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Tenofovir Disoproxil Fumarate
Tenofovir Disoproxil Fumarate (TDF) is an antiretroviral medication used to treat HIV-1 infection and chronic hepatitis B. It belongs to a class of drugs called nucleoside reverse transcriptase inhibitors (NRTIs), which work by inhibiting the action of reverse transcriptase, an enzyme critical to the replication of the HIV virus. TDF is often used as part of combination therapy for HIV and can also be prescribed as pre-exposure prophylaxis (PrEP) to reduce the risk of HIV infection in high-risk individuals.
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Frequently Asked Questions
How long does it take for Tenofovir Disoproxil Fumarate to work?
In HIV treatment, it may take several weeks to months to see significant reductions in viral load. In PrEP, the medication becomes effective after 7 days of consistent use for anal exposure and 20 days for vaginal exposure.
Can I stop taking TDF if my viral load is undetectable?
No, even if your viral load is undetectable, stopping TDF without your doctor’s guidance can lead to viral rebound and drug resistance.
What should I do if I miss a dose of Tenofovir Disoproxil Fumarate?
Take the missed dose as soon as you remember, unless it’s close to the time for your next dose. Do not take two doses at once to make up for a missed dose.
Is TDF safe for long-term use?
TDF is generally safe for long-term use, but it requires regular monitoring of kidney and bone health to ensure safety.
Can Tenofovir Disoproxil Fumarate cure hepatitis B?
TDF does not cure hepatitis B but helps control the infection by reducing viral replication. Long-term treatment may be necessary to manage the condition.
Comprehensive Drug Guide
How Does Tenofovir Disoproxil Fumarate Work?
TDF works by inhibiting the activity of reverse transcriptase, an enzyme used by HIV to convert its RNA into DNA, allowing the virus to replicate. By blocking this process, TDF helps reduce the viral load in the body and slows down the progression of the infection. In hepatitis B, TDF works similarly by inhibiting the replication of the hepatitis B virus, helping to control liver damage.
Common Dosages
- 150 mg, 200 mg, 250 mg, and 300 mg tablets
- Fixed-dose combinations with other antiretrovirals, such as Emtricitabine/Tenofovir (Truvada) or Tenofovir/Emtricitabine/Elvitegravir/Cobicistat (Stribild)
Typical Dosing
- For HIV-1 treatment: One 300 mg tablet is typically taken once daily, in combination with other antiretrovirals.
- For chronic hepatitis B: One 300 mg tablet is taken once daily.
- For PrEP: One tablet of Truvada (which contains TDF and emtricitabine) is taken once daily to reduce the risk of HIV infection.
Typical Dosing
FDA Approved Indications
- Treatment of HIV-1 infection in adults and pediatric patients aged 2 years and older.
- Treatment of chronic hepatitis B in adults and pediatric patients aged 12 years and older.
- Pre-exposure prophylaxis (PrEP) to reduce the risk of HIV-1 infection in high-risk individuals in combination with other antiretroviral medications.
Who Shouldn't Take Tenofovir Disoproxil Fumarate?
- Known hypersensitivity to tenofovir or any component of the formulation
- Severe renal impairment or patients requiring dialysis
- Liver disease without proper monitoring, as the drug can affect liver function
Advice From The Pharmacist
- Take TDF with food, as this can help improve the absorption of the medication.
- For PrEP (HIV prevention), it is important to take the medication consistently every day. Missing doses may reduce its effectiveness in preventing HIV.
- Regular monitoring of kidney function is important, as TDF can affect kidney health. Discuss with your doctor about periodic blood tests to assess kidney and liver function.
- If taking TDF for hepatitis B, do not stop the medication suddenly, as this can cause a flare-up of hepatitis B.
- Stay hydrated while on TDF to reduce the risk of kidney problems.
Side Effects of Tenofovir Disoproxil Fumarate
Common Side Effects
- Nausea
- Diarrhea
- Dizziness
- Fatigue
- Headache
Uncommon/Severe Side Effects
- Lactic acidosis: A rare but serious buildup of lactic acid in the blood, which can be life-threatening.
- Kidney problems: TDF can cause a decline in kidney function, especially in patients with pre-existing kidney conditions.
- Bone loss: TDF has been associated with decreased bone mineral density, which can increase the risk of fractures.
Risks and Warnings of Tenofovir Disoproxil Fumarate
- Lactic Acidosis and Hepatomegaly: Rare but serious side effects include the risk of lactic acidosis and liver enlargement (hepatomegaly), which can be life-threatening. Symptoms may include muscle pain, shortness of breath, or stomach pain.
- Kidney Damage: Regular monitoring of kidney function is essential as TDF can cause or worsen kidney disease.
- Bone Loss: Patients may experience a decrease in bone mineral density, increasing the risk of fractures, particularly with long-term use.
Interactions with Tenofovir Disoproxil Fumarate
Common Drug Interactions
- NSAIDs: Nonsteroidal anti-inflammatory drugs (e.g., ibuprofen) may increase the risk of kidney problems when used with TDF.
- Other antiretrovirals: When combined with other HIV medications, TDF can increase or decrease the effectiveness of these drugs. Always consult your doctor before adjusting any HIV treatment.
- Hepatitis C medications: Drugs like sofosbuvir/ledipasvir (Harvoni) may interact with TDF, requiring dose adjustments.
Alternatives to Tenofovir Disoproxil Fumarate
- Tenofovir alafenamide (TAF): A newer form of tenofovir that is associated with fewer kidney and bone side effects than TDF.
- Abacavir/lamivudine (Epzicom): An alternative NRTI combination for HIV treatment.
- Lamivudine (Epivir): Another NRTI that is used to treat both HIV and hepatitis B but may have a different side effect profile.
- Entecavir (Baraclude): A treatment option for hepatitis B that works differently than tenofovir.
