on Truvada medication.

Zocor, a drug used to lower cholesterol and some types of fats in the blood is known to highly interact with drug medications for liver, rhabdomyolysis, and renal dysfunction conditions. There is no drug interaction with Truvada. It’s advisable to let your doctor recommend if it’s best to use depending on your health condition.

Harvoni moderately interacts with Truvada as it contains ledipasvir which can raise the blood levels of tenofovir. Don’t combine any drug containing ledipasvir with Truvada tablets as may lead to increased side effects which may further harm your health.

Combining birth control meds with pre-exposure prophylaxis drugs can react with Truvada but has no adverse effect on your health. The only ARV that may cause problems if combined with such forms of birth control is Sustiva, which is included in Atripla [6].

Furthermore, ethinyl estradiol drug can interact with HIV pills making the tablets less effective and increase the chances of pregnancy.

Your doctor should give you informed medical analysis before administering Truvada. There is no sufficient data if drugs such as Diamox (acetazolamide), Flonase, acyclovir, CBD, metformin, and Synthroid can cause drug interactions if combined with Truvada. This does not mean it doesn’t interact with Truvada.

📜The Bottom Line

There are other major drug interactions with Truvada including Advil, Kaletra, and Aleve (may cause kidney complications), ibuprofen, atripla (a moderate effect which may cause liver problems) and much more.

It’s always advisable to consult your doctor to fully access your health status prior to using Truvada for HIV treatment. A doctor is keen enough to spot even the unexpected drug interactions based on the drugs you’re using.

List all the drugs you’ve been using and let him know of your health status – maybe you’ve had a major illness and you’ve been using some drugs which might affect the functionality of Truvada.

Whenever you experience any adverse effect, don’t stop medications without your doctor’s approval. First, seek medical assistance from your doctor. The doctor may recommend medical adjustment or any other medical alternative.

📚References:

  1. “WHO Model List of Essential Medicines (19th List)” (PDF). World Health Organization. April 2015.
  2. Truvada (emtricitabine / tenofovir) Disease Interactions. Drugs.com.
  3. Drug Interactions with Antiretroviral Medications. National HIV Curriculum (hiv.uw.edu). Self-Study Module. John J. Faragon, PharmD, BCPS, AAHIV-P, Rebecca G. Kinney, MD. June 12th, 2017.
  4. Raltegravir, tenofovir DF, and emtricitabine for postexposure prophylaxis to prevent the sexual transmission of HIV: safety, tolerability, and adherence. Mayer KH1, Mimiaga MJ, Gelman M, Grasso C. J Acquir Immune Defic Syndr.(2012).
  5. Drugs, Alcohol, and HIV: Entire Lesson. Hiv.va.gov.
  6. Birth Control and HIV. Thewellproject.org. Retrieved on April 3, 2019.
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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