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Author Topic: No NSAIDs With Tenofovir?  (Read 3517 times)

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Offline Inchlingblue

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No NSAIDs With Tenofovir?
« on: July 07, 2009, 02:01:28 PM »
Tenofovir-related acute kidney injury and proximal tubule dysfunction precipitated by diclofenac: a case of drug-drug interaction.

Morelle J, Labriola L, Lambert M, Cosyns JP, Jouret F, Jadoul M.
Department of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.

We describe an HIV1-positive patient under long-term tenofovir treatment who developed a severe, biopsy-proven, acute tubular necrosis with proximal tubule (PT) dysfunction, precipitated by the very recent start of diclofenac, a nonsteroidal antiinflammatory drug (NSAID). Recent studies show that NSAIDs not only alter glomerular filtration but also multidrug resistance protein (MRP) 4-mediated PT secretion of several substrates. Since the patient tolerated tenofovir well for several years prior to diclofenac use, our observation suggests that diclofenac interfered with tenofovir clearance, thereby favoring its nephrotoxicity. NSAIDs should be avoided in patients under tenofovir.


Aspirin, Ibuprofen (Advil) and Naproxen (Aleve) are considered to be NSAIDs.

I guess acetaminophen (Tylenol) is not an NSAID?

My personal "take home" message here, for whatever it's worth is, if taking Tenofovir (Viread), go easy on any of these pain relievers, especially the NSAIDs, maybe even avoid them altogether if possible. I have a friend who pops these things like Tic Tacs.

LINK:

http://www.ncbi.nlm.nih.gov/pubmed/19473619
« Last Edit: July 08, 2009, 12:24:59 PM by Inchlingblue »

Offline risred1

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Re: No NSAIDs With Tenofovir?
« Reply #1 on: July 07, 2009, 03:45:04 PM »
Tenofovir is also in Truvada and Atripla...

that said, isn't it a premature to throw all NSAID's under the bus... VIOX was a NSAID, but others are not showing the same issues that VIOX as aligned with. taking aleve or over the counter pain relief like tic tacs isn't moderation in my book, but there may be good reason for it, but we all have to think about drug interaction now don't we.

Moderation in all things as a rule, and of course caution where indicated.

risred1 - hiv +
02/07 CD4 404 - 27% - VL 15k
10/07 CD4 484 - 31% - VL 45k
05/08 CD4 414 - 26% - VL 70k
01/09 CD4 365 - 23% - VL 65k
05/09 CD4 291 - 23% - VL 115k - Started Meds - Reyataz/Truvada
06/09 CD4 394 - ?% - VL 1200 - Boosted Reyataz with Norvir and Truvada
07/09 CD4 441 - ?% - VL 118 - Boosted Reyataz with Norvir and Truvada
09/09 CD4 375 - ?% - VL Undetectable - Boosted Reyataz with Norvir and Truvada
12/09 CD4 595 - ?% - VL Undetectable - VIT D 34 - Reyataz/Truvada/Norvir

Offline aztecan

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Re: No NSAIDs With Tenofovir?
« Reply #2 on: July 08, 2009, 01:22:41 AM »
I agree, moderation in all things and, when in doubt, talk to your doctor.

The doctor should be doing routine tests on anyone taking Tenofovir in any of its incarnations to make sure the kidneys are working OK.

I have been taking Truvada, which is made up of Tenofovir and Emtriva. I also take Naproxen Sodium, (Aleve), twice a day for old Arthur.

So far so good, except Arthur isn't leaving me in peace.

HUGS,

Mark
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline Luke

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Re: No NSAIDs With Tenofovir?
« Reply #3 on: July 08, 2009, 04:51:41 AM »
It does lead to the possibility of a rather interesting dilemma though. The 'Truvada headache' is a common enough side-effect and NSAIDs are the usual treatment.

Offline bocker3

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Re: No NSAIDs With Tenofovir?
« Reply #4 on: July 08, 2009, 07:56:56 AM »
Tenofovir-related acute kidney injury and proximal tubule dysfunction precipitated by diclofenac: a case of drug-drug interaction.

Morelle J, Labriola L, Lambert M, Cosyns JP, Jouret F, Jadoul M.
Department of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.

We describe an HIV1-positive patient under long-term tenofovir treatment who developed a severe, biopsy-proven, acute tubular necrosis with proximal tubule (PT) dysfunction, precipitated by the very recent start of diclofenac, a nonsteroidal antiinflammatory drug (NSAID)...............  u]NSAIDs should be avoided in patients under tenofovir.[/u][/b]


This is quite a leap based on ONE patient's experience.

Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

Offline markaj

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Re: No NSAIDs With Tenofovir?
« Reply #5 on: July 08, 2009, 10:17:34 AM »
I'm on Truvada and my doctor gave me loads of boxes of Naproxen when I started Hep C treatment.  As Mike says, this is just one patient.  I'm not going to stop taking Naproxen, I have liver damage and they apparently are kinder to the liver than other pain killers, i'll take my chances with my kidneys.
Infected Jan 08 / diagnosed Feb 08
Feb 08 - CD4 230 (9%) VL 3.5 million
Mar 08 - CD4 440 (6%) VL 660.000
Apr 08 - CD4 420 (11%) VL 3 million
Jun 08 - CD4 200 (7%) VL 3 million
Started Kaletra/Truvada Jul 08
Jul 08  - CD4 250 (14%) VL 23.893
Aug 08 - CD4 410 (15%)  VL 4.313
Switched to Sustiva/Truvada Aug 08
Switched to Reyataz/Norvir/Truvada Sep 08
Diagnosed with Hep C, HIV meds stopped for a bit
Nov 08 - CD4 414 (12%) VL 500.000+
Started Isentress/Truvada Nov 2008
Dec 08 - CD4 381 (17%) VL 1.116
Jan 09 - CD4 534 (20%) VL <50
Started Interferon/Ribavirin Jan 09
Feb 09 - CD4 407 (24%) VL <50
Mar 09 - CD4 360 (28%) VL <50
Apr 09 - CD4 279 (30%) VL <50
Jun 09 - CD4 298 (36%) VL <50
Aug 09 - CD4 303 (35%) VL <50

Offline Inchlingblue

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Re: No NSAIDs With Tenofovir?
« Reply #6 on: July 08, 2009, 01:01:09 PM »
I'm on Truvada and my doctor gave me loads of boxes of Naproxen when I started Hep C treatment.  As Mike says, this is just one patient.  I'm not going to stop taking Naproxen, I have liver damage and they apparently are kinder to the liver than other pain killers, i'll take my chances with my kidneys.

Science changes every day. What's OK one day may not be OK the next. Apart from any possible drug interaction, the findings that NSAIDs themselves not only "alter glomerular filtration but also multidrug resistance protein (MRP) 4-mediated PT secretion of several substrates" are recent findings.

Kidney damage is a very serious thing, not to be taken lightly. Why take one's chances  in a situation where there is very real reasonable doubt? It's possible that future studies may corroborate this one and it's possible that future studies may discount this one.  As it stands right now, the evidence is compelling enough to at least approach with caution and not proceed with business as usual.

I agree that other pain killers are harder on the liver so what is a person to do? Not an easy solution but maybe a good wake-up call to explore other options in pain management?
« Last Edit: July 08, 2009, 01:03:47 PM by Inchlingblue »

Offline risred1

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Re: No NSAIDs With Tenofovir?
« Reply #7 on: July 08, 2009, 01:21:38 PM »
Part of the problem is the super techno speak. I can follow some of it, but what are we really talking about, and to what end is this an issue?

I did a search on the internet, and didn't find much on this topic.

I appreciate the information though, but I don't know what to make of it....

Especially if we are using over the counter dosing of drugs like Aleve, which has been remarkably effective for me dealing with muscle soreness and headache.

And I really dislike the across the board recommendation. NSAID's, are they all alike? or aren't they? As a class, can we expect the same effects on our kidneys, or is this isolated on other vectors.

I'll just say, URGH!
risred1 - hiv +
02/07 CD4 404 - 27% - VL 15k
10/07 CD4 484 - 31% - VL 45k
05/08 CD4 414 - 26% - VL 70k
01/09 CD4 365 - 23% - VL 65k
05/09 CD4 291 - 23% - VL 115k - Started Meds - Reyataz/Truvada
06/09 CD4 394 - ?% - VL 1200 - Boosted Reyataz with Norvir and Truvada
07/09 CD4 441 - ?% - VL 118 - Boosted Reyataz with Norvir and Truvada
09/09 CD4 375 - ?% - VL Undetectable - Boosted Reyataz with Norvir and Truvada
12/09 CD4 595 - ?% - VL Undetectable - VIT D 34 - Reyataz/Truvada/Norvir

Offline risred1

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Re: No NSAIDs With Tenofovir?
« Reply #8 on: July 08, 2009, 03:17:33 PM »
http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=ebm&log$=drug_bottom_one&part=nsaids

I found this link  based upon the original posted summary of issues with NSAID's and Tenofovir.

Does it apply? It does talk about how Naproxen does not have the same cardio risk as other NSAID's, but doesn't really talk to much about kidneys.

Additionally, after further rereading and rereading the article and looking to understand the medical language in play, that the well know association of Tenofovir and Kidney issues was exacerbated by a NSAIDs, Non-Steroidal Anti-inflamatory Drugs,  that is used to treat the pain associated with Oesteo Arthritis. (Sound Familiar?) in this case diclofenac.

My take is that the anti inflammatory action of Diclofenac prevented clearing of the Tenofovir, by constricting Kidney Tubules. The anti inflammatory action is what is in conflict with the Kidney's need to secret the Tenofovir, then the Tenofovir saturates the kidneys, causing Renal Failure.

That is my interpretation of the statement. Does that sound right or am i looking at this information wrong?

Additionally, Since this drug was to treat Oesteo Arthritis, perhaps it was a stronger NSAID, therefore the anti inflammatory action more severe than other NSAID's such as over the counter doses of Naproxen.

But it does give me pause. i know for some, Aleve is very effective treatment for Arthritis and is in daily use. I use occasionally to deal with muscle soreness and headache.

Indications are that short term use allows the kidneys to return to normal unconstricted function and may not be of serious consequence, but I'm clearly speculating here.

Obviously, we need to check Kidney function regularly and be prepared to switch from the tenofovir if necessary, or look for things like NSAID's that may be exacerbating tenofovir excretion in the Kidneys.


« Last Edit: July 08, 2009, 03:56:35 PM by risred1 »
risred1 - hiv +
02/07 CD4 404 - 27% - VL 15k
10/07 CD4 484 - 31% - VL 45k
05/08 CD4 414 - 26% - VL 70k
01/09 CD4 365 - 23% - VL 65k
05/09 CD4 291 - 23% - VL 115k - Started Meds - Reyataz/Truvada
06/09 CD4 394 - ?% - VL 1200 - Boosted Reyataz with Norvir and Truvada
07/09 CD4 441 - ?% - VL 118 - Boosted Reyataz with Norvir and Truvada
09/09 CD4 375 - ?% - VL Undetectable - Boosted Reyataz with Norvir and Truvada
12/09 CD4 595 - ?% - VL Undetectable - VIT D 34 - Reyataz/Truvada/Norvir

Offline bocker3

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Re: No NSAIDs With Tenofovir?
« Reply #9 on: July 08, 2009, 10:29:09 PM »
Kidney damage is a very serious thing, not to be taken lightly. Why take one's chances  in a situation where there is very real reasonable doubt? It's possible that future studies may corroborate this one and it's possible that future studies may discount this one.  As it stands right now, the evidence is compelling enough to at least approach with caution and not proceed with business as usual.

I don't find One patient's results compelling.  I also don't find a prescription strength NSAID being compared to over the counter NSAIDs compelling -- assuming one follows dosage recomendations.  Studies may also NOT corroborate this one.

Caution is great -- and appropriate -- but if fear of kidney disease from NSAIDs (& Tenofovi)r means we should stop taking them -- perhaps we should stop the Tenofovir too -- this is known to cause kideny damage in some individuals.  Of course, I am NOT advocating stopping Tenofovir -- I take it and I take NSAIDs, when needed.

What IS important and appropriate -- is to let you doctor know everything you take -- prescripiton, OTC, herbal, vitamins, etc.

Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

Offline mewithu

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  • mewithu
Re: No NSAIDs With Tenofovir?
« Reply #10 on: July 09, 2009, 03:51:47 AM »

 
 
 
 
Truvada comes in tablet form and is taken by mouth.

 
 
 
 
The recommended dosage of Truvada is one tablet (200 mg of emtricitabine and 300 mg of tenofovir DF) once a day. Some individuals, such as those with decreased kidney function, may require a different dose of Truvada. Individuals should always take Truvada as their doctors prescribe.

 
 
 
 


Contraindications
 
 
 
 
Warnings and side effects of Truvada may be similar to those for both of the medicines separately. (See individual drug fact sheets for emtricitabine and tenofovir DF for more information.) Individuals with advanced kidney disease should not take Truvada. Individuals should tell a doctor about any medical problems before taking this medicine.

 
 
 
 


Possible Side Effects
 
 
 
 
The medicines in Truvada, like other NRTIs, can cause a sometimes fatal lactic acidosis and liver disease as well as blood problems, muscle weakness, or changes in bone mineral density (thinning bones). Those with Hepatits B infection may notice an increase in symptoms. A doctor should be notified if an individual taking this medication experiences digestive system problems, joint or muscle pain and weakness, pain or tingling of hands or feet, headache, dizziness, and unusual tiredness or weakness. Other serious side effects of this medicine include kidney failure; severe disease of the pancreas; vomiting, abdominal pain, decreased appetite, or weight loss; general feeling of discomfort; muscle pain or cramping; difficulty with or shallow breathing; and sleepiness. Individuals should tell a doctor if they have any of these symptoms.

 
 
 
 
Other side effects may not be serious and may lessen or disappear with continued use of the medicine. Less serious side effects of this medicine include diarrhea, dizziness, intestinal gas, nausea, headache, rash, and skin discoloration. Individuals should tell a doctor if these side effects continue or are bothersome.

 
 
 
 


Drug and Food Interactions
 
 
 
 
A doctor should be notified of any other medications being taken, including prescription, nonprescription (over-the-counter), or herbal medications.

 


Clinical Trials
 
Click here to search ClinicalTrials.gov for trials that use Emtricitabine/Tenofovir disoproxil fumarate.

 


Manufacturer Information
 
Emtricitabine/Tenofovir disoproxil fumarate
  Gilead Sciences Inc
  333 Lakeside Dr
  Foster City,  CA  94404
  (800) 445-3235
   

Truvada
  Gilead Sciences Inc
  333 Lakeside Dr
  Foster City,  CA  94404
  (800) 445-3235
   



 
Updated November 5, 2008
 
1997 is when I found out, being deathly ill. I had to go to the hospital due to extreme headache and fever. I fell coma like,  two months later weighing 95 pounds and in extreme pain and awoke to knowledge of Pancreatis, Cryptococcal Meningitis, Thrush,Severe Diarea,  Wasting, PCP pneumonia. No eating, only through tpn. Very sick, I was lucky I had good insurance with the company I worked for. I was in the hospital for three months that time. 
(2010 Now doing OK cd4=210  VL= < 75)
I have become resistant to many nukes and non nukes, Now on Reyataz, , Combivir. Working well for me not too many side effects.  I have the wasting syndrome, Fatigue  . Hard to deal with but believe it or not I have been through worse. Three Pulmonary Embolism's in my life. 2012 520 t's <20 V load

Offline mewithu

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  • mewithu
Re: No NSAIDs With Tenofovir?
« Reply #11 on: July 09, 2009, 03:58:08 AM »
Viread (tenofovir)
en español
Pronunciation(s): VEER-ee-ad; ten-OH-foh-veer

What is Viread?
Viread is an HIV medication. It is in a category of HIV medicines called nucleotide reverse transcriptase inhibitors. Viread prevents HIV from altering the genetic material of healthy CD4 cells. This prevents the cells from producing new virus and decreases the amount of virus in the body.
 
Nucleotide analogues, such as Viread, are very similar to nucleoside analogues [e.g., Retrovir (AZT), Ziagen (abacavir) and Emtriva (emtricitabine)]. The only difference is that nucleotide analogues, unlike nucleoside analogues, are chemically preactivated and thus require less processing in the body for them to become active.
 
Viread, manufactured by Gilead Sciences, was approved by the U.S. Food and Drug Administration for the treatment of HIV in 2001.
 
Viread is available in pharmacies as a single drug, which is always combined with other HIV drugs, or in the fixed-dose combination tablets Truvada (Viread and Emtriva) and Atripla (Viread, Emtriva, and Sustiva [efavirenz]).
 
Viread is also active against the hepatitis B virus (HBV), the virus responsible for hepatitis B. Although it has not been approved by the FDA for the treatment of hepatitis B, some doctors prescribe it to treat both hepatitis B and HIV. See What is known about side effects? below for more important information regarding Viread and hepatitis B.
 
Gilead has established a patient assistance program (PAP) for people living with HIV who do not have private or public health insurance and are unable to afford Viread. To learn more about the PAP for Viread, call Gilead (800-226-2056). For those with private health insurance, Gilead has established a program to help cover up to $200 toward each monthly Viread co-payment (people will be responsible for paying the first $50 of their monthly Viread co-payment). To learn more about this co-pay program, call 866-784-3431.

What is already known about Viread?
The usual dose is one 300mg pill, taken once a day. If you have kidney problems, your health care provider may recommend that you take Viread less frequently.
 
Viread can be taken either with or without food.
 
 Viread is not approved for children younger than 18 years of age. To learn about treatment options for children, click here.
 
Studies have demonstrated that Viread is effective for the treatment of HIV when combined with other HIV drugs, usually with at least one other nucleoside reverse transcriptase inhibitor (NRTI) and either a protease inhibitor or non-nucleoside reverse transcriptase inhibitor (NNRTI). Viread should not be taken alone (as monotherapy) or with just one other HIV drug.
 
For HIV-positive adults beginning anti-HIV drug therapy for the first time, Viread is listed as a "preferred" NRTI option—used in combination with Sustiva—by the United States Department of Health and Human Services in its treatment guidelines. To learn more about these recommendations and options, click here.
 
Viread is active against many strains of HIV resistant to Retrovir (AZT), Zerit (d4T), Videx/Videx EC (ddI), Hivid (ddC), and Ziagen (abacavir). There is also some data from studies indicating that HIV that has become resistant to Epivir (3TC) may be even more sensitive to Viread. The drug is also active against virus containing the Q151M mutation—a single mutation that results in high-level resistance to multiple nucleoside analogues.
 
Viread may be less active against strains of HIV that contain the K65R mutation in its reverse transcriptase gene. To figure out if your virus has this mutation, your doctor can order a genotypic drug-resistance test.

What about drug interactions?
Viread should not be taken at the same time as Atripla, Truvada, or Hepsera. This is because these medications contain the same or similar active ingredients as Viread.
 HIV-positive people must be very careful about using Viread in combination with Videx/Videx EC (ddI). There are two important warnings to know about:
 
Drug regimens consisting of Sustiva (efavirenz) or Viramune (nevirapine) plus Viread and Videx EC have been associated with premature drug failure. If you are receiving Viread and Videx EC with either Sustiva or Viramune, you may want to discuss alternative options with your doctor.
 
Viread increases the amount of Videx EC in the body. This can increase the risk of Videx-related side effects. In turn, if Viread and Videx EC are used together, you may need to be followed more carefully and your health care provider may need to decrease your dose of Videx EC. If used with Viread, Videx EC should be taken at a dose of 250mg once a day (reduced from the usual daily dose of 400mg a day).
 Because there are now a number of concerns regarding the use of Viread in combination with Videx EC, many experts recommend avoiding this combination.
 
The protease inhibitors Reyataz (atazanavir), Prezista and Kaletra (lopinavir/ritonavir) can increase the amount of Viread in the blood, which could result in more side effects. You may need to be followed more carefully if you are taking Viread and Reyataz, Prezista or Kaletra together. Viread may decrease the amount of Reyataz in your blood. If you are taking Viread and Reyataz together you should also be taking Norvir.

What is known about side effects?
 Lactic acidosis, which can be fatal, and severe liver problems have been reported in people taking nucleoside reverse transcriptase inhibitors (NRTIs). This may be more likely to occur in pregnant women. Contact your doctor immediately if you experience nausea, vomiting, or unusual or unexpected stomach discomfort; weakness and tiredness; shortness of breath; weakness in the arms and legs; yellowing of the skin or eyes; or pain in the upper stomach area.
 
Viread may cause bone problems. In one clinical trial conducted by the manufacturer involving HIV-positive patients who were new to HIV therapy, Viread [combined with Sustiva and Epivir] caused decreases bone in mineral density (osteopenia) at the hip and spine. Researchers are currently looking into the seriousness of this possible side effect. If you have a history of bone fracture or are at risk for osteopenia, your doctor may want to consider ordering bone scans on a regular basis while you are taking Viread. While it's not clear if calcium and vitamin D supplementation can help with this side effect, it might be beneficial if you are taking Viread.
 
Some patients treated with Viread have had kidney problems. Viread can be problematic for HIV-positive people who have a history of kidney problems (renal impairment). If you have a history of kidney problems, your doctor will need to order a simple laboratory test to calculate your "creatinine clearance," which is a measure of your kidney function. Depending on the results of this test, you may not be able to take Viread, or you may need to take it less frequently. It is always important to be careful if using Viread in combination with drugs that cause kidney problems or other drugs that are removed from the body by the kidneys.
 
HIV drug regimens containing NRTIs, including Viread, can cause increased fat levels (cholesterol and triglycerides) in the blood, and abnormal body-shape changes (lipodystrophy; including increased fat around the abdomen, breasts, and back of the neck, as well as decreased fat in the face, arms, and legs). These side effects of HIV drug therapy are reviewed in our lessons on Lipodystrophy, Facial Lipoatrophy, and Risks To Your Heart (Hyperlipidemia).
 
In people living with HIV, the most common side effects of Viread are rash, headache, pain, diarrhea, depression, weakness, and nausea. Less common side effects include vomiting, dizziness and flatulence.
 
 If you have hepatitis B and HIV and plan to stop taking Viread, you need close medical follow-up and for several months your doctor might want to frequently check your liver enzymes after stopping treatment. This is because Viread is also active against the hepatitis B virus (HBV). If Viread is stopped abruptly, it can cause liver disease to "flare" and damage the liver.

Can pregnant women take Viread?
Viread is classified by the FDA as a pregnancy category B drug. Pregnancy category B means that animal studies have failed to demonstrate a risk to the fetus, but there are no adequate and well-controlled studies in pregnant women. Drug levels might be lower during the third trimester of pregnancy. A phase I clinical trial in late pregnancy is being conducted. HIV-positive women who become pregnant should discuss the benefits and possible side effects of HIV treatment to help protect their babies from HIV (see our lesson called Family Planning, Pregnancy & HIV).
 
It is not known whether Viread passes into breast milk and what effect they may have on a nursing baby. To prevent transmission of the virus to uninfected babies, it is recommended that HIV-positive mothers not breast-feed.

What should I tell my doctor before taking Viread?
Before taking this medication, tell your doctor if you have: kidney disease; liver disease (including hepatitis B); or bone problems.
 
Tell your doctors and pharmacists about all medicines you take. This includes prescription medications, over-the-counter products, or herbal/natural remedies.

Where can I learn more about clinical trials of Viread?
If you would like to find out if you are eligible for any clinical trials that include Viread, there is an interactive web site run by ACRIA, the AIDS Community Research Initiative of America.
 
Another useful service for finding clinical trials is AIDSinfo.nih.gov, a site run by the U.S. National Institutes of Health. They have "health information specialists" you can talk to at their toll-free number at 1-800-HIV-0440 (1-800-448-0440).
 
1997 is when I found out, being deathly ill. I had to go to the hospital due to extreme headache and fever. I fell coma like,  two months later weighing 95 pounds and in extreme pain and awoke to knowledge of Pancreatis, Cryptococcal Meningitis, Thrush,Severe Diarea,  Wasting, PCP pneumonia. No eating, only through tpn. Very sick, I was lucky I had good insurance with the company I worked for. I was in the hospital for three months that time. 
(2010 Now doing OK cd4=210  VL= < 75)
I have become resistant to many nukes and non nukes, Now on Reyataz, , Combivir. Working well for me not too many side effects.  I have the wasting syndrome, Fatigue  . Hard to deal with but believe it or not I have been through worse. Three Pulmonary Embolism's in my life. 2012 520 t's <20 V load

Offline Luke

  • Member
  • Posts: 291
Re: No NSAIDs With Tenofovir?
« Reply #12 on: July 09, 2009, 04:21:27 AM »
What IS important and appropriate -- is to let you doctor know everything you take -- prescripiton, OTC, herbal, vitamins, etc.

Hear hear

Offline smalltown66

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Re: No NSAIDs With Tenofovir?
« Reply #13 on: July 10, 2009, 10:43:13 PM »
I have been on Truvada, Reyataz, Norvir for almost 5 years. It has been a very successful drug for me, but I have began seeing affects to the kidney. I have Stage 3 kidney disease. My doctor says we cant blame it solely on the meds but Truvada( especially Viread) has toxic affects on the kidneys.

My doc has taken me off all NSAIDS. Just thought I would share my experience.

Best wishes

Smalltown66
Lifting the weight of the world sure is easier with others with the same goal.

Offline smalltown66

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Re: No NSAIDs With Tenofovir?
« Reply #14 on: July 10, 2009, 10:51:01 PM »
I have been on Truvada, Reyataz, Norvir for almost 5 years. It has been a very successful drug for me, but I have began seeing affects to the kidney. I have Stage 3 kidney disease. My doctor says we cant blame it solely on the meds but Truvada( especially Viread) has toxic affects on the kidneys.

My doc has taken me off all NSAIDS. Just thought I would share my experience.

Best wishes

Smalltown66

I should have said effects of the kidneys .Sorry I need a to review my  English grammar.
Lifting the weight of the world sure is easier with others with the same goal.

Offline Inchlingblue

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Re: No NSAIDs With Tenofovir?
« Reply #15 on: July 16, 2009, 01:17:08 PM »
Something to keep in mind for the future, if trying to avoid NSAIDs:

Developing a safer form of acetaminophen

Scientists in Louisiana are reporting development of a process for producing large batches of a new and potentially safer form of acetaminophen, the widely used pain-reliever now the source of growing concern over its potentially toxic effects on the liver. Their study, which could speed development of a next-generation pain-reliever, is scheduled for the July 17 issue of ACS' Organic Process Research & Development, a bi-monthly journal.

In June, an advisory panel of the U. S. Food and Drug Administration recommended banning certain prescription pain relievers containing acetaminophen because of the drug's potential to cause liver damage when used in high doses. Mark Trudell and colleagues note in the study that scientists recently discovered a new form of acetaminophen that has similar potency to the original drug with a lower risk of liver toxicity. But until now, scientists have had difficulty producing this substance in quantities suitable for industrial scale-up.

The researchers describe a simple, efficient method for producing the new pain-reliever using only a few starting materials and a short series of chemical reactions. In laboratory studies, they used the new method to produce milligramme quantities of the substance with 99 percent purity. The scientists point out that the new process can be performed on a much larger production level if needed.


LINK:

http://www.scientistlive.com/European-Science-News/Pharmacology/Developing_a_safer_form_of_acetaminophen/22960/

 


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