Comparative Pharmacology
Head-to-head clinical analysis: EMTRICITABINE versus LAMIVUDINE STAVUDINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EMTRICITABINE versus LAMIVUDINE STAVUDINE.
EMTRICITABINE vs LAMIVUDINE; STAVUDINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Nucleoside reverse transcriptase inhibitor; phosphorylated to emtricitabine triphosphate which competes with endogenous deoxycytidine triphosphate and incorporates into viral DNA causing chain termination.
Lamivudine is a nucleoside reverse transcriptase inhibitor (NRTI) that inhibits HIV-1 reverse transcriptase via DNA chain termination after intracellular phosphorylation to lamivudine triphosphate. Stavudine is also an NRTI that inhibits HIV-1 reverse transcriptase after phosphorylation to stavudine triphosphate.
200 mg orally once daily, typically in combination with other antiretroviral agents.
Lamivudine 150 mg plus stavudine 30 mg orally twice daily. For patients weighing ≥60 kg, stavudine 40 mg twice daily.
None Documented
None Documented
Clinical Note
moderateEmtricitabine + Ribavirin
"Emtricitabine may increase the hepatotoxic activities of Ribavirin."
Clinical Note
moderateLamivudine + Emtricitabine
"The risk or severity of adverse effects can be increased when Lamivudine is combined with Emtricitabine."
Clinical Note
moderateGanciclovir + Emtricitabine
"The risk or severity of adverse effects can be increased when Ganciclovir is combined with Emtricitabine."
Clinical Note
moderateValganciclovir + Emtricitabine
Terminal elimination half-life is approximately 10 hours (range 8–12 hours) in adults with normal renal function; prolonged to >20 hours in severe renal impairment (CrCl <30 mL/min).
Lamivudine: 5-7 hours in adults; prolonged to 19-28 hours in severe renal impairment (CrCl <10 mL/min). Stavudine: 1.0-1.6 hours; prolonged to 7.4-8.2 hours in severe renal impairment.
Renal: approximately 86% of the dose is excreted unchanged in urine via glomerular filtration and active tubular secretion. Biliary/fecal: minimal (<14% as unchanged drug and metabolites in feces).
Lamivudine: 70% renal excretion via glomerular filtration and active tubular secretion as unchanged drug; 5-10% fecal. Stavudine: 40% renal excretion via glomerular filtration and active tubular secretion; 34-39% unchanged in urine; fecal excretion minimal.
Category C
Category A/B
Antiretroviral, NRTI
NRTI
"The risk or severity of adverse effects can be increased when Valganciclovir is combined with Emtricitabine."