The most common side effects include:

• Hyperpigmentation or skin dicolouration. If your skin is sensitive, avoid direct sunlight or apply sunblock lotion on exposed areas of the skin if when outdoors.
• Headache, dizziness. Avoid driving or operating heavy ​machinery or any activity that requires alertness if affected.
• Nausea and vomiting. Dose can be given with or after meals to minimize stomach upset. Small frequent meals may help. Older children may suck on hard, sugar-free candy.
• Loose stools (Diarrhea)
• Weight loss.
• Tiredness, fatigue.
• Abnormal dreams or not being able to sleep well.
• Abnormal Fat Distribution. You may lose fat from legs, arm and face and gain fat around the abdomen and fatty lumps on the back of your neck.

Inform your doctor if any of the above the side effects become severe and bothersome.

Truvada may also cause serious side effects that require immediate medical attention. Report to you doctor immediately if you experience the following:

• ​Feeling very weak, tired and drowsy
• Unusual/unexplained muscle pain
• Deep rapid breathing (or difficulty breathing) 
• Stomach pain with nausea, vomiting or diarrhea
• Having a fast and irregular heart beat
• Signs of infection such as prolonged fever, cough, sore throat or generally feeling unwell
• Yellowing of the skin or eyes and dark-coloured urine
• Loss of appetite​

These could be signs and symptoms of lactic acidosis or liver problems.

Stop the medication immediately and seek medical attention if you experience any severe allergic reactions like skin rash (with or without blisters, mouth ulcers, fever and itching), swelling of the eyes and lips or difficulty breathing

• Truvada is usually taken once daily, in combination with other antiretroviral agents, to achieve significant decrease in viral load.
• Truvada can be administered with or without food. Swallow the tablet whole, do not crush, chew or break the tablet.

• Missing doses may make Truvada less effective and may also make the virus resistant to Truvada and other possible antiretroviral agents. This could make the virus harder to treat.
• If you forgot to take the medication, take the missed dose as soon as you remember. If you remember a missed dose at the time of your next dose, omit the missed dose and take only your regularly scheduled dose. Do not take a double dose to make up for the missed one.
• If you vomit within 1 hour of administration, take or give another dose if possible.

• Inform your doctor if you are taking any other medications or have any underlying medical condition e.g liver/kidney disease or diabetes. This is to help the doctor make informed decisions about the choice of medication for your condition.
• Do not take this medication if you are intolerant to lactose.
• Some medication may reduce its efficacy, or increase its toxicity. Do not take any other medications or herbal products without first consulting your doctor or pharmacist, because some medications may reduce the efficacy or increase the side effects of Truvada.
• As this medication may cause decrease in bone density; your doctor may advise you to take calcium and vitamin D supplements if you are more susceptible to falls.