Comparative Pharmacology
Head-to-head clinical analysis: EMTRIVA versus LAMIVUDINE STAVUDINE NEVIRAPINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EMTRIVA versus LAMIVUDINE STAVUDINE NEVIRAPINE.
EMTRIVA vs LAMIVUDINE; STAVUDINE; NEVIRAPINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Nucleoside reverse transcriptase inhibitor; emtricitabine is phosphorylated to emtricitabine 5'-triphosphate which competes with deoxycytidine 5'-triphosphate for incorporation into viral DNA, resulting in chain termination.
Lamivudine is a nucleoside reverse transcriptase inhibitor (NRTI) that inhibits HIV-1 reverse transcriptase by competing with natural substrate and causing chain termination. Stavudine is an NRTI that inhibits HIV-1 reverse transcriptase after intracellular phosphorylation to its active triphosphate form. Nevirapine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) that binds directly to HIV-1 reverse transcriptase, causing allosteric inhibition.
Emtricitabine 200 mg orally once daily.
One tablet containing lamivudine 150 mg, stavudine 30 mg (or 40 mg if weight ≥60 kg), and nevirapine 200 mg orally twice daily.
None Documented
None Documented
Terminal elimination half-life ~10 hours (mean 10 h, range 7-14 h) in adults; prolonged in renal impairment (up to 90 h in severe impairment)
Lamivudine: 5-7 h (prolonged in renal impairment); Stavudine: 1.6 h (prolonged in renal impairment, ~3.5-8 h in ESRD); Nevirapine: ~45 h (single dose), ~25-30 h (multiple doses due to autoinduction; prolonged in hepatic impairment).
Renal excretion of unchanged drug (~86%) by glomerular filtration and active tubular secretion; fecal excretion (<1%)
Lamivudine: ~70% renal (glomerular filtration and tubular secretion), ~30% unchanged; Stavudine: ~40% renal (tubular secretion), ~60% metabolized to inactive metabolites; Nevirapine: ~80% renal (metabolites, <5% unchanged), ~10% fecal.
Category C
Category A/B
Antiretroviral, NRTI
NRTI