Med of the Month: Truvada

June is Pride Month 🏳️‍🌈, making it a fitting time to spotlight one of the most influential medications in modern preventive medicine. Since its approval for HIV pre-exposure prophylaxis (PrEP), Truvada® has helped transform HIV prevention and has played a major role in reducing new HIV infections worldwide.

While dental professionals may not prescribe Truvada, we are often part of a patient's broader healthcare team. Understanding why patients take it, recognizing potential oral health considerations, and being aware of important medication interactions can help support safer, more informed care.

Generic Name: Emtricitabine and Tenofovir Disoproxil Fumarate 

Brand Name(s): Truvada

Pronunciation: EM trye SYE ta been and ten OF oh vir

About Truvada:

• Emtricitabine and tenofovir disoproxil fumarate (Truvada®) is a combination medication used for HIV-1 pre-exposure prophylaxis (PrEP) in adults and adolescents weighing at least 35 kg who are at risk of sexually acquired HIV-1 infection.

• An HIV-negative status must be confirmed before starting treatment and approximately every 3 months during use.

• Truvada is also used in combination with other antiretroviral medications to treat HIV infection in adults and children weighing at least 17 kg.

• It is important to note that Truvada does not cure HIV infection or AIDS.

Dentistry-related tidbits:

If you're treating a patient taking Truvada, a few considerations are worth keeping in mind:

Local Anesthetic Warnings: There are no specific warnings regarding local anesthetics or epinephrine use with Truvada.

Oral Manifestations: Although oral manifestations such as xerostomia, taste disturbances, and oral ulcerations have been reported with certain highly active antiretroviral therapy (HAART) regimens, current evidence suggests these effects are less commonly associated with PrEP medications such as Truvada. One study evaluating individuals using PrEP reported symptoms including dry mouth and taste disturbances; however, researchers found no significant differences in salivary flow rates or overall oral and salivary health over time. As with any patient reporting xerostomia, routine caries-risk assessment and preventive counseling remain important.

Staying Safe: important interactions to be aware of

Using a tool like MedAssent DDS Rx Check can help support safe prescribing and identify clinically relevant interactions.

The most important concern with Truvada is the potential for kidney-related toxicity, particularly when combined with other medications that can affect renal function. Examples include:

• Prolonged or high-dose NSAID therapy (e.g. aspirin, ibuprofen, naproxen, meloxicam, diclofenac, ketorolac, celecoxib, and other prescription and OTC NSAIDs)

• Antivirals (e.g. acyclovir, valacyclovir)

• Antifungals (e.g. itraconazole, ketoconazole)

• Macrolide antibiotics (e.g. azithromycin, clarithromycin, erythromycin)

Fun facts:

• In 2012, Truvada became the first FDA-approved medication for HIV pre-exposure prophylaxis (PrEP), marking a major milestone in preventive medicine.

• Before becoming widely known for HIV prevention, Truvada was used as part of combination treatment regimens for individuals living with HIV. Researchers later discovered its powerful preventive benefits, leading to the development of modern PrEP programs.

• When taken as prescribed, PrEP can reduce the risk of acquiring HIV from sexual exposure by about 99%, making it one of the most effective preventive medications available.

• 🏳️‍🌈 Many of the advances in HIV treatment, prevention, and patient access that exist today were driven by decades of advocacy from LGBTQ+ communities and their allies.

Get more dental-specific drug information with the Digital Drug Handbook (web) or BrushUp Rx (mobile app).