Home Drug Guide Emtricitabine

Drug Guide

Generic Name

Emtricitabine

Brand Names Emtriva

Classification

Therapeutic: Antiretroviral agent, nucleoside reverse transcriptase inhibitor (NRTI)

Pharmacological: Nucleoside analogue

FDA Approved Indications

  • Treatment of HIV-1 infection in adults and children ≥3 months of age

Mechanism of Action

Emtricitabine is a nucleoside reverse transcriptase inhibitor that works by incorporating into viral DNA and terminating the DNA chain, thereby suppressing viral replication.

Dosage and Administration

Adult: 200 mg once daily, orally

Pediatric: Children 3 months and older: 2 mg/kg once daily (up to 200 mg), orally

Geriatric: Use with caution; no specific dose adjustment required but consider renal function

Renal Impairment: Dose adjustment required based on renal function; typically 200 mg every 48-72 hours depending on degree of impairment

Hepatic Impairment: Use with caution; no specific dose adjustment

Pharmacokinetics

Absorption: Rapidly absorbed after oral administration with high bioavailability (~93%)

Distribution: Wide distribution; cerebrospinal fluid concentrations approximately 70% of plasma levels

Metabolism: Minimal metabolism; primarily excreted unchanged

Excretion: Renal excretion; via glomerular filtration and active tubular secretion

Half Life: 10 hours

Contraindications

  • Known hypersensitivity to emtricitabine or any component of the formulation

Precautions

  • Renal impairment: reduce dose accordingly
  • Lactic acidosis and hepatic steatosis risk, particularly in patients with advanced liver disease or mitochondrial DNA depletion syndrome
  • Hepatitis B virus co-infection: incomplete HBV suppression may lead to flare upon discontinuation; consider monitoring and treatment as appropriate

Adverse Reactions - Common

  • Headache (Common)
  • Nausea (Common)
  • Fatigue (Common)
  • Dizziness (Common)

Adverse Reactions - Serious

  • Lactic acidosis (Rare)
  • Hepatic enzyme elevations, hepatitis (Rare)
  • New or worsening renal impairment (Rare)
  • Severe skin reactions (Rare)

Drug-Drug Interactions

  • Emtricitabine is compatible with many HIV medications; avoid in patients taking drugs that affect renal excretion or cause mitochondrial toxicity without proper monitoring

Drug-Food Interactions

  • No significant food interactions known

Drug-Herb Interactions

  • Limited data; caution with herbal products affecting liver or renal function

Nursing Implications

Assessment: Monitor renal function (serum creatinine, BUN), liver function tests, and viral load

Diagnoses:

  • Risk for ineffective tissue perfusion (renal or hepatic)
  • Knowledge deficit regarding medication adherence

Implementation: Administer orally once daily with or without food. Ensure patient adherence to therapy and regular monitoring.

Evaluation: Regularly assess viral load and CD4 counts to evaluate efficacy; monitor for adverse effects

Patient/Family Teaching

  • Take medication exactly as prescribed, at the same time daily
  • Report symptoms of lactic acidosis (malaise, myalgia, respiratory distress), severe skin reactions, or any unusual symptoms immediately
  • Maintain regular follow-up appointments for lab tests and clinical assessment

Special Considerations

Black Box Warnings:

  • Lactic acidosis and severe hepatomegaly with steatosis
  • Exacerbation of hepatitis B upon discontinuation

Genetic Factors: No specific genetic markers influencing response known

Lab Test Interference: May cause false elevations in serum aminotransferase levels

Overdose Management

Signs/Symptoms: Nausea, vomiting, increased risk of lactic acidosis, hepatic toxicity

Treatment: Supportive care; no specific antidote. Hemodialysis may be considered in severe cases due to renal elimination.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F). Keep container tightly closed.

Stability: Stable up to the expiration date listed on the package.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.