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[Pharmacology](https://durgical.com/en/pharmacology/) · [Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs)](https://durgical.com/en/pharmacology/classes/nucleoside-nucleotide-reverse-transcriptase-inhibitors/)

# Emtricitabine

An NRTI almost twin to lamivudine. Usually combined with tenofovir in one tablet, to treat HIV or prevent it (PrEP).

Updated 2026-11-01

- Class: [Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs)](https://durgical.com/en/pharmacology/classes/nucleoside-nucleotide-reverse-transcriptase-inhibitors/)
- Enzyme: HIV-1 reverse transcriptase
- ATC code: J05AF09
- WHO Model List of Essential Medicines

Also called: FTC

✂**HIV-1 reverse transcriptase**Emtricitabine

ⓘ The figure shows emtricitabine triphosphate, the active form, in the polymerase site of HIV-1 reverse transcriptase with DNA.

**Target in 3D:** HIV-1 reverse transcriptase. PDB structure 6OR7 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/6OR7) · Drag to rotate · pinch to zoom

## Mechanism of action

A fluorinated cytidine analogue, very similar to lamivudine. It is phosphorylated to emtricitabine triphosphate, which competes with dCTP and ends the viral DNA chain. It selects the same M184V/I resistance mutation.

- It is phosphorylated to emtricitabine triphosphate
- It competes with dCTP at reverse transcriptase
- It is built in and ends the viral DNA chain

## Pharmacokinetics

**Elimination**
By the kidney, through filtration and tubular secretion; adjusted in kidney failure

**Half-life**
Plasma half-life about 10 hours

## Indications

- HIV-1 infection, combined with other antiretrovirals [HIV infection and AIDS →](https://durgical.com/en/conditions/hiv-infection-and-aids/)
- Pre-exposure prophylaxis (PrEP), combined with tenofovir [HIV infection and AIDS →](https://durgical.com/en/conditions/hiv-infection-and-aids/)

## Adverse effects

### Common

- Headache, diarrhoea, nausea
- Tiredness, dizziness, insomnia
- Rash
- Skin hyperpigmentation (palms and soles), very common in children

### Serious (rare, important)

- Severe hepatitis B flare after stopping
- Lactic acidosis with hepatic steatosis (class effect)

## Contraindications

- Previous hypersensitivity to emtricitabine

## Key interactions

**Lamivudine**
Same mechanism and resistance: not combined

**Drugs cleared by tubular secretion**
They can compete for renal elimination and raise either drug's levels

## What is monitored

- Hepatitis B serology before starting
- Kidney function
- Viral load and CD4; in PrEP, regular HIV tests

## Administration and safety

- By mouth, as a capsule, solution or within fixed-dose combinations
- Check it is not given together with lamivudine by duplication error

## Nursing care

- Check hepatitis B status
- Explain that dark spots on palms and soles are expected and not dangerous
- In PrEP, reinforce adherence and HIV testing

## Pregnancy and breastfeeding

Antiretroviral treatment in pregnancy protects the mother and lowers HIV transmission to the baby; the treating team chooses the regimen.

## Memory aid

'FTC = Fluorine, Tenofovir's partner, Colour on the skin'.

## Test yourself

Think of the answer, then tap the question to see it.

## Which drug is emtricitabine combined with in oral PrEP?

With tenofovir (disoproxil or alafenamide).

## Which skin effect is typical of emtricitabine?

Hyperpigmentation of palms and soles, very common in children.

## Which mutation gives resistance to emtricitabine and lamivudine?

M184V (or M184I) in reverse transcriptase.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/emtricitabine/)

## Related drugs

- [Lamivudine](https://durgical.com/en/pharmacology/lamivudine/)
- [Tenofovir disoproxil](https://durgical.com/en/pharmacology/tenofovir-disoproxil/)
- [Tenofovir alafenamide](https://durgical.com/en/pharmacology/tenofovir-alafenamide/)
- [Bictegravir](https://durgical.com/en/pharmacology/bictegravir/)

## Related conditions

- [HIV infection and AIDS](https://durgical.com/en/conditions/hiv-infection-and-aids/)

[← Back to the class: Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs)](https://durgical.com/en/pharmacology/classes/nucleoside-nucleotide-reverse-transcriptase-inhibitors/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - EMTRICITABINE capsule](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a229c922-58eb-4795-9219-6cebb1779e35) (DailyMed (U.S. National Library of Medicine), 2026); [Emtricitabine: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a604004.html) (MedlinePlus (U.S. National Library of Medicine), 2025); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=J05AF09) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [eEML - Electronic Essential Medicines List](https://list.essentialmeds.org/) (World Health Organization, 2025).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

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