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Hello L%E2%80%99m A 28 Year Old Male With Gilbert%E2%80%99s Syndrome.
Question: Hello
l%E2%80%99m a 28 year old male with gilbert%E2%80%99s syndrome. i use truvada as prep to protect myself against HIV. but in the same time i have to take phenobarbital 100 mg every night to reduce high levels of bilirubin caused by gilbert%E2%80%99s syndrome which give me jaundice. due to some searches on the internet i think these two drugs can%E2%80%99t be taken in the same time. so what should i do to be able to take phenobarbital for my jaundice and be able to take prep to protect myself against hiv?
warm regards
l%E2%80%99m a 28 year old male with gilbert%E2%80%99s syndrome. i use truvada as prep to protect myself against HIV. but in the same time i have to take phenobarbital 100 mg every night to reduce high levels of bilirubin caused by gilbert%E2%80%99s syndrome which give me jaundice. due to some searches on the internet i think these two drugs can%E2%80%99t be taken in the same time. so what should i do to be able to take phenobarbital for my jaundice and be able to take prep to protect myself against hiv?
warm regards
Brief Answer:
Truvada is safest drug other than patients with impaired renal function
Detailed Answer:
Hi,
Welcome to ASK A DOTOR
Thanks for posting your query.
Tab, Truvada conatains Tenofovir (TDF) and Emtricitabin(FTC) Both belongs to NRTI clause of ART.
Emtricitabin is one of the safest ART drug and has least side effects. Tenofovir can produce burden to kidney in a compromised kidney patients. XXXXXXX syndrome has impaired liver function. As far as my knowledge goes Tab. Truvada had no great implication on patients with impaired hepatic function. Similarly Tab. Phenobarbitone drug interaction with Truvada also not mentioned obviously. So you can take both. The fluctuations in bilirubin level is possibly due to Gilbert's syndrome and unlikely to be due to Truvada. Your Pre-Exposure Prophylaxis also not necessarily be interfered or impaired with these drugs. Stay protected.
Dr S.Murugan
Truvada is safest drug other than patients with impaired renal function
Detailed Answer:
Hi,
Welcome to ASK A DOTOR
Thanks for posting your query.
Tab, Truvada conatains Tenofovir (TDF) and Emtricitabin(FTC) Both belongs to NRTI clause of ART.
Emtricitabin is one of the safest ART drug and has least side effects. Tenofovir can produce burden to kidney in a compromised kidney patients. XXXXXXX syndrome has impaired liver function. As far as my knowledge goes Tab. Truvada had no great implication on patients with impaired hepatic function. Similarly Tab. Phenobarbitone drug interaction with Truvada also not mentioned obviously. So you can take both. The fluctuations in bilirubin level is possibly due to Gilbert's syndrome and unlikely to be due to Truvada. Your Pre-Exposure Prophylaxis also not necessarily be interfered or impaired with these drugs. Stay protected.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Kampana
thank you for your complete respond.
i checked drugs.com and it says tenofovir and phenobarbital have major interaction and phenobarbital undermines tenofovir by reducing tenofovir level in blood. could you please enlighten me about this?
warm regards
i checked drugs.com and it says tenofovir and phenobarbital have major interaction and phenobarbital undermines tenofovir by reducing tenofovir level in blood. could you please enlighten me about this?
warm regards
Brief Answer:
PrEP when used along with condom is more eficacious.
Detailed Answer:
Hi,
Welcome back.
Thanks for the information.
I searched for drug interaction of TDF to Phenobarbital. In majority of the sites where I searched have no such interaction is mentioned. I am having a handbook of drug interactions with various ART drugs. There is also no such mention.
Anyway, even if we consider that Tenofovir will have interaction with phenobarbital and reduce the concentration of Tenofovir in blood or tissue level, then also there will not be much problem for Pre-exposure prophylaxis. As per PrEP guidelines it will be 99% effective, only when used along with condom. Without condom the efficacy of PrEP will be lower than that of using Truvada along with condom. Moreover usually the prophylactic dose of a drug for any disease (eg. Injection Benzathine penicillin dose in Rheumatic fever prophylaxis, Cotrimoxazole prophylaxis for HIV infection, HCQ prophylactic dose in Covid 19 infection) is far less than the therapeutic dose. Here you are using for prevention of the infection and not for therapeutic purpose. So you are safe in continuing the PrEP (Truvada) along with Phenobarbital provided if you are using the same with condom.
Dr S.Murugan
PrEP when used along with condom is more eficacious.
Detailed Answer:
Hi,
Welcome back.
Thanks for the information.
I searched for drug interaction of TDF to Phenobarbital. In majority of the sites where I searched have no such interaction is mentioned. I am having a handbook of drug interactions with various ART drugs. There is also no such mention.
Anyway, even if we consider that Tenofovir will have interaction with phenobarbital and reduce the concentration of Tenofovir in blood or tissue level, then also there will not be much problem for Pre-exposure prophylaxis. As per PrEP guidelines it will be 99% effective, only when used along with condom. Without condom the efficacy of PrEP will be lower than that of using Truvada along with condom. Moreover usually the prophylactic dose of a drug for any disease (eg. Injection Benzathine penicillin dose in Rheumatic fever prophylaxis, Cotrimoxazole prophylaxis for HIV infection, HCQ prophylactic dose in Covid 19 infection) is far less than the therapeutic dose. Here you are using for prevention of the infection and not for therapeutic purpose. So you are safe in continuing the PrEP (Truvada) along with Phenobarbital provided if you are using the same with condom.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
thank you for your detailed respond.
so if i take truvada but don%E2%80%99t use condom, how much is the percentage of protection for me? and how many days truvada take to be completly effective after start taking it? also i take osemoperazole ( nexium) 20mg each morning for reflux problem. does it have interaction with truvada?
warm regards
so if i take truvada but don%E2%80%99t use condom, how much is the percentage of protection for me? and how many days truvada take to be completly effective after start taking it? also i take osemoperazole ( nexium) 20mg each morning for reflux problem. does it have interaction with truvada?
warm regards
Brief Answer:
Truvada can be taken along with Esomeprazole
Detailed Answer:
Hi,
Welcome back.
Truvada with condom offers a 99%protection from HIV Infection for the HIV sero negative individuals.
The very next day onwards, the protective effect will be there. Esomeprazole also will not interact with Truvada. The protective effect will not be affected. You can very well continue the same.
Dr S Murugan
Truvada can be taken along with Esomeprazole
Detailed Answer:
Hi,
Welcome back.
Truvada with condom offers a 99%protection from HIV Infection for the HIV sero negative individuals.
The very next day onwards, the protective effect will be there. Esomeprazole also will not interact with Truvada. The protective effect will not be affected. You can very well continue the same.
Dr S Murugan
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Above answer was peer-reviewed by :
Dr. Nagamani Ng
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