Used For:

• HIV-1 InfectionAs part of combination antiretroviral therapy (ART)Used with a third agent (e.g., dolutegravir, bictegravir, rilpivirine, boosted protease inhibit

Contraindications:

• Do not use in:Known hypersensitivity to emtricitabine or tenofovir alafenamideSevere renal impairmenteGFR <30 mL/min (unless on hemodialysis under specialist care)Untreated hepatitis B (HBV) without monitoring(risk of severe HBV flare if stopped suddenly)

Side Effects:

• Common Side EffectsUsually mild and well tolerated:GastrointestinalNauseaDiarrheaAbdominal discomfortCNSHeadacheFatigueDizzinessOthersMild weight gainIncreased cholesterol or triglycerides (TAF-related)Serious (Rare) Side EffectsLactic acidosis (very rare, class effect of NRTIs)Severe liver toxicityHBV reactivation after stopping drug in co-infected patientsRenal dysfunction (much less than TDF)Bone density loss (significantly lower risk than TDF)

Precautions:

• Baseline tests required before starting:HIV viral load & CD4 countRenal function (serum creatinine, eGFR)Liver function testsHBsAg (Hepatitis B screening)Do NOT stop abruptly in patients with hepatitis BUse cautiously in:Liver diseaseElderly patientsPatients on nephrotoxic drugsDrug interactions:Rifampicin, carbamazepine, phenytoin → ↓ TAF levelsAlways review ART combinations

Dietary Restrictions:

• ✔ Can be taken with or without food✔ Maintain adequate hydration❌ Avoid alcohol (↑ liver toxicity risk)✔ Balanced diet recommended❌ Avoid herbal supplements without consultation (e.g., St. John’s wort)