Used For:

• HIV Pre-Exposure Prophylaxis (PrEP)

Contraindications:

• Known hypersensitivity to tenofovir or emtricitabineSevere renal impairment (CrCl < 30 mL/min)Uncontrolled hepatitis B without monitoring (risk of flare after stopping)Bone diseases like osteoporosis (use with caution)Concomitant use of nephrotoxic drugs (e.g., high-dose NSAIDs, aminoglycosides)

Side Effects:

• CommonHeadache, dizzinessNausea, vomitingDiarrheaFatigueSkin darkening or discoloration (FTC-related)Less CommonReduced kidney functionDecreased bone mineral density / bone painLactic acidosis (rare)Liver enzyme elevationHepatitis B flare after stopping treatmentSerious but rareLactic acidosis with liver enlargementSevere renal failure / Fanconi syndromeOsteomalacia (bone softening)

Precautions:

• Baseline and periodic renal function tests (creatinine, eGFR, urinalysis) are required.Monitor liver function, especially in HBV-positive patients.Ensure HIV test is negative before starting PrEPStarting Tenof-EM in HIV-positive individuals without full ART can lead to resistance.Do not stop suddenly if co-infected with Hepatitis B — risk of severe flare.Monitor bone health in long-term therapy.Maintain strict daily adherence for PrEP effectiveness.

Dietary Restrictions:

• No strict food restrictions → can be taken with or without food.Taking with food may reduce stomach upset.Avoid alcohol (can worsen liver strain).Maintain adequate hydration (helps protect kidneys).Avoid high-dose NSAIDs (increase nephrotoxicity risk).Supplement calcium + vitamin D if bone density is low (as advised).