Viraday (Tenofovir Disoproxil Fumarate, Efavirenz, Emtricitabine)
Viraday is a single tablet drugs consist two types of anti-retroviral medicines which is active against HIV-1 infections.
Viraday involves; One non-nucleoside reverse transcriptase inhibitor: Efavirenz Two nucleoside reverse transcriptase inhibitor: Tenofovir disoproxil fumarate & Emtricitabine
Viraday is not a curable or preventable the infectious condition, but it can reduce the promotion of HIV infectious condition like AIDS. Viraday tablets is a prescription drugs; which is used under the proper supervision of medical practioner.
MECHANISM OF ACTION
Tenofovir DF converted into tenofovir and struggles with deoxyadenosine 5’ triphosphate and incooperated into viral DNA. Tenofovir DF worked as; Reverse transcriptase inhibitor; viral chain eliminator; viral production inhibitor
By the way of reverse transcriptase enzyme which is sufficient for viral production Conversion occurs in formation of triphosphorylated form which is needed for efavirenz activity Inhibition of RT leads to intercede with development of DNA duplicates of viral RNA; occurs in cell division
Emtricitabine changed to Emtricitabine 5’ triphosphate which is fundamental for cell multiply Conflict occurs between this metabolite with deoxycytidine 5’ triphosphate and infused into viral DNA leads to chain obstruction.
Viraday tablet must be administered on an empty stomach, especially at a bed time for reducing neurological disorders. Viraday should be used in adults & pediatric patients with age of 12 years or older. The usual advised dose of Viraday is one tablet to be taken orally as a single dose. Dosage alteration is not possible because Viraday tablet are a fixed dose combination.
It should not be suggested in both moderate & severe renal impaired patients with creatinine clearance below 50ml/min. The combination therapy of Viraday with rifampin, with patient weight about 50kg or more. In this scenario the dose of efavirenz should be elevates to 200mg per day.
The most common adverse effects; Lactic acidosis or hepatic steatosis, Nervous disorders, Renal impairment worsening, rash, Immune reconstitution syndrome, Liver injury, Bone defects, Fat redistribution, Severe acute exacerbation of hepatitis B
COMMON SIDE EFFECTS
Nausea , fatigue, infections, sinusitis, dizziness, headache, respiratory problems, Nasopharyngitis, anxiety, depression, insomnia, elevation of creatine kinase, cholesterol, amylase, alkaline phosphatase, AST, ALT, blood glucose, decreased neutrophils, Diarrhea, vomiting
PRECAUTIONS SHOULD BE TAKEN FOR FOLLOWING CONDITIONS
Patients should be examine correctly whether patient may suspected with HBV infection or not. The potency of Viraday has not been monitored for chronic HBV infections The Viraday treatment should be interrupt or discontinue while In lactic acidosis or hepatic steatosis To overwhelmed the problem by checking patients ECG, provides alternative medications.in case of QT extension While taking Viraday at bed time the Neurological problems should be eliminated Viraday should not be used in pregnancy condition.
Liver toxicity reduced by monitoring liver function test frequently and corrects the hepatic enzymes. Vitamin D supplements should be used for correct the bone defects Convulsion should be treated by using anti-convulsants medication Therapy should be stopped In case of immune reconstitution syndrome condition
Interaction of Viraday with the substrates of CYP3A or CYP2B6: depletion of plasma concentration of these substrates. Interaction of Viraday with the CYP3A inducers: elevation of clearance value of efavirenz results as depletion of plasma concentration Interaction of Viraday with the drugs reducing renal functions: elevation of plasma concentration of Tenofovir DF & FTC.
Interaction of Viraday with atazanavir: depletes atazanavir concentration and increases the tenofovir concentration. Interaction of Viraday with Didanosine: increasing level of Didanosine Interaction of Viraday with NNRTI: elevates the level of Efavirenz concentration
Interaction of Viraday with anti-consultants, anti-coagulant, anti-depressants, or anti-fungals: depletes the concentration of these drugs Interaction of Viraday with anti-infective, anti-mycobacterials, anti-malarial or CCB’s: depletes the effect of these drugs Interaction of Viraday with lipid lowering agents, hormonal contraceptives or Immunosuppressant: depletes the effect of these drugs.
Due to side effects by investigation and experience studies in humans shows a positive risks for human fetal is identified. Efavirenz has category D Tenofovir and Emtricitabine has category B
The drug probably safe to use during breast feeding
Stored at temperature 25°C Dispense the drug only in original container Keep away from children’s
If patient missed any dose, have the dose as soon you remember before the next dose timing or leave the missed dose and continue the regular schedule. Avoid to have double dose at one time. Please consult with the doctor.