Viraday

Viraday general information

What is Viraday used for?

Viraday tablets are a fixed dose combination treatment for Human Immunodeficiency Virus (HIV) infection in adults over age 18. Viraday tablets are used to treat HIV patients who have already received treatment with other HIV medications and have responded to all medications prescribed; they can also be used alone as monotherapy or in combination with other HIV medications. HIV impairs the immune system by attacking specific immune cells called CD4+ cells that are involved in fighting infection, which can lead to opportunistic life-threatening infection (infections that would not normally be harmful); also if too many CD4+ cells are destroyed this can result in acquired immune deficiency syndrome (AIDS). Viraday tablets prevent or slow down the ability of HIV to replicate and spread, which keeps the amount virus down to a low level and this results in an increase in CD4 cell numbers, so that the immune system can recover, reducing the risk of disease progression.

How does Viraday work?

Viraday tablets contain a combination of three antiretroviral drugs, efavirenz, emtricitabine and tenofovir disoproxil fumarate, which are only effective against RNA viruses (retroviruses) like Human Immunodeficiency Virus (HIV). These three drugs each work by inhibiting the action of the viral-specific enzyme reverse transcriptase (RT) which is needed for the virus to be able to replicate. Retroviruses convert RNA to DNA, which is then integrated into the DNA of infected immune cells so that the virus can replicate. Efavirenz is a non-nucleoside reverse transcriptase inhibitor (NNRTI) and acts by binding to a specific site on the RT enzyme and blocks its action in a manner that is noncompetitive with nucleosides, which are the precursors to the building blocks of DNA and RNA. Tenofovir and Emtricitabine are both nucleoside analogue reverse transcriptase inhibitors (NRTI), which means that they block the action of RT by competing with one of the nucleosides needed to transcribe the viral RNA into DNA, becoming incorporated into the chain of newly synthesized viral DNA and preventing it from growing (chain termination). Emtricitabine is an analogue of cytidine and tenofovir is an analogue of adenosine. The combined action of the three antiiretroviral drugs in Viraday tablets prevents the integration of the virus into the DNA of the infected CD4+ immune cell, which inhibits the replication of HIV so that no more virus can be produced and this reduces the viral load (amount of virus). Viraday tablets slow down the replication of HIV within your body but does not kill the virus already incorporated in the CD4+ cells or prevent the spread of the infection to others.

What does Viraday contain?

Viraday tablets contain three active ingredients, the antiretrovirals efavirenz (600mg), tenofovir disoproxil fumarate (300mg) and emtricitabine (200mg), used to treat HIV infection.

Treating HIV infection with Viraday

Viraday tablets contain a combination of three antiretroviral drugs, efavirenz, emtricitabine and tenofovir, which are only effective against RNA viruses (retroviruses) like Human Immunodeficiency Virus (HIV). HIV impairs the immune system by attacking specific immune cells called CD4+ cells that are involved in fighting infection, which can lead to opportunistic life-threatening infection (infections that would not normally be harmful), including pneumonia, herpes virus infections, and Mycobacterium avium complex (MAC) infection. If too many CD4+ cells are destroyed this can result in acquired immune deficiency syndrome (AIDS). The three antiretroviral drugs in Viraday tablets each work by inhibiting the action of the viral-specific enzyme reverse transcriptase (RT) which is needed for the virus to be able to replicate, as it converts viral RNA to DNA, which is then integrated into the DNA of infected immune cells so that the virus can replicate. Viraday tablets prevent the integration of HIV into the DNA of the infected CD4+ cell, which inhibits the replication of HIV so that no more virus can be produced and this reduces the viral load (amount of virus). Viraday tablets slow down the replication of HIV within your body but does not kill the virus already incorporated in the CD4+ cells or prevent the spread of the infection to others.

What are the side effects of Viraday?

The most commonly reported side effects when taking Viraday tablets include: headache, gastrointestinal upset (nausea, diarrhoea, constipation, stomach pain), anorexia, dizziness, fatigue, rash, hot flush, difficulty sleeping, nightmare, depression, depressed mood, anxiety, insomnia, altered mood, abnormal dreams. A more serious but less common side effect is a condition called lactic acidosis which is excess lactic acid in the blood due to liver damage, which may cause pancreatitis, liver failure, or renal failure.

What are the health risks when taking Viraday?

Lactic acidosis is a rare but potentially fatal condition that has been reported when taking Viraday tablets. It is caused by a build up of excess of lactic acid in the blood due to liver damage, which is usually associated with hepatomegaly (liver enlargement) with steatosis (build up of fat in the liver) and may cause pancreatitis, liver failure, or renal failure. Symptoms begin within a few months of treatment and include: nausea, vomiting and abdominal pain, difficulty breathing, loss of appetite, weight loss, motor weakness.

When should Viraday not be used?

You should not use Viraday tablets if you:

• are allergic to efavirenz, emtricitabine and tenofovir or any ingredients in Viraday
• are pregnant or are breastfeeding
• have kidney or liver disease
• have hepatitis B infection
• have a mental illness, including depression; convulsions; or bone disease like osteoporosis without discussion with your doctor, as your condition may worsen
• are taking medicines that interact with Viraday, including: cisapride for reflux, midazolam and triazolam for sedation and anxiety, the antipsychotic pimozide, bepridil for angina, Cafergot for migraine, the antifungal voriconazole and Itraconazole, other medications containing efavirenz, emtricitabine, or tenofovir, other retrovirals like ritonavir or lamivudine, herbal preparations containing St. John's wort, the anticonvulsant phenobarbital, antibiotics like clarithromycin rifampicin, statins like simvastatin for lowering cholesterol, the anticoagulant warfarin, the anticonvulsants carbamazepine and Phenytoin, the antidepressant sertraline, the calcium channel blocker diltiazem for high blood pressure, oral contraceptives

What medications interact with Viraday?

Several medications interact with Viraday and should either not be taken while you are taking Viraday or only after discussion and instruction from your doctor:

• Drugs that cause a serious reaction with Viraday: cisapride for reflux, midazolam and triazolam for sedation and anxiety, the antipsychotic pimozide, bepridil for angina, Cafergot for migraine, herbal preparations containing St. John's wort, the retroviral lamivudine
• Drugs that affect Viraday: the anticonvulsant phenobarbital, the antiinfective rifampin, other retrovirals like ritonavir
• Drugs that are affected by Viraday: the antifungals voriconazole and Itraconazole, statins like simvastatin for lowering cholesterol, the anticoagulant warfarin, the anticonvulsant carbamazepine and Phenytoin, the antidepressant sertraline, the calcium channel blocker diltiazem for high blood pressure, antibiotics like clarithromycin rifampicin, oral contraceptives

How should Viraday be taken?

You should take your Viraday tablets with a glass of water once a day on an empty stomach (1 hour before or 2 hours after a meal), preferably at bedtime, to reduce problems with side effects. You should continue to take your Viraday tablets regularly for as long as your doctor recommends, and you condition should be monitored. Do not suddenly stop taking your Viraday tablets as this may increase risk of HIV resistance.

How long should you take Viraday?

You should continue to take your Viraday tablets regularly for as long as your doctor recommends, and you condition should be monitored.

Missed dose of Viraday

If you miss a dose of Viraday tablets take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.

How should Viraday be stored?

You should store your Viraday below 25°C in a cool dry place.