Trustiva

Trustiva belongs to the class of antiretroviral medications used as a triple combination against HIV-1 infected patients over 12 years of age. Trustiva consists of three molecules tenofovir disoproxil fumarate (TDF) 300 mg, Efavirenz (EFV) 600 mg and Emtricitabine (FTC) 200 mg, indicated as a complete regimen. The molecules are mixed in a fixed-dose combination (FDC). The FDC drug is not used for complete cure of HIV but prevents the virus from multiplying in the system.

Trustiva (TDF 300 mg + EFV 600 mg + FTC 200 mg) is taken orally once daily on an empty stomach at bedtime for avoiding instances of unnecessary nervous system symptoms. It is recommended in patients with at least 40 kgs of body weight. In few cases, if patients weigh more than 50 kgs and rifampin is co-administered along with Trustiva (TDF 300 mg + EFV 600 mg + FTC 200 mg), 200 mg/day of efavirenz is added. Trustiva (TDF 300 mg + EFV 600 mg + FTC 200 mg) is strictly prohibited in patients with kidney problems (renal impairment with creatine clearance below 50 mL/min).

Additional properties of Trustiva (TDF 300 mg + EFV 600 mg + FTC 200 mg):

Characteristics	TDF 300 mg	EFV 600 mg	FTC 200 mg
Absorption in the system	1 hour and 40 minutes	3 to 5 hours	1 to 2 hours
Binding with viral cells	–	Binding affinity- 99.5 to 99.7%	–
Bioavailability	25%	–	93%
Time for eliminating 50% of drug	17 hours	52- 76 hours	10 hours

Warnings related to Trustiva (TDF 300 mg + EFV 600 mg + FTC 200 mg):

• The FDC drug is not used in EFV-allergic patients (hypersensitivity) as it may cause toxic skin problems (Stevens-Johnson syndrome or erythema multiforme)
• Trustiva (TDF 300 mg + EFV 600 mg + FTC 200 mg) is not recommended along with certain drugs including some prescribed, non-prescribed, vitamins, calcium and herbal supplements
• Administration of antiretrovirals may cause long-term health complications due to the accumulation of body fat
• Trustiva (TDF 300 mg + EFV 600 mg + FTC 200 mg) might also lead to excessive production of lactic acid in the blood or hepatotoxicity (hepatomegaly with steatosis) with symptoms like dark urine, yellow-colored skin or eyes, loss of appetite, sickness (nausea) and pain in the stomach area, tiredness, irregular heartbeats or breathing, dizziness and cold hands or legs
• Hepatitis B viral infection testing is very crucial before the administration of antiretroviral therapy
• If patients are taking or had recently used nephrotoxic agents, administering Trustiva (TDF 300 mg + EFV 600 mg + FTC 200 mg) may cause kidney dysfunctions (Acute renal failure and Fanconi syndrome)
• Close monitoring of bone mineral density (due to TDF) should be carried out for avoiding bone fractures, osteoporosis-related symptoms, or bone loss
• In few cases, there are chances of procuring neuro-psychotic symptoms including severe anxiety and depression, aggressive behavior, delusions and psychosis-like symptoms occurring due to EFV. Consult your doctor immediately if such symptoms are witnessed
• Trustiva (TDF 300 mg + EFV 600 mg + FTC 200 mg) is not recommended in pregnancy as it might harm the fetus

Side-effects of Trustiva (TDF 300 mg + EFV 600 mg + FTC 200 mg):

The most common side-effects associated with Trustiva (TDF 300 mg + EFV 600 mg + FTC 200 mg) are headache, difficulty in sleeping and concentrating, unusual dreams and drowsiness. However, these side-effects are reduced if the drug is taken at bedtime on an empty stomach for a few weeks.

Other side effects:

• Skin rashes
• Tiredness (Fatigue)
• Diarrhea with upset stomach, gas and vomiting
• Increased hump-like body fat in the upper back and neck
• Discoloration of the skin with spots and freckles
• Swelling of face, lips, tongue or throat
• Shortness of breath (Dyspnea)
• Indigestion
• Weakness
• Inflammation of pancreas

Note: These are not all side-effects of Trustiva (TDF 300 mg + EFV 600 mg + FTC 200 mg), consult your doctor if you have any additional queries related to the side-effects of the drug.