Truvada

Combination product

Pronunciation: em-tri-SIT-a-been and ten-OF-oe-veer (troo-VAH-da)

Combination of Emtricitabine and Tenofovir.

Each component keeps its own pharmacology page; the combination itself adds no new mechanism.

Truvada mascot — mnemonic cartoon — Visual mnemonic: Truvada mascot
**“True Vader”**

Components (2)

Emtricitabine ballicule — decagon mechanism diagram — Emtricitabine

Tenofovir ballicule — decagon mechanism diagram — Tenofovir

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Severe acute HBV exacerbations reported after discontinuation in HBV-infected individuals (monitor hepatic function ≥several months; anti-HBV therapy may be warranted). For PrEP: prescribe only to confirmed HIV-negative individuals (test immediately before and at least q3mo during use); drug-resistant HIV-1 has emerged when PrEP was used during undetected acute HIV-1 infection.

FDA dosing	Population	Start	Target	Max
HIV-1 treatment (with other antiretrovirals)	Adults & peds ≥35 kg	1 tab (FTC 200 mg/TDF 300 mg) QD, with or without food	Same	1 tab QD
HIV-1 treatment (with other antiretrovirals)	Peds 17 to <35 kg (able to swallow tablet)	Weight-tiered low-strength tab QD: 17–<22 kg: 100/150 mg; 22–<28 kg: 133/200 mg; 28–<35 kg: 167/250 mg	Same; monitor weight and adjust	1 tab QD per tier
HIV-1 pre-exposure prophylaxis (PrEP)	HIV-negative adults & adolescents ≥35 kg	1 tab (FTC 200 mg/TDF 300 mg) QD, with or without food	Same	1 tab QD

Renal Treatment: CrCl ≥50 no adjustment; CrCl 30–49 1 tab q48h (monitor closely); CrCl <30 or hemodialysis not recommended. PrEP: not recommended if CrCl <60. No pediatric renal-dosing data

Hepatic Undefined

Renal dosing intervals use CrCl calculated with ideal (lean) body weight

Instructions

Test for HBV before or when initiating
Assess serum creatinine, estimated CrCl, urine glucose and protein before initiation and during use (plus serum phosphorus in CKD)
PrEP: confirm HIV-negative immediately before starting, at least q3mo during use, and on diagnosis of any STI; do not start with signs/symptoms of acute HIV-1 unless negative status confirmed
PrEP: use as part of comprehensive prevention strategy; effectiveness strongly correlated with daily adherence

Available strengths

tab 100/150, 133/200, 167/250, 200/300 mg

Contraindications

PrEP: unknown or positive HIV-1 status

Cautions

Severe acute HBV exacerbation on discontinuation in HBV-infected individuals — monitor months after stopping
PrEP in undetected HIV-1 infection selects drug resistance — TRUVADA alone is not a complete treatment regimen
New or worsening renal impairment incl. acute renal failure and Fanconi syndrome; avoid concurrent/recent nephrotoxic agents (e.g., high-dose/multiple NSAIDs)
Bone mineral density decreases and mineralization defects (osteomalacia with proximal renal tubulopathy); consider BMD assessment with fracture history/osteoporosis risk
Lactic acidosis/severe hepatomegaly with steatosis, incl. fatal cases — suspend if suspected
Immune reconstitution syndrome (HIV-1 treatment)

Adverse reactions

Treatment (≥10%): diarrhea, nausea, fatigue, headache, dizziness, depression, insomnia, abnormal dreams, rash
PrEP (>2% and > placebo): headache, abdominal pain, weight decreased
Skin hyperpigmentation (FTC, 3%)

Pregnancy APR observational data: no increased risk of major birth defects (FTC 2.3%, TDF 2.1% vs 2.7% background); for at-risk women, consider continuing/initiating PrEP during pregnancy (HIV acquisition risk rises in pregnancy)

Lactation HIV-1 treatment: do not breastfeed (CDC — HIV transmission risk). PrEP: weigh benefits/risks; do not breastfeed if acute HIV-1 suspected; FTC detectable (low) in infant plasma, tenofovir undetectable

Cost

Truvada

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $/mo	CostPlus
100/150 mg	tab	30 qd	$305.83	out of stock
133/200 mg	tab	30 qd		offered
167/250 mg	tab	30 qd		offered
200/300 mg	tab	30 qd	$15.87	offered

Part D rank #265.

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