Tenofovir Alafenamide

What is Tenofovir Alafenamide

Tenofovir alafenamide is a hepatitis B virus (HBV) nucleoside analog reverse transcriptase inhibitor.

It is indicated for the treatment of chronic HBV infection in adults with compensated liver disease.

Similar to tenofovir disoproxil fumarate, the FDA-approved package labeling for tenofovir alafenamide contains a Black Box Warning regarding the potential for acute exacerbations of hepatitis B in patients following treatment discontinuation.

Avoid the use of tenofovir alafenamide in patients with an estimated creatinine clearance of less than 15 mL/min who are NOT receiving chronic hemodialysis.

For patients on hemodialysis, no dosage adjustment is needed and the drug should be administered after completion of the hemodialysis treatment on dialysis days.

Brand Name

Vemlidy

Indications

  • hepatitis B infection
  • hepatitis B virus

Side Effects

  1. abdominal pain
  2. angioedema
  3. arthralgia
  4. back pain
  5. bone fractures
  6. bone pain
  7. cough
  8. diarrhea
  9. dyspepsia
  10. elevated hepatic enzymes
  11. Fanconi syndrome
  12. fatigue
  13. flatulence
  14. glycosuria
  15. headache
  16. hepatic decompensation
  17. hepatic failure
  18. hepatitis B exacerbation
  19. hepatomegaly
  20. hyperamylasemia
  21. hypercholesterolemia
  22. hypophosphatemia
  23. lactic acidosis
  24. myalgia
  25. nausea
  26. osteopenia
  27. osteoporosis
  28. pancreatitis
  29. rash
  30. renal failure (unspecified)
  31. steatosis
  32. urticaria
  33. vomiting
  34. weakness
  35. weight gain

Monitoring Parameters

  • hepatitis B serology
  • LFTs
  • plasma HIV RNA
  • pregnancy testing
  • serum bilirubin (total and direct)
  • serum cholesterol
  • serum creatinine
  • serum lipid profile
  • serum phosphate
  • urinalysis

Contraindications

  • alcoholism
  • Black patients
  • breast-feeding
  • children
  • females
  • hepatic disease
  • hepatitis B and HIV coinfection
  • hepatitis B exacerbation
  • hepatomegaly
  • hepatotoxicity or lactic acidosis
  • Hispanic patients
  • hypercholesterolemia
  • hyperlipidemia
  • hypertriglyceridemia
  • hypophosphatemia
  • infants
  • neonates
  • obesity
  • osteomalacia
  • osteoporosis
  • pancreatitis
  • pregnancy
  • renal disease
  • renal failure

Interactions

  • Acalabrutinib
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acyclovir
  • Adefovir
  • Alogliptin; Metformin
  • Amikacin
  • Aminoglycosides
  • Aminosalicylate sodium, Aminosalicylic acid
  • Amiodarone
  • Amlodipine; Celecoxib
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amphotericin B
  • Amphotericin B cholesteryl sulfate complex (ABCD)
  • Amphotericin B lipid complex (ABLC)
  • Amphotericin B liposomal (LAmB)
  • Aspirin, ASA
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Bacitracin
  • Barium Sulfate
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Boceprevir
  • Brigatinib
  • Cabozantinib
  • Canagliflozin; Metformin
  • Capmatinib
  • Carbamazepine
  • Carboplatin
  • Carvedilol
  • Celecoxib
  • Choline Salicylate; Magnesium Salicylate
  • Cidofovir
  • Cisplatin
  • Clarithromycin
  • Cobicistat
  • Colchicine; Probenecid
  • Conivaptan
  • Cyclosporine
  • Daclatasvir
  • Dapagliflozin; Metformin
  • Darolutamide
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dichlorphenamide
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diflunisal
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Dofetilide
  • Elexacaftor; tezacaftor; ivacaftor
  • Eliglustat
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enalapril; Felodipine
  • Ertugliflozin; Metformin
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Esomeprazole; Naproxen
  • Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestimate
  • Etodolac
  • Famotidine; Ibuprofen
  • Felodipine
  • Fenoprofen
  • Flibanserin
  • Flurbiprofen
  • Foscarnet
  • Fosphenytoin
  • Fostamatinib
  • Gadobutrol
  • Gadoversetamide
  • Ganciclovir
  • Gentamicin
  • Glecaprevir; Pibrentasvir
  • Glipizide; Metformin
  • Glyburide; Metformin
  • grapefruit juice
  • Hydrocodone; Ibuprofen
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Indomethacin
  • Isavuconazonium
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Ivacaftor
  • Kanamycin
  • Ketoconazole
  • Ketoprofen
  • Ketorolac
  • Lansoprazole; Naproxen
  • Ledipasvir; Sofosbuvir
  • Linagliptin; Metformin
  • Lopinavir; Ritonavir
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • Magnesium Salicylate
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meloxicam
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Mifepristone
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nitisinone
  • Non-Ionic Contrast Media
  • Nonsteroidal antiinflammatory drugs
  • Obeticholic Acid
  • Omeprazole; Amoxicillin; Rifabutin
  • Orlistat
  • Osimertinib
  • Oxaliplatin
  • Oxaprozin
  • Oxcarbazepine
  • Pamidronate
  • Paromomycin
  • Phenobarbital
  • Phenytoin
  • Pirfenidone
  • Piroxicam
  • Plazomicin
  • Polymyxin B
  • Polymyxins
  • Posaconazole
  • Primidone
  • Probenecid
  • Ranolazine
  • Regorafenib
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rifaximin
  • Rivaroxaban
  • Rofecoxib
  • Rolapitant
  • Salicylates
  • Salsalate
  • Sapropterin
  • Simeprevir
  • Sofosbuvir; Velpatasvir
  • Sofosbuvir; Velpatasvir; Voxilaprevir
  • St. John’s Wort, Hypericum perforatum
  • Streptomycin
  • Sulindac
  • Tacrolimus
  • Tafamidis
  • Tedizolid
  • Telithromycin
  • Temsirolimus
  • Testosterone
  • Tezacaftor; Ivacaftor
  • Ticagrelor
  • Tipranavir
  • Tobramycin
  • Tolmetin
  • Tolvaptan
  • Trandolapril; Verapamil
  • Trospium
  • Tucatinib
  • Valacyclovir
  • Valdecoxib
  • Valganciclovir
  • Valproic Acid, Divalproex Sodium
  • Vancomycin
  • Vemurafenib
  • Verapamil
  • Zoledronic Acid
  • Zonisamide
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