efavirenz--emtricitabine--tenofovir-disoproxil-fumarate-drug-combination and Acute-Kidney-Injury

We describe a patient with acute renal failure and irreversible kidney damage after an overdose with the fixed dose combination of efavirenz/tenofovir disoproxil fumarate/emtricitabine (Atripla). The acute kidney injury was most probably caused by tenofovir. Efavirenz and emtricitabine seemed relatively safe in overdose. The pharmacokinetics in overdose of all 3 drugs and the effect of hemodialysis on the tenofovir clearance were studied by measuring the plasma concentrations and by the use of clinical pharmacokinetic software.

Topics: Acute Kidney Injury; Alkynes; Anti-HIV Agents; Benzoxazines; Cyclopropanes; Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination; Emtricitabine; HIV Infections; HIV-1; Humans; Male; Middle Aged; Tenofovir