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The drug name provided appears to be encoded. Assuming the intended drug is **Tenofovir Disoproxil Fumarate (TDF)**, also known as **Voihep**, here is the requested information:
## Overview
Tenofovir disoproxil fumarate (TDF) is a nucleotide analog reverse transcriptase inhibitor (NtRTI). It is a prodrug that is converted intracellularly to tenofovir diphosphate, which competes with deoxyadenosine triphosphate and inhibits viral reverse transcriptase.
## Primary Indications
* Treatment of human immunodeficiency virus (HIV-1) infection in combination with other antiretroviral agents.
* Treatment of chronic hepatitis B virus (HBV) infection.
## Adult Dosing
* **HIV-1 Infection:** 300 mg orally once daily.
* **Chronic Hepatitis B:** 300 mg orally once daily.
## Pediatric Dosing
Dosing in pediatric patients varies by age and weight. Specific recommendations should be followed from FDA-approved labeling or established institutional protocols.
* **HIV-1 Infection (6 to <12 years of age, weighing 17 kg to <22 kg):** 150 mg orally once daily.
* **HIV-1 Infection (6 to <12 years of age, weighing 22 kg to <28 kg):** 200 mg orally once daily.
* **HIV-1 Infection (6 to <12 years of age, weighing ≥28 kg) or 12 to <18 years of age:** 300 mg orally once daily.
## Dose Adjustments
* **Renal Impairment:** Dose adjustment is required based on creatinine clearance (CrCl).
* CrCl 30-49 mL/min: 300 mg every 48 hours.
* CrCl <30 mL/min (and not on hemodialysis): 300 mg every 72 hours or after 3 doses of hemodialysis.
* *Note: Use is not recommended in patients with CrCl <30 mL/min or on hemodialysis due to potential for accumulation.*
* **Hepatic Impairment:** No dose adjustment is generally recommended.
## Contraindications
* Hypersensitivity to tenofovir disoproxil fumarate or any component of the formulation.
## Adverse Effects
Common adverse effects include diarrhea, nausea, vomiting, abdominal pain, asthenia, dizziness, headache, and rash.
Serious adverse effects can include:
* **Nephrotoxicity:** Proximal tubulopathy, renal impairment, acute renal failure.
* **Bone Abnormalities:** Decreased bone mineral density (osteomalacia), bone fractures.
* **Lactic Acidosis:** Particularly in combination with other nucleoside/nucleotide analogs.
* **Hepatotoxicity:** Exacerbations of hepatitis B, hepatic steatosis, hepatocellular injury.
* **Immune Reconstitution Inflammatory Syndrome (IRIS).**
## Key Drug Interactions
* **Didanosine:** Coadministration increases didanosine plasma concentrations and may increase the risk of didanosine-related adverse events. Concomitant use is generally not recommended. If coadministration is unavoidable, dose adjust didanosine and monitor for toxicity.
* **Atazanavir, Lopinavir/Ritonavir:** May increase tenofovir concentrations.
* **Cidofovir, other nephrotoxic drugs:** Increased risk of nephrotoxicity.
* **Drugs eliminated by active tubular secretion:** May increase concentrations of tenofovir and/or the coadministered drug, increasing the risk of adverse events.
## Monitoring
* **Renal function:** Serum creatinine and urinalysis (including urine protein and glucose) at baseline and periodically during treatment.
* **Bone mineral density:** Especially in patients with a history of fractures or other risk factors for osteoporosis.
* **Liver function tests:** Especially in patients with pre-existing liver disease or with chronic hepatitis B.
* **Viral load and CD4 count:** For HIV treatment efficacy.
* **Hepatitis B viral DNA:** For hepatitis B treatment efficacy.
## Clinical Pearls
* TDF can be taken with or without food.
* Due to the risk of renal toxicity, monitor renal function closely, especially in patients with pre-existing renal disease or those taking other nephrotoxic medications.
* Bone demineralization can occur; consider bone density monitoring and calcium/vitamin D supplementation.
* Patients with chronic hepatitis B should be monitored for signs and symptoms of hepatic flares upon discontinuation.
***
*Disclaimer: This information is intended for healthcare professionals. Always consult the most current prescribing information and your institution's protocols before making any clinical decisions.*
