Nucleotide reverse transcriptase inhibitor (prodrug)
Tenofovir alafenamide
Brand names: Vemlidy
Adult dose
Dose: 25mg PO OD with food
Route: PO
Frequency: OD
Dose adjustments
Renal
Avoid if eGFR <15
Clinical pearls
- Chronic HBV with compensated liver disease
- Better renal/bone profile than TDF
Contraindications
- Hypersensitivity
Side effects
- Headache
- Nausea
- HBV reactivation if stopped
- Lactic acidosis (rare)
Interactions
- P-gp inducers (rifampicin — avoid)
- Some antiretrovirals
Monitoring
- LFTs
- HBV DNA
- Renal function
Reference: BNF; NICE TA471; EASL; https://bnf.nice.org.uk/drugs/tenofovir-alafenamide/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- DIPSS — Dynamic International Prognostic Scoring System for Myelofibrosis · Cancer Prognosis
- BALL Score for Relapsed/Refractory CLL · Leukaemia
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023