Please note Tenofovir is principally cleared through the kidney and dosing adjustments due to renal impairment have not been clinically tested.
The followings are extracts from the label information for Tenofovir:
2.3 Dose Adjustment for Renal Impairment in Adults
Significantly increased drug exposures occurred when VIREAD was administered to subjects with moderate to severe renal impairment [See Clinical Pharmacology (12.3)].
I am not aware that impaired renal function precludes treatment for HCV. I have read that kidney disease is a negative predictor of SVR but, so too are a lot of conditions yet people have overcome them. I have seen articles which discuss the plasma levels of ribavirin with renal impaired patients. The suggestion is that rather than weight base dose these patients the dose should be arrived at by considering GFR (glomerular filtration rate).
This is from Clinical Care Options @ http://tiny.
should I take Isentress again at 7;30 am so that I maintain the 7:30am/7:30pm timeline for Isentress? The pharmacist and lots of online resources stressed the importance of taking the pills on time each time.
I began taking truvada and isentress 65 hours after my potential exposure to HIV and I have taken them for 4 days. But I did not take them at the exact same time everyday. But I am sure I was never late or early by more than 1 hour. Will the effectiveness get affected by this? And is 65 hours too late for PEP? How likely will PEP fail in my case???
By "AGE" I'm assuming you mean a persons age in years. I don't believe age has anything to do with Janumet's "effectiveness" but age has a larger role with renal function. To make it clear for other readers, Janumet is combination of two drugs; Sitagiptin and Metformin.
This a brief from the Merck web site - makers of Janumet - Section 8.5 - Geriatric Use JANUMET.
I also have kidney damage from a bout of high blood pressure 4 years ago, and I am a frequent kidney stone former, so I am being watched carefully by a nephrologist too. I have renal panels frequently too. I was wondering if any of this could increase my stone risk. I was reading about the cytomel and stones. The nephrologist wants me to remain on the synthroid and cytomel.
I think it depends on some individual factors, particularly renal clearance of the drug. I found this information in the drug reference:
According to the manufacturer's tests, the drug reaches maximum serum levels between 15 and 44 hours after subcutaneous injection of a single dose. The mean elimination half-life is 22 to 60 hours (mean = 40 hours). So, I would expect that after 7 days (4.2 half-lifes) that the concentration would be about 5.5% (0.5^4.2) of the maximum levels.
I had a risk exposure and had a base hiv test 4th gen ab/ag 25 hours after pep or after 2 truvadas and 3 isentress. Could this affect the negative result of the base test? Is the base test considered conclusive? The only risk exposure is no longer since the other party hiv test was negative and the exposure was low risk.
Thanks for your help...
Hi, after being exposed to HIV 15 days ago, I'm on day 14 of PEP (Truvada & Isentress). I wonder if facial lipoatrophy (sunken cheeks, temples, eyes, etc) can develop as early as two weeks of being taking these meds. I'm a male model and I make a living of my face. Last week I was fired from 3 photo-shoots in a row. I don't know if I'm really experiencing facial fat waste, or if my face just reflects all the emotional distress I've been through for the past 2 weeks.
Glomerular filtration rate or its approximation of the creatinine clearance are measured whenever renal disease is suspected or careful dosing of nephrotoxic drugs is required. The normal ranges of GFR, adjusted for body surface area for males is 70 ± 14 mL/min/m2 (56-84) . Risk factors for kidney disease include diabetes, high blood pressure, family history and older age.
Take care and keep us posted.
I had a sexual encounter and they have put me on truvada and isentress for 4 weeks. It is one week over but I have very bad stomach. I usually have a chronic gastritis due to helyco bacter that I have not managed so far to get rid of.
My doctor said I could take Nexium 20 which is my usual medication for this matter but to try no to take it everyday beacaus of interaction with isentress but he is gone on vacation now and I have a really upset stomach and I dont know what to do.
PEP is very effective - it should be three drugs -- typically two medications Truvada + Isentress. Mass had a 2 year study where no one on PEP got infected.
There are preferred opiates drugs that are use in patients with liver disease that have shorter half-lives and have less harmful side effects on the renal system. Your liver doctor should be aware of these drugs and be able to determine if you may be able to use them.
With regards to OTC medications, normal recommended doses of acetaminophen can be safely given to patients who suffer from cirrhosis in the short term.
But regarding this Vit D , should i need to take along with calcium supllements Or no need? I have renal stones of 0.5mm. Does this have any effect on this?
If you are stage 3 you can take any analgesic within dosing limits. Your liver function has not been altered by your liver disease yet. If you become stage 4 (cirrhosis) then you will have to modify what drugs you can take because the liver is no longer able to process drugs in a normal manner.
Tramadol is an synthetic opiate and should not be taken for "mild" pain.
Call your local pharmacist. We at MedHelp are not allowed to give out dosing instructions. Your pharmacist will be able to tell you exactly how to dose the medications. If your regular pharmacy is closed on Sunday, call any pharmacist availabe at your local grocery store or drug store such as Walgreens, CVS, or RiteAid.
Hello - I understand that oral with a person who is HIV+ is low risk, but would it be a good idea to take PEP anyway? My concern is the side effects of the Isentress and Truvada combination. I have the medication, but if infection is very highly unlikely, I think I shouldn't. Friends are telling me not to worry and doctor says it is up to me (which I know). Opinions?
RENAL RISK
TORADOL is CONTRAINDICATED in patients with advanced renal impairment and in patients at risk for renal failure due to volume depletion (see WARNINGS).
RISK OF BLEEDING
TORADOL inhibits platelet function and is, therefore, CONTRAINDICATED in patients with suspected or confirmed cerebrovascular bleeding, patients with hemorrhagic diathesis, incomplete hemostasis and those at high risk of bleeding (see WARNINGS and PRECAUTIONS).
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