Tenofovir Disoproxil
/api/v1/drug/tenofovir-disoproxilBoxed warning
WARNING: POSTTREATMENT EXACERBATION OF HEPATITIS Severe acute exacerbations of hepatitis have been reported in HBV-infected patients who have discontinued anti-hepatitis B therapy, including tenofovir disoproxil fumarate tablets. Hepatic function should be monitored closely with both clinical and laboratory follow-up for at least several months in patients who discontinue anti-hepatitis B therapy, including tenofovir disoproxil fumarate tablets. If appropriate, resumption of anti-hepatitis B therapy may be warranted [See Warnings and Precautions ( 5.1 )]. WARNING: POSTTREATMENT EXACERBATION OF HEPATITIS See full prescribing information for complete boxed warning. Severe acute exacerbations of hepatitis have been reported in HBV-infected patients who have discontinued anti-hepatitis B therapy, including tenofovir disoproxil fumarate tablets. Hepatic function should be monitored closely in these patients. If appropriate, resumption of anti-hepatitis B therapy may be warranted. (5.1)
Mechanism of action
Sourced from openFDATenofovir disoproxil fumarate is an antiviral drug [See Microbiology ( 12.4 )].
Indications
Sourced from openFDA- & USAGE Tenofovir disoproxil fumarate tablets are a nucleotide analog HIV-1 reverse transcriptase inhibitor and an HBV reverse transcriptase inhibitor. • Tenofovir disoproxil fumarate tablets are indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection in adults and pediatric patients 2 years of age and older.ICD-10: B20
Contraindications
Sourced from openFDA- None. None.contraindicated
Dosage & administration
Sourced from openFDADOSAGE & ADMINISTRATION • Recommended dose for the treatment of HIV-1 or chronic hepatitis B in adults and pediatric patients 12 years of age and older (35 kg or more): 300 mg once daily taken orally without regard to food. (2.1) • Recommended dose for the treatment of HIV-1 in pediatric patients (2 to less than 12 years of age): o Tablets: For pediatric patients weighing greater than or equal to 17 kg who can swallow an intact tablet, one tenofovir disoproxil fumarate tablet (300 mg based on body weight) once daily taken orally without regard to food. (2.2) • Dose recommended in renal impairment in adults: o Creatinine clearance 30 to 49 mL/min: 300 mg every 48 hours. (2.3) o Creatinine clearance 10 to 29 mL/min: 300 mg every 72 to 96 hours. (2.3) o Hemodialysis: 300 mg every 7 days or after approximately 12 hours of dialysis. (2.3) 2.1 Recommended Dose in Adults and Pediatric Patients 12 Years of Age and Older (35 kg or more) For the treatment of HIV-1 or chronic hepatitis B: The dose is one 300 mg tenofovir disoproxil fumarate tablet once daily taken orally, without regard to food. In the treatment of chronic hepatitis B, the optimal duration of treatment is unknown. Safety and efficacy in pediatric patients with chronic hepatitis B weighing less than 35 kg have not been established.
Warnings & precautions
Sourced from openFDA• New onset or worsening renal impairment: Can include acute renal failure and Fanconi syndrome. Assess estimated creatinine clearance before initiating treatment with tenofovir disoproxil fumarate tablets. In patients at risk for renal dysfunction, assess estimated creatinine clearance, serum phosphorus, urine glucose, and urine protein before initiating treatment with tenofovir disoproxil fumarate tablets and periodically during treatment. Avoid administering tenofovir disoproxil fumarate tablets with concurrentor recent use of nephrotoxic drugs. (5.2) • Lactic acidosis/severe hepatomegaly with steatosis: Discontinue treatment in patients who develop symptoms or laboratory findings suggestive of lactic acidosis or pronounced hepatotoxicity. (5.3) • Coadministration with other products: Do not use with other tenofovir-containing products (e.g., ATRIPLA, BIKTARVY, COMPLERA, DESCOVY, GENVOYA, ODEFSEY, STRIBILD, TRUVADA, or VEMLIDY). Do not administer in combination with HEPSERA. (5.4) • HIV testing: HIV antibody testing should be offered to all HBV-infected patients before initiating therapy with tenofovir disoproxil fumarate tablets. Tenofovir disoproxil fumarate tablets should only be used as part of an appropriate antiretroviral combination regimen in HIV-infected patients with or without HBV coinfection. (5.5) • Decreases in bone mineral density (BMD): Consider assessment of BMD in patients with a history of pathologic fracture or other risk factors for osteoporosis or bone loss. (5.6) • Immune reconstitution syndrome: Observed in HIV-infected patients.
Adverse reactions
Sourced from openFDAThe following adverse reactions are discussed in other sections of the labeling: • Severe Acute Exacerbation of Hepatitis [See Boxed Warning, Warnings and Precautions ( 5.1 )]. • New Onset or Worsening Renal Impairment [See Warnings and Precautions ( 5.2 )]. • Lactic Acidosis/Severe Hepatomegaly with Steatosis [See Warnings and Precautions ( 5.3 )]. • Bone Effects [See Warnings and Precautions ( 5.6 )]. • Immune Reconstitution Syndrome [See Warnings and Precautions ( 5.7)]. • In HIV-infected adult subjects: Most common adverse reactions (incidence greater than or equal to 10%, Grades 2 to 4) are rash, diarrhea, headache, pain, depression, asthenia, and nausea. (6.1) • In HBV-infected subjects with compensated liver disease: Most common adverse reaction (all grades) was nausea (9%). (6.1) • In pediatric subjects: Adverse reactions in pediatric subjects were consistent with those observed in adults. (6.1) • In HBV-infected subjects with decompensated liver disease: Most common adverse reactions (incidence greater than or equal to 10%, all grades) were abdominal pain, nausea, insomnia, pruritus, vomiting, dizziness, and pyrexia. (6.1) To report SUSPECTED ADVERSE REACTIONS, contact NorthStar Rx LLC at 1-800-206-7821 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch 6.1 Adverse Reactions from Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
Use in specific populations
Sourced from openFDANursing mothers: Women infected with HIV should be instructed not to breastfeed. (8.3) 8.1 Pregnancy Pregnancy Category B There are no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, tenofovir disoproxil fumarate tablets should be used during pregnancy only if clearly needed. Antiretroviral Pregnancy Registry: To monitor fetal outcomes of pregnant women exposed to tenofovir disoproxil fumarate tablets, an Antiretroviral Pregnancy Registry has been established. Healthcare providers are encouraged to register patients by calling 1-800-258-4263. Risk Summary Animal Data Reproduction studies have been performed in rats and rabbits at doses up to 14 and 19 times the human dose based on body surface area comparisons and revealed no evidence of impaired fertility or harm to the fetus due to tenofovir. 8.3 Nursing Mothers Nursing Mothers: The Centers for Disease Control and Prevention recommend that HIV-1 infected mothers not breastfeed their infants to avoid risking postnatal transmission of HIV-1. Samples of breast milk obtained from five HIV-1 infected mothers in the first post-partum week show that tenofovir is secreted in human milk. The impact of this exposure in breastfed infants is unknown.
Pharmacokinetics
Sourced from openFDA- Metabolism
- The pharmacokinetics of tenofovir DF have been evaluated in healthy volunteers and HIV-1 infected individuals. Tenofovir pharmacokinetics are similar between these populations.
Overdosage
Sourced from openFDALimited clinical experience at doses higher than the therapeutic dose of tenofovir disoproxil fumarate tablets 300 mg are available. In Study 901, 600 mg tenofovir DF was administered to 8 subjects orally for 28 days. No severe adverse reactions were reported. The effects of higher doses are not known. If overdose occurs the patient must be monitored for evidence of toxicity and standard supportive treatment applied as necessary. Tenofovir is efficiently removed by hemodialysis with an extraction coefficient of approximately 54%. Following a single 300 mg dose of tenofovir disoproxil fumarate tablets, a four-hour hemodialysis session removed approximately 10% of the administered tenofovir dose.
Approval history
Sourced from openFDA- Oct 26, 2001NDANDA021356Gilead Sciences Inc
- Aug 2, 2004NDANDA021752Gilead
- Aug 10, 2011NDANDA202123Gilead Sciences Inc
- Jan 18, 2012NDANDA022577Gilead Sciences Inc
- Aug 27, 2012NDANDA203100Gilead Sciences Inc
- Feb 28, 2018NDANDA022141Mylan Labs Ltd
- Mar 22, 2018NDANDA022142Mylan Labs Ltd
- Aug 30, 2018NDANDA210807Msd Merck Co
FAERS reports
- 1Bone Density Decreased20,16529%
- 2Chronic Kidney Disease12,84818%
- 3Renal Failure11,30716%
- 4Osteonecrosis11,04316%
- 5Bone Loss10,90916%
- 6Multiple Fractures9,86714%
- 7Tooth Loss9,82214%
- 8Renal Injury9,77414%
- 9Osteoporosis9,19913%
- 10Skeletal Injury8,67612%
- 11Pain8,41412%
- 12Emotional Distress7,96411%
- 13Anxiety7,60511%
- 14Anhedonia7,00710.0%
- 15Osteopenia4,8997.0%
Literature
Recent PubMed references pinned to Tenofovir Disoproxil as a MeSH major topic. Citations link to pubmed.ncbi.nlm.nih.gov.
- Comparative safety of B/F/TAF versus other antiretroviral therapy regimens for treatment-experienced people with HIV-1: a systematic literature review and network meta-analysis.Journal of comparative effectiveness research · 2026 · Curteis T, Eddowes LA, Karlsson A, et al.PMID 42206806DOI 10.57264/cer-2026-0013
- Prevotella bivia Influences Antiretroviral Pharmacokinetics and Viral Replication in an Ex Vivo Vaginal Tissue Model.Clinical and translational science · 2026 · Lantz AM, Collins LB, Hirsch EB, et al.PMID 42148717DOI 10.1111/cts.70597
- Tenofovir, Interferon Pathways, and Mucosal Immunity: Implications for People Living With HIV.American journal of reproductive immunology (New York, N.Y. : 1989) · 2026 · Hladik F, Hughes SM, Levy CN, et al.PMID 42113488DOI 10.1111/aji.70255
- A Comparative Study of Entecavir and Tenofovir Alafenamide on Quantitative HBsAg Reduction in Patients With CHB.Journal of medical virology · 2026 · Lee J, Jin YJPMID 42101128DOI 10.1002/jmv.70958
- Tenofovir Alafenamide in the Treatment of Chronic Hepatitis B Virus Infection in the High-Replicative Low-Inflammatory Phase: A 48-Week Randomized Controlled Trial.Journal of medical virology · 2026 · Luo Q, Xu R, Zhang Y, et al.PMID 42095461DOI 10.1002/jmv.70960
- Formulation Development of Topical Inserts Containing Doxycycline and Doxycycline Combined with Tenofovir Alafenamide and Elvitegravir for the Prevention of Sexually Transmitted Infections.AAPS PharmSciTech · 2026 · Agrahari V, Peet MM, Monpara J, et al.PMID 42091755DOI 10.1208/s12249-026-03427-1
- Exposure-response modeling of QTc interval and creatine kinase-MB in healthy people and treatment-naïve adults living with HIV-1 treated with ainuovirine monotherapy or combined with lamivudine and tenofovir DF.European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences · 2026 · Zhou Z, Zhang Y, Yun X, et al.PMID 42086178DOI 10.1016/j.ejps.2026.107544
- A minimal physiologically based pharmacokinetic model for predicting the metabolism of tenofovir prodrugs in the liver of human with fibrosis.Drug metabolism and disposition: the biological fate of chemicals · 2026 · He H, Zhu J, Chen J, et al.PMID 42085925DOI 10.1016/j.dmd.2026.100263
Clinical trials
The 10 most recently updated of 1,353 ClinicalTrials.gov registrations naming Tenofovir Disoproxil as an intervention. Registration is not evidence of efficacy or safety — reference crosswalk only.
- Early Metabolic Effects of Antiretroviral Drugs in Healthy volUnteers: a Phase 2 Randomized StudyRecruiting · Phase 2 · Interventional · 120 enrolled · National Institute of Allergy and Infectious Diseases (NIAID)NCT05652478updated 2026-06-12
- A Study of GS-3242 in Combination With Lenacapavir Versus Biktarvy in Virologically Suppressed People With HIV-1Not yet recruiting · Phase 2 · Interventional · 175 enrolled · Gilead SciencesNCT07645287updated 2026-06-12
- A Study to Provide Continued Access to Study Drug to Children and Adolescents Who Have Completed Clinical Studies Involving Gilead HIV TreatmentsRecruiting · Phase 4 · Interventional · 350 enrolled · Gilead SciencesNCT06337032updated 2026-06-10
- Resistance Profile to Antiretroviral Medications in Individuals Living With HIV Who Failed a First-Line Regimen With Tenofovir / Lamivudina and Dolutegravir in BrasilCompleted · Interventional · 777 enrolled · Federal University of São PauloNCT07618507updated 2026-06-10
- Post-Injectable Cabotegravir Antiretroviral Salvage Strategy Options TrialRecruiting · Phase 4 · Interventional · 100 enrolled · University of Witwatersrand, South AfricaNCT06485154updated 2026-06-09
- Comparative Trial Between Ainuovirine(ANV)/Lamivudine(3TC)/Tenofovir(TDF) and Efavirenz(EFV)/Lamivudine/Tenofovir RegimensNot yet recruiting · Phase 4 · Interventional · 60 enrolled · Shanghai Public Health Clinical CenterNCT07631897updated 2026-06-08
- A Clinical Study of MK-8527 to Prevent Human Immunodeficiency Virus Type 1 (HIV-1) (MK-8527-011)Recruiting · Phase 3 · Interventional · 4,390 enrolled · Merck Sharp & Dohme LLCNCT07044297updated 2026-06-08
- A Clinical Study of Islatravir and Ulonivirine for People With HIV-1 Who Have Not Been Treated Before (MK-8591B-062)Recruiting · Phase 2 · Phase 3 · Interventional · 570 enrolled · Merck Sharp & Dohme LLCNCT07266831updated 2026-06-08
- Biktarvy in Treatment-Naïve Late Presenters With HIV-1 InfectionCompleted · Phase 4 · Interventional · 202 enrolled · Peking Union Medical College HospitalNCT04296695updated 2026-06-05
- Inhibition of HBV Replication and Biological Reversal of Cirrhosis (F3-F4) and HCC by FlavonoidsCompleted · Phase 4 · Interventional · 134 enrolled · Trieu, Nguyen Thi, M.D.NCT07084948updated 2026-06-05
Frequently asked questions
- How does Tenofovir Disoproxil work?
- Tenofovir disoproxil fumarate is an antiviral drug [See Microbiology ( 12.4 )].
- What is Tenofovir Disoproxil used for?
- According to FDA labeling, Tenofovir Disoproxil carries indications including: & USAGE Tenofovir disoproxil fumarate tablets are a nucleotide analog HIV-1 reverse transcriptase inhibitor and an HBV reverse transcriptase inhibitor. • Tenofovir disoproxil fumarate tablets are indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection in adults and pediatric patients 2 years of age and older.. This is a reference summary of labeled uses, not medical advice or a treatment recommendation.
- What class of drug is Tenofovir Disoproxil?
- Tenofovir Disoproxil is classified as Nucleoside and nucleotide reverse transcriptase inhibitors, Nucleoside Reverse Transcriptase Inhibitors, Decreased Reverse Transcription to DNA.
- What are the brand names for Tenofovir Disoproxil?
- Tenofovir Disoproxil is marketed under brand names including Atripla, Cimduo, Complera, Delstrigo, Stribild, Symfi, Temixys, Truvada.
- What are the contraindications for Tenofovir Disoproxil?
- Tenofovir Disoproxil labeling lists contraindications including: None. None.. Always consult the full prescribing information and a clinician.
tenofovir-disoproxil is illustrative MVP content compiled from public sources. pharmacopeia is for educational and informational use only and is not a substitute for professional medical advice.