Tenofovir Alafenamide and Emtricitabine Tablets (Descovy) is a fixed-dose combination preparation composed of emtricitabine and tenofovir alafenamide. It is used for the treatment of HIV-1 infection and pre-exposure prophylaxis (PrEP) in specific populations.

Precautions for Administration of Tenofovir Alafenamide and Emtricitabine Tablets (Descovy)

Pre-Administration Assessment and Contraindication Confirmation

A comprehensive assessment of the patient must be conducted before initiating Tenofovir Alafenamide and Emtricitabine Tablets.

This medicine contains emtricitabine, and patients with hepatitis B may experience severe acute exacerbation of hepatitis after discontinuing the drug.

Before administration, it is necessary to detect hepatitis B virus markers, and strengthen liver function monitoring for patients infected with hepatitis B.

When used as pre-exposure prophylaxis (PrEP) for HIV-1, Tenofovir Alafenamide and Emtricitabine Tablets are strictly prohibited for individuals with unknown HIV status or confirmed HIV-1 infection; otherwise, it may induce the emergence of drug-resistant virus strains.

If a patient presents with symptoms of acute HIV-1 infection, such as fever, fatigue, and rash, the drug can only be initiated after confirming that the patient is HIV-negative.

Dosage and Administration

The recommended dosage for adults and adolescents with a body weight of ≥35 kg is one 200mg/25mg tablet once daily.

Pediatric patients with a body weight of 25 kg to <35 kg use the same specification (200mg/25mg tablets), while those with a body weight of 14 kg to <25 kg should use 120mg/15mg tablets.

There is no strict restriction on taking the medicine before or after meals, but it is necessary to maintain regular daily administration.

Pre-exposure prophylaxis (PrEP) for HIV-1: Only applicable to adults and adolescents with a body weight of ≥35 kg, taking one 200mg/25mg tablet each time, once daily.

For patients with renal insufficiency, Tenofovir Alafenamide and Emtricitabine Tablets are not recommended for those with a creatinine clearance rate of 15 to 30 mL/min, or for patients with end-stage renal disease who do not receive regular hemodialysis.

Medication Monitoring for Tenofovir Alafenamide and Emtricitabine Tablets (Descovy)

Baseline Assessment and Regular Testing

Serum creatinine and estimated glomerular filtration rate: All patients need to undergo serum creatinine, urine glucose, and urine protein tests before medication administration and at clinically appropriate time points.

Patients with chronic kidney disease also need to monitor blood phosphorus levels.

Dynamic Screening of HIV Infection Status

When Tenofovir Alafenamide and Emtricitabine Tablets are used for pre-exposure prophylaxis (PrEP), HIV testing must be performed before medication administration and once every 3 months during the medication period. Additionally, screening should be strengthened when diagnosing other sexually transmitted infections.

Special Monitoring for Adverse Reactions

Renal toxicity monitoring: Special attention should be paid to potential risks of renal injury, including acute renal failure, proximal renal tubular dysfunction, and Fanconi syndrome. Enhanced monitoring is particularly required when patients are concurrently using nephrotoxic drugs.

Assessment of Metabolic Indicators and Bone Health

For long-term medication use, it is necessary to monitor changes in blood lipids and bone mineral density.

Clinical trials have shown that some patients may experience a decrease in bone mineral density in the lumbar spine or hip, and clinical evaluation of long-term effects is required.

Key Terminology Notes (for Clarity in Medical Context)

Fixed-dose combination preparation: A pharmaceutical product containing two or more active ingredients in a single, pre-measured dosage form, ensuring convenient and accurate administration.

Pre-exposure prophylaxis (PrEP): A preventive strategy where individuals at high risk of HIV infection take antiretroviral drugs regularly to reduce the risk of acquiring HIV.

Creatinine clearance rate: A clinical indicator used to assess renal function, reflecting the kidneys' ability to filter creatinine (a waste product) from the blood.

Fanconi syndrome: A rare renal disorder characterized by impaired reabsorption of various substances (e.g., glucose, amino acids, electrolytes) in the renal tubules, potentially leading to electrolyte imbalances and bone disease.