title: Acute Kidney Injury After Efavirenz/Tenofovir Disoproxil Fumarate/Emtricitabine (Atripla) Overdose.
abstract: 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.
authors.affiliation: *Department of Clinical Pharmacy, Maastricht University Medical Center, Maastricht, the Netherlands; †Caphri School for Public Health and Primary Care, Maastricht, the Netherlands; ‡Department of Pharmacy, Radboud University Medical Center, Nijmegen, the Netherlands; and Departments of §Medical Microbiology, and ¶Integrated Care, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Thomas
authors.initials: T
authors.lastname: Havenith
authors.forename: David
authors.initials: D
authors.lastname: Burger
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Visschers
authors.forename: Jolanda
authors.initials: J
authors.lastname: Schippers
authors.forename: Astrid
authors.initials: A
authors.lastname: Oude Lashof
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000480:Alkynes; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D048588:Benzoxazines / Q000009:adverse effects* / Q000627:therapeutic use; D003521:Cyclopropanes; D000068257:Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination / Q000009:adverse effects* / Q000627:therapeutic use; D000068679:Emtricitabine / Q000009:adverse effects* / Q000627:therapeutic use; D015658:HIV Infections / Q000188:drug therapy; D015497:HIV-1 / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D000068698:Tenofovir / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D000068257:Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination; D000068698:Tenofovir; D000068679:Emtricitabine; C098320:efavirenz