Tenofovir

Aka: Tenofovir, Tenofovir Disoproxil, TDF, Tenofovir Alafenamide, TAF, Viread

1. See Also
   1. Anti-Retroviral Therapy
   2. Nucleoside Reverse Transcriptase Inhibitor
2. Preparations
   1. Tenofovir Disoproxil Fumarate (TDF)
      1. Original Tenofovir formulation and used in Stribild, Truvada and Complera
      2. Associated with nephrotoxicity and decreased Bone Mineral Density
   2. Tenofovir Alafenamide Fumarate (TAF)
      1. Tenofovir formulation released in 2016 and used in Genvoya, Descovy, Odefsey
      2. TAF appears to have less adverse Renal Function and Bone Mineral Density effects than the original TDF
      3. TAF is associated with greater weight gain and dyslipidemia than TDF
3. Mechanism
   1. Nucleoside Reverse Transcriptase Inhibitor
4. Adverse Effects
   1. See nRTI for adverse effects attributed to the class
   2. Renal dysfunction
      1. Increased Serum Creatinine
      2. Proteinuria
      3. Electrolyte abnormalities
         1. Glycosuria
         2. Hypophosphatemia
      4. Acute Renal Failure (1% risk)
         1. Associated with longer duration of therapy, advanced HIV or pre-existing renal disease
   3. Gastrointestinal
      1. Diarrhea
      2. Nausea or Vomiting
      3. Flatulence
   4. Miscellaneous
      1. Headache
      2. Hepatitis B flares on withdrawal of medication
5. Dosing
   1. Dose: 300 mg orally daily
6. Monitoring
   1. Obtain Urinalysis every 6 months when on Tenofovir Disoproxil Fumarate
   2. Obtain baseline Renal Function and Phosphorus, then at 2-8 weeks, and then every 3-6 months
7. References
   1. (2016) Presc Lett 23(9)
   2. (2009) Treat Guidel Med Lett 7(78): 11-22 [PubMed]
   3. Reust (2011) Am Fam Physician 83(12): 1443-51 [PubMed]