The Common Truvada Side Effects You Should Know

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The US Food and Drug Administration (FDA) first approved Truvada as a treatment for human immunodeficiency virus (HIV) in 2004. In 2012, the FDA then approved it for use as a preventative medication, or pre-exposure prophylaxis (PrEP), for those with a high risk of contracting HIV. 

Truvada is a branded medication that combines emtricitabine and tenofovir disoproxil fumarate (TDF), antiviral medicines that prevent HIV from multiplying in your body. Truvada was chosen as a PrEP because it has few long-term side effects. But, there are concerns about TDF side effects and, in turn, the Truvada side effects that this component may cause.

Here we take a look at the side effects of Truvada so you know what to expect if your doctor prescribes this medication. 

The Side Effects of Truvada

As with any medication, Truvada PrEP side effects vary in severity and likelihood. Usually, more common side effects are less severe while less common side effects can vary in severity. 

Common, Less Severe Side Effects

If experienced, these more common side effects are often less severe. While this is not an exhaustive list, the most common non-severe side effects include:

  • Headache
  • Diarrhea
  • Nausea
  • Fatigue
  • Skin rash
  • Dizziness
  • Strange dreams 
  • Insomnia
  • Low energy
  • Abnormal fat distribution

Of these common side effects, nausea, diarrhea, and headache, and a mild Truvada rash are those experienced most by patients and participants in clinical trials. 

Infrequent, Less Severe Side Effects

The following Truvada PrEP side effects are less common but tend not to be very severe if they do occur:

  • Weight loss
  • Vomiting
  • Itching
  • Hives
  • Throat irritation
  • Abdominal pain
  • Weakness
  • Anxiety
  • Skin inflammations with blisters
  • Inflammation of the sinus tissue
  • Maculopapular rash

The final Truvada side effect on this list is another kind of Truvada rash. A maculopapular rash features both bumpy and flat skin lesions. 

Maculopapular rashes often occur alongside infections and body immune responses so in the case of this Truvada rash you will likely experience other side effects at the same time such as fever, headache, and muscle pain.

Infrequent, Severe Side Effects

While these PrEP side effects are less frequent, it is important to be aware of them due to their severity. If you experience any of the following Truvada PrEP side effects or their respective signs and symptoms you should seek immediate medical attention:

  • Difficulty breathing
  • Fanconi Syndrome – this kidney condition causes excessive thirst, urination, and vomiting.
  • Kidney disease – Truvada can cause a reduction in kidney function so doctors prescribing it often monitor kidney function throughout the treatment plan. Some symptoms of kidney disease you should be aware of include fatigue, fluid retention, increased urination, loss of appetite, and nausea. 
  • Acute inflammation of the pancreas – this sudden and acute form of pancreatitis can cause bleeding, infections, and cysts. Symptoms include abdominal tenderness, fever, rapid heart rate, nausea, and vomiting. 
  • Low blood phosphate level – otherwise known as hypophosphatemia, symptoms of this condition include muscle weakness, bone fractures, bone pain, and numbness. But, these symptoms tend not to appear until your phosphate levels are very low. 

The kidney and bone complications listed above, as well as other rarer side effects, have been the subject of several Truvada lawsuits in recent years, with users seeking legal compensation from Gilead, the manufacturer of Truvada.

While these problems have only been noted in small numbers of HIV-positive people, those most at risk are older people who have been taking Truvada as a treatment for HIV for several years.

In comparison, PrEP users tend to be younger and so these contentious side effects may have less of an impact on them. But, regardless of your age or how you’re taking Truvada, it’s vital to be aware of the potential impact of this drug on your long-term health. 

Rare, Less Severe Side Effects

These side effects of Truvada are less severe and also very rare. But, there is still a small chance that you may experience some of the following side effects when taking Truvada:

  • Back pain
  • Joint pain
  • Muscle pain
  • General, non-specific pain
  • Muscle weakness
  • Cough
  • Fever
  • Inflammation of the nose
  • Indigestion
  • Excessive sweating 
  • Skin discoloration

Some of these rare PrEP side effects may be signs of other illnesses associated with HIV or with general illnesses such as influenza. But, experiencing these rare side effects for an extended period of time may signify that Truvada is the cause. 

Rare, Severe Side Effects

These Truvada PrEP side effects may be very rare but they can have very serious consequences for Truvada users should they occur:

  • Acute tubular necrosis (ATN), a serious kidney injury which can lead to kidney failure. Symptoms include drowsiness, dehydration, fluid retention, nausea, confusion, and low urination. 
  • Kidney failure
  • Abnormal liver function, liver damage, and inflammation
  • Enlarged, fatty liver
  • Peripheral neuropathy, a painful condition affecting the nerves in the arms and legs. This can cause symptoms such as numbness, sensitivity to touch, and lack of coordination. 
  • Rhabdomyolysis, a condition leading to the breakdown of muscle tissue, with symptoms including the classic triad of muscle weakness, muscle pain, and dark urine. 
  • Angioedema, a type of allergic reaction that may occur alongside hives
  • Decreased calcification or bone density
  • Osteomalacia, a softening of the bones
  • Increased blood acidity as a result of high levels of lactic acid
  • Pneumonia

Again, several of these rare but severe side effects relate to kidney and bone complications, we well as liver damage and muscle and nerve damage. 

The Truvada Side Effects You Need to Know

Many of these Truvada side effects are rare or at least infrequent, while the most common side effects tend to be less serious. 

But if your doctor prescribes Truvada, either as a PrEP drug or a treatment for HIV, it’s important to be aware of the severe reactions this drug can have, including several forms of bone, kidney, and liver damage. 

For more informative articles and new stories, be sure to check out our other blog posts!

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