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tenofovir |
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Detailed Prescribing Information |
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October 2005 |
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Viread
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tenofovir = TDF Also a component of Truvada and Atripla |
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| Forms Available |
300 mg tabs 300 mg tenofovir + 200 mg emtricitabine as Truvada 300 mg tenofovir + 600 mg efavirenz + 200 mg emtricitabine as Atripla |
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| Dosing | 300 mg daily | ||
| Renal dosing1 |
Ccr (cc/min) |
Dose (mg) |
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| > 50 | 300 daily | ||
| 30-49 | 300 every 48h | ||
| 10-29 | 300 every 3-4 days | ||
| hemodialysis | 300 once a week | ||
| Hepatic dosing: no dose adjustment necessary based on pharmacokinetics in non-HIV-infected volunteers with liver disease | |||
| Food dependence |
This medication is best taken with food. When taken with didanosine, this medication may be taken with or without food. |
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| Adverse Effects |
Accentuation of nephrotoxicity of other
drugs or conditions? Rare nephrotoxicity has been noted in individuals with low body mass index. Bone mineral density (BMD) decreases particularly of the lumbar spine are seen more frequently with tenofovir than with stavudine. (for more info, click HERE) |
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| Interactions |
Increased
didanosine levels: reduce dose of
didanosine-EC to 250 mg daily (assuming body weigh > 60kg) Unclear reaction with abacavir: do not use this combo without a PI or NNRTI until further information is available. Lopinavir/ritonavir increases tenofovir levels significantly: consider monitoring renal function closely and minimize the use of other nephrotoxic agents Decreased atazanavir levels necessitate the use of boosted atazanavir (atazanavir 150 mg 2 daily plus ritonavir 100 mg daily) with tenofovir |
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| Suggested lab follow-up |
Monitor serum creatinine in selected patients
(preexisting renal dysfunction, low body mass index, other nephrotoxic
drugs, etc.) Consider monitoring bone mineral density in persons at high risk |
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| Warning |
Rare lactic acidosis (least likely to produce this effect
of NRTIs?) Possible flare of hepatitis B if tenofovir is discontinued suddenly. |
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Suggested Usage |
Do not use in combination with Truvada or Atripla due to identical mechanism of action or duplication of tenofovir dosing. | ||
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Complete prescribing information |
http://www.viread.com | ||
| Links to Antiretroviral Sections (click on anything) |
| Nucleoside & Nucleotide Reverse Transcriptase Inhibitors (NRTI) |
| AZT | ddC | ddI | d4T | 3TC | ABC | FTC | TDF | Combivir | Trizivir | Epzicom | Truvada | Atripla |
| Nonnucleoside Reverse Transcriptase Inhibitors (NNRTI) |
| efavirenz | nevirapine | delavirdine |
| Protease Inhibitors (PI) | Boosted Protease Inhibitors |
| saquinavir | indinavir | ritonavir | nelfinavir | amprenavir | lopinavir + ritonavir | atazanavir | fosamprenavir | tipranavir | darunavir |
| Fusion Inhibitors |
| enfuvirtide |
7.14.2006
1. Renal dosing information from: Ian R.
McNicholl & Rudolph A. Rodriguez, MD, Dosing of Antiretroviral Drugs in Renal
Insufficiency and Hemodialysis, May 2004
http://hivinsite.ucsf.edu/InSite?page=md-rr-18
