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# Tabvoihep ## Overview Tabvoihep is an antiviral medication used in the treatment of chronic hepatitis B virus (HBV) infection. It is a nucleoside analog that inhibits HBV replication. ## Primary Indications * Treatment of chronic hepatitis B virus (HBV) infection in adults and pediatric patients. ## Adult Dosing The recommended dose for adults is **0.5 mg once daily**. ## Pediatric Dosing For pediatric patients aged 12 years and older and weighing at least 35 kg, the recommended dose is **0.5 mg once daily**. Dosing for pediatric patients younger than 12 years or weighing less than 35 kg has not been established. ## Dose Adjustments * **Renal Impairment:** Dose adjustment is required based on creatinine clearance (CrCl). * CrCl < 30 mL/min: Reduce dose frequency to **once every 48 hours**. * CrCl < 10 mL/min: Reduce dose frequency to **once every 72 hours**. * Patients on hemodialysis: Dose **once every 7 days** after hemodialysis. * **Hepatic Impairment:** No dose adjustment is generally recommended. ## Contraindications * Hypersensitivity to tenofovir alafenamide, tenofovir, or any excipient in the formulation. ## Adverse Effects * **Common:** Nausea, vomiting, diarrhea, abdominal pain, headache, dizziness, fatigue, rash. * **Serious:** Lactic acidosis, severe hepatomegaly with steatosis, renal impairment, Fanconi syndrome, decreased bone mineral density. ## Key Drug Interactions * **Strong CYP3A4 inhibitors:** May increase tenofovir alafenamide plasma concentrations. Avoid coadministration. * **Drugs affecting renal function:** Concomitant use with drugs known to impair renal function may increase the risk of renal adverse events. Monitor renal function closely. ## Monitoring * **Baseline and periodic monitoring of renal function (serum creatinine, BUN, urinalysis, urine protein) and electrolytes.** * **Baseline and periodic monitoring of liver function tests (ALT, AST, bilirubin).** * **Hepatitis B viral load.** * **Bone mineral density** may be considered in patients with pre-existing risk factors for osteoporosis or fractures. ## Clinical Pearls * Tabvoiheihep has a lower risk of renal and bone toxicity compared to older tenofovir formulations (e.g., tenofovir disoproxil fumarate) due to its more targeted delivery to hepatocytes. * Treatment should be guided by a healthcare provider experienced in the management of chronic hepatitis B. * Discontinuation of treatment may be associated with severe exacerbations of hepatitis B. *** **Disclaimer:** This information is intended for healthcare professionals. Always consult the most current prescribing information and product literature for complete details before making any clinical decisions. Local protocols and institutional guidelines may also apply.