Comparative Pharmacology
Head-to-head clinical analysis: EMTRICITABINE versus LAMIVUDINE ZIDOVUDINE NEVIRAPINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EMTRICITABINE versus LAMIVUDINE ZIDOVUDINE NEVIRAPINE.
EMTRICITABINE vs LAMIVUDINE; ZIDOVUDINE; NEVIRAPINE
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 and HBV reverse transcriptase. Zidovudine is also an NRTI that inhibits HIV-1 reverse transcriptase. Nevirapine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) that directly binds to HIV-1 reverse transcriptase and inhibits RNA-dependent and DNA-dependent DNA polymerase activities. The combination inhibits HIV replication.
200 mg orally once daily, typically in combination with other antiretroviral agents.
One tablet (150 mg lamivudine, 300 mg zidovudine, 200 mg nevirapine) orally 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 in renal impairment; Zidovudine: 0.5-3 hours, prolonged in hepatic impairment; Nevirapine: 25-30 hours (single dose), 40-45 hours after multiple doses due to autoinduction.
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% unchanged in urine via glomerular filtration and active tubular secretion; Zidovudine: ~75% metabolized to inactive glucuronide (G-ZDV), ~20% excreted unchanged in urine; Nevirapine: ~80% metabolized by CYP3A4/2B6, ~10% unchanged in urine, ~1% in feces.
Category C
Category A/B
Antiretroviral, NRTI
NRTI
"The risk or severity of adverse effects can be increased when Valganciclovir is combined with Emtricitabine."