Discontinue use if hypersensitivity reactions occur. Concomitant use w/ other cytidine analogues eg, emtricitabine, adefovir dipivoxil; integrase class resistance; nephrotoxic drugs (eg, aminoglycosides, amphotericin B, foscarnet, ganciclovir, pentamidine, vancomycin, cidofovir or interleukin-2); drugs that reduce exposure (eg, Mg/Al-containing antacid, Fe & Ca supplements, multivit & inducing agents, etravirine, tipranavir/ritonavir, rifampicin, St. John's wort & certain antiepileptics); metformin; didanosine. Patients w/ severe liver disease; chronic hepatitis B or C; CrCl <50 mL/min or serum phosphate <1 mg/dL. Discontinue use in patients co-infected w/ HIV & HBV; closely monitor for at least 4 mth after discontinuation of therapy. Monitor liver biochemistries in patient w/ hepatitis B &/or C co-infection. Bone abnormalities associated w/ proximal renal tubulopathy. Lactic acidosis; lipodystrophy; immune reactivation syndrome. Mitochondrial dysfunction. Discontinue immediately if pancreatitis occur. Opportunistic infections. Osteonecrosis in patients w/ advanced HIV-disease &/or long-term exposure to CART. Galactose intolerance eg, galactosaemia, Lapp lactase deficiency or glucose-galactose malabsorption. May affect ability to drive & use machinery. Pregnancy & lactation. Avoid use at the time of conception through 1st trimester of pregnancy.
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