Trioday

Trioday is a combined medication used to control HIV (human immunodeficiency virus) in adult patients. Each tablet contains the combination of the three anti-retrovirus medicines: Tenofovir disoproxil fumarate 300mg, Lamivudine 300mg, and Efavirenz 600mg.

Tenofovir is a nucleotide reverse transcriptase inhibitor (NRTI) and it has potent activity against human immunodeficiency virus (HIV-1 and HIV-2) and hepatitis B virus. Tenofovir inhibits HIV-1 reverse transcriptase and hepatitis B virus polymerase by a specific mechanism which results in the termination of the DNA strand synthesis.

Lamivudine is a nucleoside reverse transcriptase inhibitor (NRTI). It is a highly effective selective HIV-1 and HIV-2 replication inhibitor. It is also active against those HIV strains that are resistant to Zidovudine. To a small extent, Lamivudine also inhibits RNA- and DNA-dependant HIV reverse transcriptase.

Efavirenz is an anti-retroviral medication. Efavirenz is a selective HIV-1 non-nucleoside reverse transcriptase inhibitor (NNRTI). It is a non-competitive inhibitor of the HIV-1 reverse transcriptase, however it doesn`t inhibit HIV-2 reverse transcriptase and human cells DNA polymerase (α, β, γ, and δ).

The standard recommended dose is one tablet per day, taken at the same time every day.

The medication is taken orally, preferably before going to bed and on an empty stomach. The therapy must be prescribed by a doctor with the experience in HIV treatment.

The most common side effects of Tenofovir (with the frequency over 10% and within 2-4 severity grades) include: skin rash, diarrhea, headache, pain, depression, asthenia, and nausea.

The most common side effects of Lamivudine include: headache, nausea, general weakness, fatigue, nasal symptoms, diarrhea, and coughing.

The most common side effects of Efavirenz (in over 5% of the cases, ranging from mild to severe grades) include: skin rash, dizziness, nausea, headache, fatigue, insomnia, and nausea.

Counter indications:

Tenofovir: Decreased kidney function, peripheral neuropathy, intolerance to any components of the drug, use in pediatric patients below 18.

Lamivudine: Life threatening allergic reactions (such as anaphylaxis and Stevens-Johnson syndrome) to Lamivudine or any other components of the drug.

Efavirenz: Concurrent treatment with terfenadine, astemizole, cisapride, midazolam, and triazolam; hypersensitivity to Efavirenz or any other components of the drug.

With care:

Tenofovir: Decreased liver function.

Lamivudine: Lactate acidosis and apparent hepatomegaly with steatosis, hepatitis exacerbation, kidney failure, liver failure, pancreatitis (including past medical history), peripheral neuropathy (including past medical history).

Efavirenz: The medication has to be used with care in patients with the apparent decrease in liver function. It is recommended to test the activity of the liver transaminases on a regular basis in patients with hepatitis B or C, or when these infections are suspected in the past medical history, as well as in patients, receiving other medications that may have hepatotoxic action. In case there is an acute persistent rise in the activity of the transaminases up to the level more than five times exceeding the upper limit of normal, it is required to assess the benefits of further treatment against the risks of significant hepatotoxic action.