Tab%25252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520voihep

**Tab%25252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520voihep** ## Overview Tab%25252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520voihep is a brand name for **tenofovir disoproxil fumarate (TDF)**, a nucleoTDFide reverse transcriptase inhibitor (NtRTI) used in the treatment of HIV-1 infection and chronic Hepatitis B virus (HBV) infection. ## Primary Indications * Treatment of HIV-1 infection in combination with other antiretroviral agents. * Treatment of chronic Hepatitis B virus (HBV) infection. ## Adult Dosing * **HIV-1:** 300 mg orally once daily. * **Chronic HBV:** 300 mg orally once daily. ## Pediatric Dosing * **HIV-1:** Dosing for pediatric patients depends on age and weight. Generally, 10 mg/kg orally once daily, not to exceed the adult dose of 300 mg daily, for children weighing 17 kg to less than 65 kg. For children 6 years of age or older weighing at least 65 kg, the adult dose of 300 mg once daily may be used. Dosing for younger or smaller children is complex and requires specific consideration of available formulations and weight-based calculations. Consult product labeling or local pediatric HIV guidelines for precise dosing. * **Chronic HBV:** Dosing for pediatric patients with chronic HBV is not well established for this indication. Consult product labeling or pediatric hepatology guidelines. ## Dose Adjustments * **Renal Impairment:** Dose adjustment is required in patients with moderate to severe renal impairment. * CrCl 30-49 mL/min: 300 mg every 48 hours. * CrCl 10-29 mL/min: 300 mg every 72 hours. * CrCl <10 mL/min or on hemodialysis: 300 mg every 7 days after a full weekly dose. * Dose adjustment is generally not required for hepatic impairment, but caution is advised. ## Contraindications * Hypersensitivity to tenofovir disoproxil fumarate or any of its components. ## Adverse Effects * **Common:** Diarrhea, nausea, vomiting, abdominal pain, headache, dizziness, rash. * **Serious:** * **Renal toxicity:** Including acute kidney injury and Fanconi syndrome. Monitor renal function regularly. * **Bone toxicity:** Decreased bone mineral density (osteopenia, osteoporosis) and osteomalacia. * **Lactic acidosis and severe hepatomegaly with steatosis:** Potentially fatal. * **Immune reconstitution inflammatory syndrome (IRIS):** Can occur in patients with advanced HIV infection and OIs. ## Key Drug Interactions * **Nephrotoxic agents:** Coadministration with drugs that are nephrotoxic may increase the risk of renal adverse events (e.g., aminoglycosides, NSAIDs, certain antivirals like adefovir, cidofovir, and high-dose or multiple NSAIDs). * **Didanosine:** Avoid coadministration due to increased risk of pancreatitis and elevated systemic exposure of didanosine. * **Lopinavir/ritonavir:** Increased exposure to tenofovir. Monitor for renal toxicity. * **Atazanavir:** Increased exposure to tenofovir. Monitor for renal toxicity. ## Monitoring * **Baseline and periodic renal function tests:** Serum creatinine, BUN, and urinalysis. * **Baseline and periodic electrolytes:** Especially phosphate. * **Bone mineral density:** Consider in patients with a history of pathologic bone fractures. * **Liver function tests:** Especially in patients with chronic HBV. * **HIV viral load and CD4 count:** For HIV treatment. * **Hepatitis B viral load:** For HBV treatment. ## Clinical Pearls * TDF can be administered with or without food. * Consider switching to tenofovir alafenamide (TAF) in patients with pre-existing renal impairment or risk factors for renal disease, as TAF has a lower risk of renal and bone toxicity. * Ensure adequate hydration. * Patients should be advised not to take other medications containing tenofovir disoproxil fumarate. *** **Disclaimer:** This information is intended for clinical use and is not a substitute for professional medical advice. Always consult the most current prescribing information and your healthcare provider for diagnosis and treatment.