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How Does Truvada Work and How to Take it Properly

Truvada is a fixed-dose combination pill that combines two drugs: emtricitabine and tenofovir disoproxil fumarate to fight human immunodeficiency virus (HIV)—the virus that causes AIDS. This medication is being manufactured by the research-based biopharmaceutical company Gilead Sciences, the same company that brought Atripla, Genvoya, Viread, and other game changer HIV drugs in the market.

Truvada in a nutshell

What makes Truvada different from other antiretroviral therapies (ART)? The drug is recommended by the Department of Health and Human Services HIV guidelines for treatment naïve patients. It is also the only ART approved by the FDA for pre- and post-exposure prophylaxis. Simply put, aside from treating existing HIV infection, it can also prevent patients from contracting the virus should they get exposed. Preventive methods are extremely important in managing HIV because infected individuals with undetectable viral load are less likely to transmit the virus. If all people living with HIV will take ART and everyone who are anticipating possible exposure to the virus will take prophylaxis meds, the chances of infecting other people will be greatly reduced. We will be discussing how the two blockbuster drugs in Truvada combat HIV-1 infection. As mentioned previously, Truvada contains two NRTIs or nucleoside/nucleotide analog reverse transcriptase inhibitors. These drugs have been the cornerstones of HIV therapy since the discovery of the disease. Dual NRTIs play a central role in slowing HIV progression. It has been found to suppress the effects of the virus for long period of time, resulting in plummeting numbers of HIV infection and AIDS-related deaths.

How do NRTIs work?

NRTIs work by preventing the virus from reproducing. HIV makes copies of itself by infecting the immune cells called CD4 T-cells. When you are exposed to the virus, HIV copies its own genetic code into your immune cell’s DNA. If this process succeeds, your cells will be forced to create more copies of the virus. But HIV’s genetic code is in the form of RNA, which has to be converted to DNA to create an infection. The enzyme reverse transcriptase is crucial in performing this process. Antiretroviral agents all work by disrupting viral replication. In the case of NRTI drugs, also known as nukes, it contains faulty nucleotides that the enzyme needs to convert HIV RNA to DNA. This prevents the enzyme from building correct DNAs, thus stopping viral replication.

Emtricitabine (Emtriva) is a nucleoside reverse transcriptase inhibitor, while tenofovir (Viread) is a nucleotide analogue. Their mechanisms of action are the same that’s why they belong to the same drug class. The only difference is that nucleoside analogues have to undergo phosphorylation process to be active in the body. Tenofovir, being a nucleotide analogue, is already chemically activated so it doesn’t need to undergo phosphorylation.

How to take Truvada?

Antiretroviral medications transformed HIV from a dreaded lethal infection to a manageable chronic disease, but the wonders of anti-HIV drugs are useless if they are not taken the right way. For a successful treatment outcome, you have to follow your healthcare provider’s instructions seriously. According to the manufacturer’s website, there are three important things to know when taking Truvada: (1) Take the drug as prescribed by your doctor, (2) Take Truvada with or without meals, and (3) Take it at the same time each day.

Additional tips;

  • Each bottle of Truvada contains 30 pills, which need to be taken for 30 consecutive days.
  • Missing a dose or taking more pills a day could be harmful.
  • You can take this drug even when you had a drink or planning to drink alcohol during the day.
  • You need to take Truvada continuously for a week before there is enough medication in your body to protect you from HIV during anal sex.
  • You need to take Truvada continuously for 30 days before there is enough medication in your body to protect you from HIV during vaginal exposure.
  • Place your medication bottle in an area where it can be easily seen, so you’ll remember to take it on time.
  • Always take an extra pill when you’re outside your home or travelling, especially if you might stay over in someone else’s place.
  • Sharing your meds to friends and family can harm them.
  • Keep your medication bottle at room temperature, away from direct sunlight and freezing temperature.

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