Truvada

Not for treating chronic HBV infection; test for HBV before starting therapy and closely monitor patients co-infected with HBV and HIV for several months after stopping treatment (discontinuing therapy may exacerbate HBV infection); if appropriate, initiate anti-hepatitis B therapy may be warranted (esp. in those with advanced liver disease or cirrhosis). Risk of drug resistance with use for PrEP in undiagnosed HIV-1 infection. Do not initiate for PrEP if signs/symptoms of acute HIV infection present; use approved test and confirm negative status prior to initiation, at least every 3 months during therapy, and upon diagnosis of any other STIs. Counsel patients about safer sex practices. Suspend therapy if lactic acidosis or pronounced hepatotoxicity (eg, hepatomegaly, steatosis) occurs. Monitor CrCl, serum creatinine, serum phosphorus (in CKD patients), urine glucose, urine protein prior to and during therapy in all patients. History of pathologic fracture or risk factors for osteoporosis or bone loss: consider monitoring bone mineral density (BMD); calcium/vitamin D supplement may be beneficial. Pregnancy. Nursing mothers: not recommended.