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What should I discuss with my healthcare provider before taking emtricitabine, lopinavir, ritonavir, and tenofovir (AccessPak for HIV PEP Expanded with Kaletra)?

You should not take this medication if you have severe liver or kidney disease, or if you are allergic to emtricitabine (Emtriva, Atripla), lopinavir (Kaletra), ritonavir (Norvir), or tenofovir (Viread). Do not take this medication with other medicines that also contain emtricitabine or tenofovir (Atripla, Emtriva, Viread).

The following drugs can cause serious or life threatening medical problems if you take them together with emtricitabine, lopinavir, ritonavir, and tenofovir:

• alfuzosin (Uroxatrol);
• lovastatin (Mevacor, Altoprev, Advicor) or simvastatin (Zocor, Simcor, Vytorin);
• St. John's wort;
• pimozide (Orap);
• midazolam (Versed ) or triazolam (Halcion);
• rifampin (Rimactane, Rifadin, Rifater, Rifamate);
• sildenafil (Revatio for pulmonary arterial hypertension); or
• an ergot medicine such as D.H.E. 45, Ergomar, Cafergot, Ergotrate, Methergine, Migergot, or Migranal.

To make sure you can safely take emtricitabine, lopinavir, ritonavir, and tenofovir, tell your doctor if you have any of these other conditions:

• liver or kidney disease;
• heart disease or heart rhythm disorder;
• low levels of potassium in your blood;
• a bleeding disorder such as hemophilia;
• osteopenia (low bone mineral density); or
• pancreas problems, diabetes, or high cholesterol.

Some people develop a life-threatening condition called lactic acidosis while taking emtricitabine or tenofovir. You may be more likely to develop lactic acidosis if you are overweight or have liver disease, if you are a woman, or if you have taken HIV or AIDS medications for a long time. Talk with your doctor about your individual risk.

FDA pregnancy category C. It is not known whether this medication will harm an unborn baby. HIV can be passed to your baby if you are not properly treated during pregnancy. Take all of your HIV medicines as directed to control your infection.

Women with HIV or AIDS should not breast-feed a baby. Even if your baby is born without HIV, the virus may be passed to the baby in your breast milk.

Do not give this medicine to a child without medical advice.

How should I take emtricitabine, lopinavir, ritonavir, and tenofovir (AccessPak for HIV PEP Expanded with Kaletra)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

To be sure this medication is helping your condition and not causing harmful effects, your blood will need to be tested often. Your kidney and liver function or bone density may also need to be tested. Visit your doctor regularly.

If you have hepatitis B you may develop liver symptoms after you stop taking this medicine, even months after stopping. Your doctor may want to check your liver function at regular visits for several months after you stop using the medicine. Do not miss any follow-up visits to your doctor.

HIV/AIDS is usually treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice. Every person with HIV or AIDS should remain under the care of a doctor.

Store at room temperature away from moisture and heat. Do not freeze.

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