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Feel/Protect

Tenofovir + Emtricitabine

PrEP · 300/200mg · Multiple manufacturers · Schedule H

HIV prevention. 99% effective when taken daily. Judgment-free, discreet, doctor-supervised. Because prevention is better than treatment. Monthly subscription, no questions asked.

₹1,999

/month

Includes: Doctor consultation · Prescription · Medication · Delivery

100% refund if not medically appropriate

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What happens after you purchase

You pay

Secure checkout via Razorpay

Doctor calls you

Free consultation within 2hrs

Prescription issued

If medically appropriate

Delivered

Delivered within 48hrs

Efficacy

99% daily

Brand

Tenvir-EM

Monitoring

Every 3 months

Confidentiality

Complete

Pharmacology

How PrEP works

Pre-exposure prophylaxis works by maintaining protective antiviral drug levels in at-risk tissues, blocking HIV replication at the earliest stage of infection. Daily dosing ensures continuous prevention.

Nucleotide Reverse Transcriptase Inhibition

Both tenofovir and emtricitabine block HIV's ability to reverse-transcribe its RNA into DNA, stopping infection before it can establish.

Dual-Agent Protection

Two antiretrovirals together provide synergistic protection and reduce the risk of drug-resistant virus emergence.

Steady-State Coverage

Daily dosing maintains protective drug concentrations in genital tissues, rectal tissue, and bloodstream where transmission occurs.

Pharmacokinetics

How your body processes it

PrEP's efficacy depends on adequate bioavailability and tissue penetration. Understanding pharmacokinetics explains why daily consistency is critical and tissue protection timelines vary by exposure route.

Tenofovir Bioavailability (fasted)	~25%
Tenofovir Bioavailability (with food)	~40% (higher with meals)
Tenofovir T_max	~1 hour (oral)
Tenofovir Plasma half-life	~17 hours (plasma parent)
Tenofovir Active metabolite half-life	~150 hours (intracellular TFV-DP; drives efficacy)
Emtricitabine Bioavailability	~93%
Emtricitabine T_max	~1–2 hours
Emtricitabine half-life	~10 hours (plasma); ~39 hours (intracellular FTC-TP)
Protein binding (both)	<1% (minimal plasma protein binding)
Metabolism	Tenofovir: minimal; excreted unchanged. Emtricitabine: hepatic glucuronidation.
Excretion	Both primarily renal (~70%+ unchanged); minimal fecal
Rectal tissue protection	~7 days of daily dosing (achieves protective levels)
Vaginal tissue protection	~21 days of daily dosing (slower tissue penetration)

Source: FDA tenofovir/emtricitabine prescribing information, Anderson et al. 2012 tissue pharmacokinetics

Dosing

Optimal protocol

PrEP efficacy depends on consistent daily adherence. Protection builds over 7–21 days of daily dosing depending on exposure route. Missed doses reduce efficacy significantly.

Standard Daily Dosing

1 tablet (TDF 300mg / FTC 200mg) once daily, same time each day. Take with or without food (food improves bioavailability slightly but not required). Consistent timing improves adherence and maintains steady-state protection.

DAILY

Protection Timeline

Rectal exposure: 7 days of daily dosing achieves 99% protection. Vaginal/penile exposure: 21 days daily for full protection. Take PrEP even if unsure about exposure — better coverage than on-demand dosing. Single missed dose reduces efficacy.

ADHERENCE CRITICAL

Missed Doses

If you miss one dose: take ASAP (unless next dose is <2 hours away). If you miss 1–3 doses: restart daily dosing. If you miss >3 consecutive days: restart the protection timeline (7–21 days). Irregular adherence significantly reduces efficacy.

FLEXIBILITY LIMITED

Storage & Access

Store at room temperature (25°C / 77°F); protect from moisture. Do NOT refrigerate. Keep in original container. Access: prescribed by HIV prevention specialists or infectious disease doctors. Not available OTC; requires medical consultation.

PRESCRIPTION ONLY

Evidence

Published research

PrEP has the strongest evidence base of any HIV prevention tool. Multiple large, multinational trials demonstrate >95% efficacy when taken daily.

2010 New England Journal of Medicine PMID: 21091279

Grant et al. iPrEx Trial — MSM Daily PrEP

Landmark RCT in 2,499 MSM across Americas/Asia/Europe. Overall: 44% HIV reduction. In adherent users (>90% adherence): 92% efficacy. Demonstrated PrEP's protective effect and critical importance of adherence. Foundation for US FDA approval.

LANDMARK RCT — 2,499 MSM

2012 New England Journal of Medicine PMID: 22784037

Anderson et al. PARTNERS PrEP — Serodiscordant Couples

RCT in 4,747 serodiscordant heterosexual couples (Africa, India). TDF/FTC: 75% efficacy in preventing HIV acquisition in uninfected partners. Daily adherence remained critical predictor of protection.

RCT — SERODISCORDANT COUPLES

2015 New England Journal of Medicine PMID: 26624850

Molina et al. IPERGAY — On-Demand PrEP in MSM

RCT in 400 MSM (France). On-demand PrEP (dosing 2–24 hours before/after sex) achieved 86% efficacy. Daily PrEP superior (99%) but on-demand offers alternative for less frequent exposures. WHO now recommends both strategies.

RCT — ON-DEMAND EFFICACY

Safety

Side effects & safety

PrEP is well-tolerated in most users. Early side effects typically resolve within 2–4 weeks. Serious adverse events are rare but require monitoring, particularly renal function.

Nausea

Headache

Weight Loss (early)

Diarrhea

Fatigue

Abdominal Pain

Monitoring required

Renal impairment: Monitor serum creatinine every 6 months (baseline, then annually if stable). Tenofovir can reduce renal function — contraindicated if CrCl <60 mL/min or history of kidney disease. Bone mineral density: ~1% loss in first year, stabilizes after. Monitor in users <25 years or with risk factors. Hepatitis B: Do NOT stop abruptly (may cause flare) — requires HBsAg testing before starting and careful discontinuation if stopping.

Interactions

Drug interactions

PrEP has minimal CYP interactions (neither tenofovir nor emtricitabine are CYP substrates). Major concern is renal function with nephrotoxic drugs.

Nephrotoxic Drugs (Aminoglycosides, NSAIDs high-dose)

CAUTION/AVOID: Concurrent use with renal-toxic agents increases risk of kidney damage. High-dose NSAIDs (ibuprofen >2400mg/day, naproxen >1000mg/day) should be avoided. If necessary, use lowest dose for shortest duration. Monitor renal function closely.

Mechanism: Additive renal injury (glomerulonephritis/tubular dysfunction)

Hepatitis B Co-Infection

CRITICAL: Both TDF and FTC are active against HBV. If HBsAg positive, DO NOT discontinue abruptly — risk of severe hepatitis flare. Requires HBV monitoring and specialist guidance. Continue PrEP even if HBV+ (provides dual protection). Do NOT stop without physician approval.

Mechanism: HBV drug resistance if stopped abruptly

Metformin

CAUTION: Metformin + tenofovir both renally excreted; concurrent use may increase lactic acidosis risk in renal impairment. Requires baseline renal function test and 6-monthly monitoring. Use is generally safe if CrCl >60 mL/min.

Mechanism: Competition for renal excretion; additive renal stress

Other Antiretrovirals (minimal)

If HIV-positive user is on antiretroviral therapy (ART), PrEP components (TDF/FTC) may already be in regimen. Avoid duplication; work with HIV specialist on optimal combination. Generally safe together at different dosing.

Mechanism: Minimal interaction; duplication concern

Condoms & Other Prevention (synergistic)

PrEP is MOST effective when combined with condoms, testing, and partner treatment (U=U: Undetectable = Untransmittable). Synergistic protection: PrEP + condoms + partner suppression achieves near-complete HIV prevention.

Mechanism: Additive prevention efficacy

FAQ

Common questions

How effective is PrEP?

PrEP is 99% effective at preventing HIV when taken daily as prescribed. Real-world effectiveness is slightly lower (90-95%) due to adherence variability, but remains the most effective prevention method available.

Do I still need condoms?

While PrEP is highly effective for HIV, condoms provide additional protection against other STIs. Most experts recommend dual protection: PrEP + condoms. Discuss your personal risk with your physician.

What are the side effects?

Most common: nausea (usually mild and temporary), diarrhea, headache. Serious side effects are rare. Tenofovir can rarely affect kidney function, which is monitored through quarterly blood tests.

How often do I need testing?

HIV testing every 3 months is recommended while on PrEP. Kidney function and liver function monitored every 3 months. This catches any complications early and ensures continued safety.

Is it confidential?

Yes. All consultations, prescriptions, and medical records are completely confidential. arq uses discreet packaging and maintains strict privacy. No judgment, no stigma—just health protection.