tenofovir disoproxil: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
tenofovir disoproxil: clinical details
Prescribing considerations
- Treatment should be initiated by a clinician experienced in HIV or chronic hepatitis B management.
- Offer HIV antibody testing before treatment for hepatitis B.
- Assess renal and bone risk, concurrent nephrotoxins and the complete antiviral regimen.
- Plan clinical and laboratory surveillance before discontinuing treatment for chronic hepatitis B.
- Consider resistance history in treatment-experienced HIV infection.
Contraindications and cautions
- Hypersensitivity to tenofovir disoproxil or any product excipient.
- This lactose-containing product should not be used in specified rare hereditary disorders of galactose metabolism or absorption.
- Use particular caution with renal impairment, osteoporosis, previous fractures, older age or decompensated liver disease.
Monitoring
- Renal function, including estimated creatinine clearance and serum phosphate, before and during treatment.
- Investigate glycosuria, hypokalaemia, hypophosphataemia, muscle weakness or bone pain for proximal tubulopathy.
- Consider bone assessment or specialist review for bone abnormalities or substantial fracture risk.
- Monitor virological response and relevant HIV or hepatitis B markers.
- Monitor for hepatic exacerbation after discontinuation in hepatitis B.
Clinical pharmacology
Tenofovir disoproxil is converted intracellularly to tenofovir diphosphate, which terminates viral DNA synthesis. Tenofovir is mainly eliminated through the kidneys and has low potential for CYP450-mediated interactions.
Formulation and product differences
- The selected product is a lactose-containing film-coated tablet.
- In exceptional circumstances, it may be disintegrated in water, orange juice or grape juice.
- Granules may be available for people unable to swallow film-coated tablets; products are not automatically interchangeable.
tenofovir disoproxil preparations and strengths
Tablet
Route: Oral
Strengths: 245 mg
tenofovir disoproxil interactions
Review all prescribed, non-prescription and recreational substances for kidney toxicity and antiretroviral duplication.
Other tenofovir disoproxil or tenofovir alafenamide products
Avoid duplication because exposure and toxicity may increase.
Adefovir dipivoxil
Concurrent use should be avoided.
Didanosine
Tenofovir increases didanosine exposure; concurrent use is not recommended.
Nephrotoxic medicines
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.