Microsoft word - compleradraftb.doc

For inquiries between 8am-10pm and for emergencies 24 hours call: 1-888-511-6222 St. Paul’s Hospital (SPH) Ambulatory Care Pharmacists: 604-806-8151. Please call two weeks in advance if booking a SPH pharmacy appointment with the receptionist at 604-806-8060. COMPLERA (RILPIVIRINE, EMTRICITABINE & TENOFOVIR) What is Complera? • Complera is a combination antiretroviral (ARV) agent used to inhibit replication of the HIV rilpivirine (Edurant) 25 mg [a non-nucleoside reverse transcriptase inhibitor (NNRTI)] emtricitabine (FTC) 200 mg [a nucleoside reverse transcriptase inhibitor (NRTI)] tenofovir (Viread) 300 mg [a nucleotide reverse transcriptase inhibitor (NRTI)] It is available as a purplish-pink tablet (30 tablets/bottle) The usual adult dose is one tablet once daily with a meal. Swallow tablets with plenty of water. Do not drink grapefruit juice with Complera. • ALWAYS take Complera with a meal to get the right drug levels in your body. A protein drink by itself is not a meal. See the table below for meal suggestions. Table: Meal Options Comprising 500-600 kcal
- 2 slices of whole wheat toast with peanut butter, fresh fruit, and 1 cup orange juice (509 calories)
- 2 eggs, 2 strips of bacon, and 2 slices of wheat toast with butter (520 calories)
- 2 toasted breakfast pastries, yogurt, and 1 cup of juice (596 calories)
- Plain bagel with 2 tbsp cream cheese, yogurt, and a banana (569 calories)
- Roast beef sandwich on a hard roll with mayonnaise and cheese (582 calories)
- 2 slices of cheese pizza and 1 can of regular soda (550 calories)
- Peanut butter and jelly sandwich on wheat bread, a banana, and 1 cup skim milk (562 calories)
- Veggie burger on a bun with tomato soup and a side salad (500 calories)
- Grilled chicken Caesar salad (521 calories)
- 2 cups of spaghetti with marinara sauce and 1 slice of bread (514 calories)
- Salmon with rice and fresh vegetables (596 calories)
- Tofu and vegetable stir-fry with brown rice and a side salad (527 calories)
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Complera cannot be used with some medications that are used to prevent or treat stomach ulcers, heartburn or acid reflux disease eg. omeprazole [Losec], lansoprazole [Prevacid], rabeprazole [Pariet], pantoprazole [Pantoloc], esomeprazole [Nexium]. It is important to talk to your pharmacist or doctor, if you are taking these medications. Other acid lowering medications can be used with Complera, but must be spaced apart: • Take antacids (eg. calcium carbonate [Tums, Rolaids], aluminum/magnesium hydroxide [Maalox]) at least 2 hours before or 4 hours after your Complera dose. Take H2 antagonists (eg. ranitidine [Zantac], cimetidine, famotidine [Pepcid], nizatidine) at least 12 hours before or 4 hours after your Complera dose. Alcohol is not recommended in the first 4 weeks of therapy and should be used with caution thereafter. If you are pregnant or plan to become pregnant, talk to your doctor. The effect of Complera on pregnant women or their unborn babies is not known. Take Complera every day as prescribed as missing doses can lead to the development of drug resistance. If you miss a dose, take it as soon as you remember. If it is close to your next scheduled dose, skip the missed dose and take your next dose at the usual time. Do not take two doses at the same time. DO NOT STOP Complera without consulting your doctor. What should I expect? Side effects reported with Complera include diarrhea, decreased appetite, depressed mood, sleep problems, headache, weakness, tiredness, stomach pain, nausea, vomiting, gas, skin discoloration, rash, dizziness and drowsiness. Talk to your doctor or pharmacist if these symptoms occur and continue to bother you or get worse. If you develop a severe rash or a rash with symptoms, such as fever, blistering, mouth sores, swelling or muscle/joint aches OR if you notice any symptoms of a possible change in your heart beat, such as dizziness, increased heart beats, fainting or seizures,contact your doctor IMMEDIATELY. Complera can rarely cause kidney problems. This can occur even after being on medication for many months. Some conditions (eg. older age, diabetes or high blood pressure) or taking certain medications that can be harmful to the kidney may increase your risk for developing this problem. Redistribution or accumulation of body fat, blood fat changes and/or diabetes may occur in patients receiving antiretroviral therapy. Your doctor or pharmacist can provide you with further information on this topic. Warning: Complera can interact with a number of medications and result in potentially serious and/or life-threatening complications. Medications that should not be used with Complera include some anti-seizure medications, anti-tuberculosis medications, anti-ulcer/heartburn medications, steroids and St. John’s wort. Always check with the pharmacist (1-888-511-6222) or your physician before starting any new therapies (prescription, non prescription and herbal) to ensure the safety of the combination Complera should be stored in a cool, dry place at room temperature (15-30 degrees Celsius). Store all medication out of the reach of children. Labwork to be done: CBC with differential, liver enzymes, kidney tests, fasting glucose and lipid panel, plasma viral load, CD4 count

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