Additional conditions apply. Consult your pharmacist or local waste disposal company.Drug interactions may change how your medications work or increase your risk for serious side effects. During treatment with emtricitabine-tenofovir DF, 13% of patients lost at least 5% of BMD at the spine.Increased creatine kinase (at least 10 x ULN) has been reported in 9% and 7% of patients using emtricitabine plus tenofovir alafenamide and emtricitabine plus tenofovir DF, respectively, each with elvitegravir plus cobicistat.In virologically-suppressed tenofovir DF-treated patients who switched to emtricitabine plus tenofovir alafenamide with elvitegravir plus cobicistat, mean BMD increased between baseline and week 48; decreased BMD was also reported.Rhabdomyolysis, osteomalacia, muscular weakness, and myopathy may occur as a result of proximal renal tubulopathy.Rhabdomyolysis, muscular weakness, and myopathy have also been reported during postmarketing experience with tenofovir DF.-Common (1% to 10%): Decreased bone mineral density (BMD)-Common (1% to 10%): Increased creatine kinase, bone fractures, -Frequency not reported: Increased biochemical markers of bone metabolism, increased BMD, fractures (excluding fingers and toes)-Very common (10% or more): Increased creatine kinase-Very common (10% or more): Increased creatine kinase-Common (1% to 10%): Myalgia, arthralgia, back pain-Uncommon (0.1% to 1%): Rhabdomyolysis, muscular weakness-Frequency not reported: Decreased BMD, increased biochemical markers of bone metabolism-Postmarketing reports: Osteomalacia (manifested as bone pain and which may contribute to fractures)Hyperglycemia (greater than 250 mg/dL) has been reported in up to 2% of patients using emtricitabine-tenofovir DF.Lactic acidosis and severe hepatomegaly with steatosis (including fatal cases) have been reported with the use of nucleoside analogs.Hypokalemia, lactic acidosis, and hypophosphatemia have also been reported during postmarketing experience with tenofovir DF.-Common (1% to 10%): Hyperglycemia, hypertriglyceridemia, increased or decreased serum glucose-Common (1% to 10%): Anorexia, increased serum glucose-Frequency not reported: Redistribution of body fat (lipodystrophy), increased glucose levels-Common (1% to 10%): Depression, insomnia, abnormal dreams, -Very common (10% or more): Insomnia, abnormal dreams-Common (1% to 10%): Rash event (including rash, maculopapular rash, exfoliative rash, generalized rash, macular rash, pruritic rash, vesicular rash)-Very common (10% or more): Rash event (including rash, pruritus, maculopapular rash, -Common (1% to 10%): Skin discoloration (palmar-plantar hyperpigmentation)-Postmarketing reports: Angioedema, urticaria, rash-Very common (10% or more): Rash event (including rash, pruritus, maculopapular rash, urticaria, vesiculobullous rash, pustular rash)Skin discoloration (hyperpigmentation) was very common in pediatric patients using emtricitabine.Rash has also been reported during postmarketing experience with tenofovir DF.Increased creatinine (1.1 to 1.3 x ULN: up to 2%; greater than 1.4 x ULN: less than 1%) has been reported with emtricitabine-tenofovir DF.In 2 trials in antiretroviral therapy-naive HIV-1-infected patients (median estimated glomerular filtration rate [eGFR] 115 mL/min at baseline) using emtricitabine plus tenofovir alafenamide with elvitegravir plus cobicistat, mean serum creatinine increased by 0.1 mg/dL from baseline to week 48; median UPCR was 44 mg/g at baseline and at week 48. Increased AST (greater than 170 units/L) and ALT (greater than 170 units/L) have been reported in 3% and 2% of females using emtricitabine-tenofovir DF, respectively.Increased AST (greater than 5 x ULN) has been reported in 2% and 2% of patients using emtricitabine plus tenofovir alafenamide and emtricitabine plus tenofovir DF, respectively, each with elvitegravir plus cobicistat.Severe acute exacerbations of hepatitis have been reported in patients with hepatitis B after discontinuation of this drug and were associated with liver failure and liver decompensation in some emtricitabine-treated patients.Hepatic steatosis and hepatitis have also been reported during postmarketing experience with tenofovir DF.Decreased neutrophils (1000 to 1300/mm3: up to 13%; less than 750/mm3: up to 5%) and hemoglobin (8.5 to 10 mg/dL: 4%; less than 9.4 mg/dL: up to 2%) have been reported with emtricitabine-tenofovir DF.Anemia was common in pediatric patients using emtricitabine.-Very common (10% or more): Decreased neutrophils (up to 13%)-Common (1% to 10%): Sinusitis, upper respiratory tract infections, nasopharyngitis-Very common (10% or more): Rhinitis, increased coughIncreased serum amylase (greater than 175 units/L) has been reported in up to 8% of patients using emtricitabine-tenofovir DF.In clinical trials, nausea was the most common side effect reported in antiretroviral therapy-naive HIV-1-infected patients using emtricitabine plus tenofovir alafenamide with elvitegravir plus cobicistat.Increased amylase (greater than 2 x ULN) has been reported in 2% and 4% of patients using emtricitabine plus tenofovir alafenamide and emtricitabine plus tenofovir DF, respectively, each with elvitegravir plus cobicistat.-Common (1% to 10%): Diarrhea, nausea, abdominal pain (included abdominal pain, upper abdominal pain, lower abdominal pain, gastrointestinal pain, abdominal discomfort)-Common (1% to 10%): Diarrhea, nausea, increased serum amylase, abdominal pain (included abdominal pain, upper abdominal pain, lower abdominal pain, gastrointestinal pain, abdominal discomfort), vomiting-Common (1% to 10%): Diarrhea, vomiting, abdominal pain, flatulence, increased amylase-Very common (10% or more): Diarrhea, nausea, abdominal pain-Common (1% to 10%): Increased amylase (including increased pancreatic amylase), increased serum lipase, vomiting, dyspepsia-Very common (10% or more): Diarrhea, vomiting, nauseaIn clinical trials of HIV-1-uninfected individuals, decreased BMD was reported.

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