Drug reference
HIV infection in combination with other antiretroviral drugs | Chronic hepatitis B infection with compensated liver disease (with evidence of viral replication, and histologically documented active liver inflammation or fibrosis) | Chronic hepatitis B infection with decompensated liver disease ▶BY MOUTH ▶Adult: 245 mg once daily DOSE EQUIVALENCE AND CONVERSION ▶7.5 scoops of granules contains approx. 245 mg tenofovir disoproxil (as fumarate).
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NICE decisions ▶Tenofovir disoproxil for the treatment of chronic hepatitis B (July 2009) NICE TA173 Tenofovir is an option for the treatment of chronic hepatitis B. www.nice.org.uk/guidance/ta173
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→Appendix 1: tenofovir disoproxil
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▶Common or very common Abdominal distension. flatulence ▶Uncommon Proximal renal tubulopathy ▶Rare or very rare Acute tubular necrosis. hepatic disorders . nephritis. nephrogenic diabetes insipidus. renal impairment
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Manufacturer advises caution in decompensated hepatic disease (limited information available).
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Dose adjustments Granules: 132 mg once daily if eGFR 30–50 mL/minute/1.73 m2; 66 mg once daily if eGFR 20–30 mL/minute/1.73 m2; 33 mg once daily if eGFR 10–20 mL/minute/1.73 m2. Tablets: 245 mg every 2 days if eGFR 30–50 mL/minute/1.73 m2; 245 mg every 3–4 days if eGFR 10–30 mL/minute/1.73 m2. Monitoring Monitor renal function—interrupt treatment if further deterioration.
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▶Test renal function and serum phosphate before treatment, then every 4 weeks (more frequently if at increased risk of renal impairment) for 1 year and then every 3 months, interrupt treatment if renal function deteriorates or serum phosphate decreases. ▶When treating chronic hepatitis B with tenofovir, monitor liver function tests every 3 months and viral markers for hepatitis B every 3–6 months during treatment (continue monitoring for at least 1 year after discontinuation— recurrent hepatitis may occur on discontinuation).
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Granules: mix 1 scoop of granules with 1 tablespoon of soft food (e.g. yoghurt, apple sauce) and take immediately without chewing. Do not mix granules with liquids.
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There can be variation in the licensing of Infection different medicines containing the same drug. Granules CAUTIONARY AND ADVISORY LABELS 21 ▶Viread (Gilead Sciences International Ltd) Tenofovir disoproxil (as Tenofovir disoproxil fumarate) 33 mg per 1 gram Viread 33mg/g granules | 60 gram P £54.50 Tablet CAUTIONARY AND ADVISORY LABELS 21 ▶Tenofovir disoproxil (Non-proprietary) Tenofovir disoproxil 245 mg Tenofovir 245mg tablets | 30 tablet P £64.08 DT = £39.05 (Hospital only) | 30 tablet P £16.84–£204.39 DT = £39.05 | 168 tablet P £36.36 ▶Viread (Gilead Sciences International Ltd) Tenofovir disoproxil (as Tenofovir disoproxil fumarate) 123 mg Viread 123mg tablets | 30 tablet P £102.60 DT = £102.60 Tenofovir disoproxil (as Tenofovir disoproxil fumarate) 163 mg Viread 163mg tablets | 30 tablet P £135.98 DT = £135.98 Tenofovir disoproxil (as Tenofovir disoproxil fumarate) 204 mg Viread 204mg tablets | 30 tablet P £170.19 DT = £170.19 Tenofovir disoproxil 245 mg Viread 245mg tablets | 30 tablet P £204.39 DT = £39.05 eiiii F 683
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Patients or carers should be given advice on how to administer tenofovir granules. Missed doses If a dose is more than 12 hours late, the missed dose should not be taken and the next dose should be taken at the normal time.
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245 mg once daily
First-line fragment. Read the complete Indications and Dose section above.
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