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AIDS InfoNet www.aidsinfonet.org Fact Sheet Number 419
TENOFOVIR (Viread)
WHAT IS TENOFOVIR? WHAT ABOUT DRUG supplements may be helpful. This is especially
Tenofovir (Viread), also called bis-POC PMPA, true for people with osteopenia or
RESISTANCE? osteoporosis. This is important for young
is a drug used as part of antiretroviral therapy Many new copies of HIV are mutations. They
(ART). It is manufactured by Gilead Sciences. people because bone density normally
are slightly different from the original virus. increases during this period.
The FDA approved tenofovir for use against Some mutations can keep multiplying even
HIV in October 2001. Generic versions have when you are taking an ARV. When this
been tentatively approved under PEPFAR (see happens, the drug will stop working. This is
fact sheet 475.) called “developing resistance” to the drug. See HOW DOES TENOFOVIR REACT
Fact Sheet 126 for more information on WITH OTHER DRUGS?
Tenofovir is a nucleotide analog reverse resistance. Tenofovir can interact with other drugs or
transcriptase inhibitor, or nuke. These drugs supplements you are taking. These
stop HIV from multiplying by preventing the Sometimes, if your virus develops resistance interactions can change the amount of each
reverse transcriptase enzyme from working. to one drug, it will also have resistance to other drug in your bloodstream and cause an
This enzyme changes HIV’s genetic material ARVs. This is called “cross-resistance.” under- or overdose. New interactions are
(RNA) into the form of DNA. This has to occur However, tenofovir seems to have very little constantly being identified. Make sure that
before HIV’s genetic code is inserted into an cross resistance with other ARVs. your health care provider knows about ALL
infected cell’s genetic codes. drugs and supplements you are taking.
Resistance can develop quickly. It is very
important to take ARVs according to Tenofovir results in higher blood levels of
WHO SHOULD TAKE instructions, on schedule, and not to skip didanosine (Videx). ddI and tenofovir should
TENOFOVIR? or reduce doses. not be used together, especially in patients
Tenofovir was approved in 2001 as an with a high viral load and a low CD4 count.
antiretroviral drug (ARV) for people with HIV A benefit of tenofovir is that it works against Serious ddI side effects may result.
infection. In 2010 it was approved for use by several strains of HIV that are already resistant
people between 12 and 18 years of age. In to AZT or ddI. Tenofovir blood levels increase if it is taken
2011 it was approved for use in children ages with the protease inhibitors atazanavir
2 to 12. It has not been carefully studied in (Reyataz) and lopinavir/ritonavir (Kaletra).
people older than age 65. In US treatment HOW IS TENOFOVIR TAKEN? This can increase the risk of tenofovir side
guidelines (see fact sheet 404), tenofovir is The normal adult dose of tenofovir is 300 effects. Tenofovir decreases blood levels of
listed as a preferred drug for people just milligrams (mg) taken as one pill, once a day, atazanavir. Ritonavir should be taken when
starting ART. with or without a meal. People who are taking atazanavir is taken with tenofovir.
both tenofovir and ddI (didanosine, Videx)
There are no absolute rules about when to should take tenofovir 2 hours before, or one Tenofovir does not affect blood levels of
start ART. You and your health care provider hour after didanosine. A prodrug of tenofovir, methadone, ribavirin or adefovir. There is no
should consider your CD4 cell count, your viral GS7340, is being developed. When it breaks known interaction between tenofovir and
load, any symptoms you are having, and your down in the body, it produces tenofovir. In buprenorphine.
attitude about taking ARVs. Fact Sheet 404 early studies it is much more potent than
has more information about guidelines for the tenofovir and may have fewer side effects. Three regimens should normally not be used
use of ARVs. Children ages 2 to 5 will use a powder without careful analysis or extra ARVs:
formulation. For children ages 6 to 12, there Tenofovir + abacavir + lamivudine (Viread
Be sure to let your health care provider know if are pills of 150 mg, 200 mg, 250 mg. Dosing is + Ziagen + Epivir)
you have any kidney problems. People with based on age and weight. Tenofovir + didanosine + lamivudine
kidney damage may need to take a reduced (Viread + Videx + Epivir)
dose of tenofovir. Tenofovir is also available in Truvada, a Tenofovir + Videx EC + either efavirenz
combination of tenofovir and emtricitabine (see or nevirapine in patients new to ART with
If you take tenofovir with other ARVs, you can fact sheet 421). high viral loads.
reduce your viral load to extremely low levels,
and increase your CD4 cell counts. This Tenofovir is eliminated by the kidneys. It is not
should mean staying healthier longer. WHAT ARE THE SIDE EFFECTS? metabolized in the liver, so it is not expected to
With the start of any ART there may be interact with many other drugs. However,
Tenofovir may also help control Hepatitis B temporary side effects such as headaches, medications with names that end in “-ovir,”
(see fact sheet 506). However, Hep B got high blood pressure, or a general sense of such as acyclovir and ganciclovir, may interact
much worse in some people who were taking feeling ill. These side effects are likely to get with tenofovir.
tenofovir and then stopped taking it. Get tested better or even disappear over time.
for hepatitis B before you start taking tenofovir Tenofovir should be used as part of
to treat HIV. If you have hepatitis B and stop The most common side effects of tenofovir are combination antiretroviral therapy (ART)
taking tenofovir, your health care provider nausea, vomiting and loss of appetite. against HIV. It is normally used along with a
should carefully monitor your liver function for Tenofovir can cause kidney damage. nucleoside analog reverse transcriptase
several months. Creatinine levels should be monitored in inhibitor (nuke) plus a non-nucleoside reverse
people taking tenofovir. Tenofovir can also transcriptase inhibitor (NNRTI) or a protease
Tenofovir is also being studied for the damage the liver. People taking tenofovir inhibitor.
prevention of HIV infection. Gilead hopes that should have their liver health monitored.
just one pill a day will be effective.
Tenofovir can reduce bone mineral density Revised January 21, 2012
(see fact sheet 557). Calcium or vitamin D
A project of the New Mexico AIDS Education and Training Center. Partially funded by the National Library of Medicine
Fact Sheets can be downloaded from the Internet at http://www.aidsinfonet.org
