Tenvir Em
✅ Protects against HIV infection
✅ Prevents Virus Multiplication
✅ Potential for Hepatitis B Treatment
✅ Improves Quality of Life
✅ Generic version of Truvada ®
Tenvir Em contains Emtricitabine and Tenofovir.
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
⚡ Quick Answer — What is Tenvir-EM?
Tenvir-EM is a fixed-dose tablet combining tenofovir disoproxil fumarate (TDF) 300 mg and emtricitabine (FTC) 200 mg. It is used for HIV pre-exposure prophylaxis (PrEP) to prevent sexually transmitted HIV, as part of combination HIV treatment, and in HIV post-exposure prophylaxis (PEP). Manufactured by Cipla as a generic equivalent of Gilead’s Truvada®. One tablet once daily; HIV-negative status and kidney function must be confirmed before starting PrEP.
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Tenvir-EM is a two-drug fixed-dose antiretroviral tablet combining tenofovir disoproxil fumarate (TDF) 300 mg and emtricitabine (FTC) 200 mg. It is manufactured by Cipla to pharmaceutical-grade standards and contains the same active ingredients as Gilead Sciences’ branded Truvada® — at a fraction of the price. Each tablet is taken once daily, with or without food.
Tenvir-EM has three major clinical uses: HIV pre-exposure prophylaxis (PrEP), HIV combination treatment, and HIV post-exposure prophylaxis (PEP). It is on the WHO Model List of Essential Medicines and is the backbone of most global PrEP programmes, including the CDC’s in the United States.
What Is Tenvir-EM?
Tenvir-EM is a combination of two nucleos(t)ide reverse transcriptase inhibitors (NRTIs):
- Tenofovir disoproxil fumarate (TDF) — a nucleotide analogue that blocks HIV reverse transcriptase
- Emtricitabine (FTC) — a cytidine analogue that also blocks reverse transcriptase and is synergistic with TDF
When taken consistently, Tenvir-EM produces intracellular drug levels in genital, rectal, and blood tissues high enough to prevent HIV from establishing infection after exposure — or to suppress HIV replication in an already infected person (when used as part of a three-drug regimen).
Tenvir-EM is indicated for:
- HIV-1 pre-exposure prophylaxis (PrEP) — in HIV-negative adults at substantial risk of HIV acquisition
- HIV-1 post-exposure prophylaxis (PEP) — as part of a 28-day triple-drug regimen after suspected HIV exposure
- HIV-1 combination treatment — as the NRTI backbone alongside a third agent (integrase inhibitor, NNRTI, or boosted protease inhibitor)
- Chronic Hepatitis B — off-label but clinically common, because TDF is licensed for HBV monotherapy in other products
How Does Tenvir-EM Work?
Both TDF and FTC are pro-drugs that are phosphorylated inside cells into their active triphosphate forms:
- Intracellular tenofovir diphosphate and emtricitabine triphosphate compete with natural nucleotides for incorporation into the growing HIV DNA chain
- Once incorporated, they act as chain terminators — HIV reverse transcriptase cannot extend the DNA strand, so the viral genome cannot replicate
- With consistent daily dosing, drug levels in rectal tissue reach protective concentrations within about 7 days and in vaginal tissue within about 20 days
- Clinical trials (iPrEx, Partners PrEP, PROUD) show that when Tenvir-EM is taken as prescribed, it reduces sexual HIV acquisition by more than 99%
PrEP is most effective when taken every day. Missed doses lower protection, particularly for receptive vaginal exposure where drug uptake into tissue is slower than in rectal tissue.
Uses and Indications
- HIV-1 pre-exposure prophylaxis (PrEP) — men who have sex with men, serodiscordant couples, transgender individuals, people who inject drugs, and any HIV-negative adult at ongoing sexual risk
- HIV-1 post-exposure prophylaxis (PEP) — combined with a third agent (usually an integrase inhibitor like dolutegravir or raltegravir) for 28 days after suspected HIV exposure. Must be started within 72 hours of exposure; sooner is better
- HIV-1 combination treatment — NRTI backbone with a third-agent partner
- Chronic Hepatitis B — TDF component is active against HBV
Tenvir-EM Dosage and Administration
| Scenario | Recommended Dose | Duration / Notes |
|---|---|---|
| Daily PrEP (standard) | 1 tablet once daily | Indefinite while exposure risk persists; same time daily is best |
| On-demand “2-1-1” PrEP (MSM only) | 2 tablets 2–24 h before sex; 1 tablet 24 h after; 1 tablet 48 h after | Per IPERGAY trial protocol; MSM population only, not validated in vaginal sex |
| PEP (triple therapy) | 1 tablet once daily + third agent | Start within 72 h of exposure; 28-day course |
| HIV treatment | 1 tablet once daily + third agent | Lifelong; adherence >95% required for durable viral suppression |
| CrCl 30–49 mL/min | 1 tablet every 48 hours | Reduced dosing interval |
| CrCl <30 mL/min or dialysis | Not recommended | Switch to tenofovir alafenamide (TAF)-based option such as Tenvir-AF |
| Hepatic impairment | Standard dose | No adjustment needed |
How to Take Tenvir-EM Properly
- Swallow the tablet whole with water; can be taken with or without food
- Take at roughly the same time each day — missed doses reduce protection
- Before starting PrEP, confirm HIV-negative status with a 4th-generation antigen/antibody test and a screen for hepatitis B and creatinine / eGFR
- While on PrEP, test for HIV every 3 months, renal function every 6 months, and STIs at least every 6 months
- Do not take Tenvir-EM alone as HIV treatment if you are HIV-positive — this can select for drug-resistant virus. A third agent is required
- If a PrEP dose is missed by less than 24 hours, take it as soon as possible. If missed by more than 24 hours, take the next scheduled dose and carry on
Side Effects of Tenvir-EM
Most people tolerate Tenvir-EM well. Side effects are usually mild and improve within 2–4 weeks of starting the tablet.
| Severity | Side Effect |
|---|---|
| Common (≥1 in 10) | Headache, nausea, diarrhoea, fatigue — especially in the first 2–4 weeks (“start-up syndrome”) |
| Common (≥1 in 100) | Dizziness, abdominal pain, flatulence, mild rash, sleep disturbance, raised liver enzymes |
| Uncommon | Decline in kidney function (rise in creatinine, proximal tubular dysfunction, rarely Fanconi syndrome), mild reduction in bone mineral density |
| Rare but serious | Lactic acidosis with hepatic steatosis (NRTI class effect), severe renal impairment, hepatitis B flare on discontinuation in HBV-positive patients |
Seek urgent medical attention for severe abdominal pain with vomiting, jaundice, sharp decline in urine output, confusion, or rapid breathing — these can be features of lactic acidosis, a rare but serious NRTI-class complication.
Warnings and Precautions
- HIV test before and during PrEP. Starting Tenvir-EM (two drugs only) in someone with undiagnosed HIV can select for resistance and compromise future treatment. A 4th-generation HIV test at baseline and every 3 months is essential
- Renal function. TDF can cause dose-related kidney injury. Check eGFR at baseline, 3 months, then every 6–12 months. Avoid if eGFR <30 mL/min
- Bone health. Modest reductions in bone mineral density are seen with long-term TDF. Consider supplemental calcium and vitamin D
- Hepatitis B co-infection. Stopping Tenvir-EM in someone with chronic HBV can trigger a severe hepatitis flare. If discontinuation is necessary, liver function must be monitored closely
- STI screening. PrEP prevents HIV but not other STIs — routine syphilis, gonorrhoea, and chlamydia screening remains important
- Pregnancy and breastfeeding. Tenvir-EM is considered safe in pregnancy for both treatment and PrEP. Breastfeeding is not recommended for HIV-positive women (except in low-resource settings under WHO guidance)
Contraindications — Who Should NOT Take Tenvir-EM
- Known hypersensitivity to tenofovir disoproxil fumarate, emtricitabine, or any excipient
- Use as PrEP in someone who is HIV-positive or of unknown HIV status
- Severe renal impairment (CrCl <30 mL/min, or on dialysis) — consider switching to a tenofovir alafenamide (TAF)-based combination such as Tenvir-AF
Drug Interactions
| Drug / Class | Interaction |
|---|---|
| NSAIDs (ibuprofen, diclofenac, naproxen) | Additive nephrotoxicity — avoid chronic high-dose NSAIDs |
| Aminoglycosides, IV amphotericin B, IV vancomycin | Significant nephrotoxicity — avoid combination where possible |
| Didanosine (ddI) | Do not combine — raises ddI levels and toxicity |
| Ledipasvir / sofosbuvir (Harvoni) and other HCV direct-acting antivirals | May raise tenofovir levels — monitor renal function |
| Other NRTIs containing emtricitabine or lamivudine | Redundant — do not combine |
| Ritonavir-boosted PI regimens | Moderate rise in tenofovir levels — clinically manageable |
| St John’s wort | Lowers FTC and TDF levels marginally; avoid in HIV treatment |
Always share a full list of prescription and non-prescription medications, including recreational drugs and herbal supplements, with your prescriber before starting Tenvir-EM.
What to Do in Case of Overdose
Acute overdose of TDF/FTC is uncommon and usually causes gastrointestinal symptoms only. Neither drug is meaningfully cleared by dialysis. Management is supportive. Contact your local poisons service or emergency department immediately if a significant overdose is suspected.
Storage Instructions
- Store below 30 °C in a dry place, away from direct sunlight
- Keep in the original bottle or blister packaging
- Keep out of reach of children
- Do not use after the expiry date printed on the pack
- Dispose of unused tablets via a pharmacy take-back scheme where available
Related Alternatives on MedsBase
Looking for related PrEP or HIV medication options?
- Ricovir EM — Mylan’s TDF/FTC, clinically equivalent to Tenvir-EM
- Tavin EM — Hetero Labs’ TDF/FTC alternative
- Tenof-EM — another TDF/FTC brand
- Tenvir-AF — tenofovir alafenamide (TAF) + FTC, the newer-generation alternative with lower renal and bone toxicity
- Tenvir — tenofovir 300 mg monotherapy for Hepatitis B
- Tenvir-L — tenofovir + lamivudine (3TC) alternative NRTI backbone
- Browse all HIV medications →
Frequently Asked Questions
How effective is Tenvir-EM as PrEP?
When taken every day as prescribed, TDF/FTC PrEP reduces the risk of sexually transmitted HIV by more than 99%. Efficacy falls with missed doses — particularly in receptive vaginal exposures, where tissue drug levels take longer to reach protective concentrations.
How long does Tenvir-EM take to start working as PrEP?
Protective drug levels in rectal tissue are reached after about 7 days of daily dosing. For vaginal tissue, allow 20 days. The CDC recommends 7 days of daily use before relying on it for receptive anal sex, and 20 days for vaginal or other exposures.
Can I use Tenvir-EM “on demand” instead of daily?
The on-demand “2-1-1” schedule (2 tablets 2–24 h before sex, 1 tablet at 24 h after, 1 tablet at 48 h after) is supported by the IPERGAY trial and is a WHO- and French-guideline option for men who have sex with men only. It has not been validated for vaginal sex, trans women on feminising hormones, or people who inject drugs — daily dosing remains the standard outside that specific population.
Is Tenvir-EM the same as Truvada?
Yes in active ingredients — both contain tenofovir disoproxil fumarate 300 mg and emtricitabine 200 mg. Tenvir-EM is manufactured by Cipla in India and is clinically equivalent to Gilead’s branded Truvada®, at a much lower price.
Do I need STI testing while on PrEP?
Yes — Tenvir-EM prevents HIV but not syphilis, gonorrhoea, chlamydia, HSV, or other STIs. Routine screening at 3–6 month intervals is strongly recommended.
What tests do I need before starting PrEP?
HIV (4th-generation antigen/antibody test), hepatitis B (surface antigen, surface antibody, core antibody), creatinine / eGFR, and ideally a baseline STI screen. If you have chronic hepatitis B, Tenvir-EM is safe and often beneficial, but discontinuation must be carefully managed.
Can I use Tenvir-EM for HIV post-exposure prophylaxis (PEP)?
Yes — as part of a three-drug PEP regimen. Tenvir-EM supplies the two NRTIs; a third drug (usually dolutegravir or raltegravir) is added. PEP must be started within 72 hours of exposure, ideally within 24 hours, and continued for 28 days.
What happens if I miss a PrEP dose?
If you miss a dose by less than 24 hours, take it as soon as you remember. If it has been more than 24 hours, skip the missed dose and take the next scheduled one. Do not double up. If you miss multiple doses, protection is reduced — restart the 7- or 20-day tissue load-up window.
Is Tenvir-EM safe for my kidneys?
TDF can cause dose-related kidney effects in a minority of users. Baseline and periodic eGFR monitoring is required. If renal function declines, or you already have CrCl <30 mL/min, switching to the newer tenofovir alafenamide (TAF) formulation (e.g. Tenvir-AF) is preferred — TAF has substantially lower renal and bone toxicity.
Can I stop Tenvir-EM if my HIV risk changes?
Yes — PrEP can be stopped when risk goes down. Current guidance is to take Tenvir-EM for 7 more days after your last exposure to ensure any recent exposure is fully covered. If you have chronic hepatitis B, do NOT stop without medical supervision because of flare risk.
Does Tenvir-EM interact with hormonal contraception or feminising HRT?
No clinically significant interaction with combined or progestogen-only oral contraceptives or with feminising hormone therapy (oestradiol, cyproterone, spironolactone). Tenvir-EM does not reduce contraceptive effectiveness.
Tenvir-EM blocks HIV but does not prevent bacterial STIs (syphilis, chlamydia, gonorrhoea); for layered protection many users add doxycycline 100 mg as CDC-endorsed doxy-PEP — our PrEP Starter Pack (Tenvir-EM + doxycycline 100 mg) bundles both in matched 1, 3, or 6-month tiers, single shipment.
If Tenvir EM is unavailable or you prefer a different manufacturer for your daily PrEP regimen, Tavin EM (tenofovir disoproxil fumarate 300 mg + emtricitabine 200 mg) from Emcure Pharmaceuticals is the same TDF/FTC composition cited in the iPrEx, PROUD and Partners-PrEP trials.
Men who want a lower-renal-impact alternative to Tenvir-EM (tenofovir disoproxil + emtricitabine) often choose Taficita (tenofovir alafenamide 25 mg + emtricitabine 200 mg) — the TAF-based PrEP regimen with reduced kidney and bone-density effects.
Other Sexual Health Medications
- Ricovir EM (TDF/FTC 300+200 mg)
- Tenof EM (TDF/FTC 300+200 mg)
- Tavin EM (TDF/FTC 300+200 mg)
- Taficita (TAF/FTC 25+200 mg, Descovy generic)
- STD Protection Pack
Medical Disclaimer: Information on this page is for educational purposes only and does not replace medical advice. Always consult a qualified clinician before starting, stopping, or changing any medication.
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| Strength | 300 mg + 200 mg |
|---|---|
| Quantity | 30 Tablet/s, 60 Tablet/s, 90 Tablet/s, 180 Tablet/s |
| Pharma Form | Tablet/s |
| Manufacturer | Cipla Inc |
| Treatment | HIV Infection |
| Generic Brand | Tenofovir + Emtricitabine |
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