Emtriva – brand name

emtricitabine – generic name

FTC – other name

Emtriva belongs to a class of HIV drugs called nucleoside reverse transcriptase inhibitors (NRTIs), also known as nucleoside analogs or “nukes.”

Emtriva is very similar to another NRTI called Epivir (lamivudine or 3TC).

Emtriva and the other NRTIs block reverse transcriptase, a protein that HIV needs to make more copies of itself. This may slow down HIV disease.

The Food and Drug Administration (FDA) has approved Emtriva for use in combination with other HIV drugs for the treatment of HIV infection in adults and children more than three months old.

Emtriva comes in:

• 200 milligram (mg) capsules

• Liquid

The usual dose for adults is one 200 mg capsule once a day.

Check with your child’s doctor for children’s dosing.

If you have a kidney problem, your dose of Emtriva may need to be lowered.

Emtriva must be used with other HIV medications to treat HIV.

You can take Emtriva with food or on an empty stomach, but taking it with food may cut down on nausea or other side effects.

Some people use Emtriva in a combination pill called Truvada, which contains Emtriva plus Viread (tenofovir).

Emtriva is one of the easiest HIV drugs to take—you take one pill, once a day. Once-daily drugs are convenient but more demanding, because good adherence is crucial. Missing or skipping doses can cause your blood levels of the drug to fall too low and resistance can develop. When your virus becomes resistant to an HIV medication, that drug may stop working.

Emtriva can be used if you are beginning treatment for the first time.

It is not yet clear whether Emtriva is a good option for people who are switching from other HIV drugs that no longer work:

• Emtriva probably will not work as well if your HIV is already resistant to Epivir or Ziagen (abacavir)
• Emtriva may still work if your HIV is resistant to Zerit (stavudine or d4T), Retrovir (zidovudine or AZT), or Videx EC (didanosine or ddI)

Your doctor can run a resistance test to help determine whether Emtriva is likely to work for you.

If your virus develops resistance to Emtriva then it may stop working or not work as well for you. You also may not get as much benefit from the other NRTIs.

Sometimes taking more than one medication can cause drug interactions. To date no drug interactions have been identified between Emtriva and other medications. However, this does not mean that interactions will not be discovered in the future.

Emtriva should not be combined with Epivir or drugs that contain Epivir (Epzicom, Combivir, or Trizivir) because there is no added benefit.

Be sure your doctor knows about all the medications you are taking (including over-the-counter, prescription, street drugs, and herbs), even if you only use them occasionally.

For more information and additional resources to check interactions between the particular drugs you are taking, see our info sheet on drug interactions.

So far it seems that most people find Emtriva easy to tolerate, but it is possible that uncommon long-term side effects could show up later.

If you do experience any side effects from Emtriva, they are likely to be temporary and go away as your body adjusts to the medication. If you experience any of the side effects listed below, call your doctor for advice. Do not just stop taking your medication.

• Diarrhea
• Nausea
• Headaches
• Skin rash
• Skin discolorations

More serious side effects:

• An increase of lactic acid in the blood ( lactic acidosis), an enlarged and fatty liver, and liver failure have been reported in people using NRTIs. Lactic acidosis is a rare but potentially fatal side effect. Symptoms include nausea, vomiting, or stomach pain; feeling very weak and tired; shortness of breath.
• Lipodystrophy, which may include elevated blood sugar (glucose), elevated lipid levels ( cholesterol and triglycerides), and fat gain or loss in certain areas. The exact causes of lipodystrophy are not known, but may include HIV and/or HIV drugs. It is unclear if Emtriva will cause or impact symptoms of lipodystrophy. For more information on lipodystrophy, see our info sheet.

If you are experiencing persistent, unusual, or serious side effects, call your doctor right away.

Emtriva has been studied in both men and women. Its effectiveness and side effects seem very similar in both men and women.

• Emtriva was approved based on studies showing that it worked better or at least as well as other NRTIs. Study 301A included 571 participants who had not taken HIV drugs before, including 15 percent women, or about 85 women.
• In this study, Emtriva plus Videx plus Sustiva (efavirenz) worked better than Zerit plus Videx plus Sustiva, with 81 percent of those taking Emtriva and 68 percent of those taking Zerit achieving HIV viral loads below 400 copies.
• Study 303 compared Emtriva and a similar drug, Epivir, in people who were already taking HIV drugs. This study included 14 percent women, or about 61 women out of 440 total participants. In this trial, Emtriva and Epivir worked about equally well in people who were also taking Zerit or Retrovir plus a protease inhibitor.

In terms of side effects, research has shown that the pharmacokinetics of Emtriva (how the drug is processed by the body) are similar in women and men. But past studies of medical records indicate that women (especially overweight women) taking NRTI drugs are more likely than men to develop elevated lactic acid levels and enlarged fatty livers.

Studies have shown that pregnant women who use HIV drugs can greatly reduce the risk of passing HIV on to their babies. There have been no formal studies on the use of Emtriva during pregnancy. Check with your doctor about the best treatment options for you and your baby if you are thinking of getting pregnant.

Click this link for more information about pregnancy.

Emtriva works against the hepatitis B virus (HBV), however it is not yet approved for hepatitis B treatment. Get tested for hepatitis B before you start taking Emtriva to treat HIV.

If you are co-infected with both viruses, speak to your doctor about treatment options. In addition, if you are co-infected and taking Emtriva for HIV treatment, discontinuing the drug may result in worsening hepatitis symptoms.  If you stop Emtriva, you need close medical follow-up for several months after stopping treatment with Emtriva. Follow-up includes medical exams and blood tests to check for HBV that is getting worse. “Flare-ups” of HBV infection, in which the disease suddenly gets worse, can occur if you stop taking Emtriva.

People who are starting HIV treatment for the first time may develop Immune Reconstitution Syndrome or IRS (also called Immune Reconstitution Inflammatory Syndrome or IRIS). IRS can happen as a result of the immune system getting stronger and responding to an HIV-related infection such as Mycobacterium avium infection (MAC), cytomegalovirus (CMV), Pneumocystis jirovecii pneumonia (PCP), or tuberculosis (TB). People may have been treated for these infections in the past or not even know they have them. If you notice any unusual symptoms soon after starting HIV drugs for the first time, let your doctor know right away so you can be evaluated and, if necessary, treated.