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Antiviral — Hepatitis B (Nucleotide Analogue)

Tenofovir (TDF/TAF)

Brand names: Viread (TDF), Vemlidy (TAF)

Tenofovir (as the disoproxil or alafenamide prodrug) is a nucleotide reverse transcriptase inhibitor used in hepatology to treat chronic hepatitis B virus infection.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Its active form inhibits HBV DNA polymerase (reverse transcriptase), suppressing viral replication and reducing hepatitis B viral load.

Prescribing in practice

  • Stopping treatment can precipitate a severe acute exacerbation of hepatitis, so do not discontinue without specialist supervision and close monitoring of liver function.
  • The disoproxil formulation is associated with renal impairment and reductions in bone mineral density, whereas the alafenamide formulation has a more favourable renal and bone profile.
  • Test for HIV co-infection before starting, as tenofovir-based therapy has implications for HIV management and resistance.

Monitoring

Monitor renal function and, with the disoproxil prodrug, consider bone health, alongside periodic HBV viral load and liver function tests.

Counselling the patient

  • Take it regularly and do not stop without specialist advice, as your hepatitis can flare badly.
  • Attend for blood tests to check your kidneys and the response of your hepatitis.

Evidence & guidelines

Tenofovir is recommended by NICE as a first-line antiviral for chronic hepatitis B with a high barrier to resistance.

Reference: EASL HBV Clinical Practice Guidelines 2017; Marcellin et al. NEJM 2008; WHO HBV Guidelines 2015; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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