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# Tabvolhep ## Overview Tabvolhep is a brand name for a formulation of tenofovir alafenamide (TAF), a nucleotide analog reverse transcriptase inhibitor (NtRTI). ## Primary Indications * Treatment of Human Immunodeficiency Virus type 1 (HIV-1) infection in adults and pediatric patients. ## Adult Dosing * **Recommended Dose:** 25 mg orally once daily. ## Pediatric Dosing * **Recommended Dose:** 25 mg orally once daily for pediatric patients weighing at least 35 kg. For pediatric patients weighing less than 35 kg, specific dosing should be determined based on local guidelines or other available TAF formulations if indicated. ## Dose Adjustments * **Renal Impairment:** No dose adjustment necessary for mild to moderate renal impairment. Caution is advised in severe renal impairment; monitor renal function. * **Hepatic Impairment:** No dose adjustment necessary in patients with mild to moderate hepatic impairment. Data in severe hepatic impairment are limited; use with caution. ## Contraindications * Hypersensitivity to TAF or any component of the formulation. ## Adverse Effects * **Common:** Diarrhea, nausea, headache, abdominal pain, rash, dizziness, fatigue, cough. * **Serious:** Lactic acidosis, severe hepatomegaly with steatosis, immune reconstitution inflammatory syndrome (IRIS), new-onset or worsening renal impairment, bone mineral density decrease, lipid abnormalities. ## Key Drug Interactions * **Strong CYP3A4 Inducers (e.g., rifampin, carbamazepine, phenytoin):** May decrease tabvolhep concentrations, potentially leading to loss of virologic response. Avoid concurrent use. * **Antacids:** Separate administration by at least 2 hours. * **Other Antiretrovirals:** Consult specific drug interaction databases for potential additive toxicities or reduced efficacy. ## Monitoring * Liver function tests (LFTs) including ALT, AST, bilirubin. * Renal function tests including serum creatinine and estimated glomerular filtration rate (eGFR). * Lipid profile (fasting or non-fasting). * Bone mineral density may be considered, especially in patients with risk factors for osteoporosis. * Viral load and CD4 count. ## Clinical Pearls * TAF has a lower incidence of renal and bone toxicity compared to tenofovir disoproxil fumarate (TDF). * Administer as a complete treatment regimen for HIV-1 infection. * It is important to counsel patients on adherence and potential side effects. Please verify the current prescribing information for definitive guidance.