Odefsey is a complete single-tablet HIV regimen combining three antiretroviral medicines:

• Emtricitabine: a nucleoside reverse transcriptase inhibitor (NRTI) that blocks HIV replication
• Rilpivirine: a non-nucleoside reverse transcriptase inhibitor (NNRTI) that blocks a key enzyme HIV uses to copy its genetic material
• Tenofovir alafenamide (TAF): a newer form of tenofovir that delivers the drug to cells at a lower dose with less impact on kidneys and bone density

Odefsey is used in adults and adolescents who are already virologically stable on HIV treatment and are switching to simplify their regimen, or in treatment-naive adults with a viral load below a certain threshold.

Take one tablet once daily with a full meal. Food is essential because rilpivirine needs food to be properly absorbed. Without food, rilpivirine levels are insufficient to suppress the virus.

Take at the same time each day. Do not stop without speaking to your HIV doctor.

If you remember within 12 hours of your usual dose time, take it with food immediately. If more than 12 hours have passed, skip that dose and take the next one as usual. Never take two doses at once.

Contact your HIV specialist or a poison control centre immediately.

• Store below 30°C
• Keep in the original container with the lid tightly closed
• Keep out of reach of children

Most people tolerate Odefsey well.

Common side effects:

• Nausea
• Headache
• Insomnia and abnormal dreams (associated with rilpivirine)
• Dizziness
  
  

Important monitoring:

• Kidney function: monitored with blood and urine tests. TAF has less kidney impact than older tenofovir formulations
• Bone density: improved compared to older tenofovir, but monitoring may be indicated
• Depression and mood changes: rilpivirine has been associated with mood disturbances. Report any new or worsening depression
• Hepatitis B flare: do not stop Odefsey without medical advice if you have hepatitis B

HIV viral load, kidney function, liver function, and blood count are checked regularly.

Rilpivirine has important interactions:

• Proton pump inhibitors (omeprazole, pantoprazole): significantly reduce rilpivirine levels. Discuss with your HIV doctor before taking these together
• Antacids: can interfere with Odefsey absorption. If you use antacids regularly, mention this to your pharmacist so they can advise on timing
• Rifampicin, carbamazepine, phenytoin, phenobarbital, St John's Wort: dramatically reduce rilpivirine levels and cannot be used with Odefsey
  

Always check interactions before starting new medicines while on Odefsey

Who is Odefsey suitable for?

Odefsey is suitable for people with HIV who are already virologically stable (undetectable viral load) and want to switch to a simpler, lower pill burden regimen. It is particularly preferred for people who have kidney concerns or reduced bone density, as TAF is gentler on kidneys and bones than older tenofovir formulations. People with prior NNRTI resistance or certain resistance mutations may not be suitable candidates.

Why must I take it with a full meal?

Rilpivirine absorption is significantly reduced when taken without food. A full meal (over 500 calories) increases rilpivirine levels by 40 percent compared to fasting. Inadequate drug levels can allow HIV to replicate and resistance mutations to develop. A protein supplement drink is not sufficient: you need a proper meal.

Ace provides accurate and independent information medically reviewed on prescription medications. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.