This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

  • If you have hepatitis B virus infection and take tenofovir but then stop taking it, your hepatitis B could flare up and become worse. Your doctor will need to monitor your liver function closely if you stop treatment. You may need to start treatment for hepatitis B again.

  1. Tenofovir oral tablet is available as generic drug and as a brand-name drug. Brand name: Viread, Vemlidy.
  2. Tenofovir comes in two forms: an oral tablet and an oral powder.
  3. Tenofovir oral tablet is approved to treat HIV infection and chronic hepatitis B virus infection.

Tenofovir is a prescription drug. It comes as an oral tablet and oral powder.

Tenofovir oral tablet is available as a generic drug and as the brand-name drugs Viread and Vemlidy.

This drug is used as part of a combination therapy. That means you’ll likely take this drug in combination with other drugs to treat your condition.

Why it’s used

Tenofovir is used to treat:

  • HIV infection, in combination with other antiretroviral drugs. This drug doesn’t eliminate the virus entirely, but it helps to control it.
  • chronic hepatitis B virus infection.

How it works

Tenofovir belongs to a class of drugs called nucleoside reverse transcriptase inhibitors (NRTIs). It’s also a hepatitis B virus reverse transcriptase inhibitor (RTI). A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Tenofovir works in the same way for both HIV infection and chronic hepatitis B virus infections. It blocks the effectiveness of reverse transcriptase, an enzyme required for each virus to make copies of itself. Blocking reverse transcriptase can reduce the amount of the virus in your blood.

Tenofovir can also increase CD4 cell count. CD4 cells are white blood cells that fight infection.

Tenofovir oral tablet doesn’t cause drowsiness, but it can cause other side effects.

More common side effects

The more common side effects that occur with tenofovir include:

  • depression
  • pain
  • back pain
  • diarrhea
  • headache
  • trouble sleeping
  • nausea or vomiting
  • rash

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Lactic acidosis. Symptoms can include:
    • weakness
    • muscle pain
    • stomach pain with nausea and vomiting
    • irregular or rapid heartbeat
    • dizziness
    • trouble breathing
    • feelings of coldness in the legs or arms
  • Liver enlargement. Symptoms can include:
    • dark urine
    • abdominal pain or discomfort
    • fatigue
    • yellowing skin
    • nausea
  • Worsening hepatitis B virus infection. Symptoms can include:
    • abdominal pain
    • dark urine
    • fever
    • nausea
    • weakness
    • yellowing of the skin and the whites of your eyes (jaundice)
  • Decreased bone mineral density
  • Immune reconstitution syndrome. Symptoms can include those of past infections.
  • Kidney damage and reduced kidney function. This can happen slowly without many symptoms, or cause symptoms such as:
    • fatigue
    • aching
    • puffiness

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Tenofovir oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with tenofovir are listed below.

Antibiotics from the aminoglycoside group

Taking certain antibiotics with tenofovir can increase your risk of kidney damage. These drugs are mainly intravenous (IV) drugs given in hospitals. They include:

  • gentamicin
  • amikacin
  • tobramycin

Nonsteroidal anti-inflammatory drugs (NSAIDs)

While taking tenofovir, don’t use high doses of NSAIDs, take more than one at a time, or take them for long periods of time. Doing these things may result in kidney damage. Examples of NSAIDs include:

  • diclofenac
  • ibuprofen
  • ketoprofen
  • naproxen
  • piroxicam

Hepatitis B virus drug

Do not use adefovir dipivoxil (Hepsera) together with tenofovir.

Antiviral drugs (not HIV drugs)

Taking antiviral drugs with tenofovir can increase your risk of kidney damage. Examples of these drugs include:

  • cidofovir
  • acyclovir
  • valacyclovir
  • ganciclovir
  • valgancyclovir

HIV drugs

If you need to take certain HIV drugs with tenofovir, your doctor may change your dosage of tenofovir or the other HIV drug. Examples of these drugs include:

  • atazanavir (Reyataz, alone or “boosted” with ritonavir)
  • darunavir (Prezista), “boosted” with ritonavir
  • didanosine (Videx)
  • lopinavir/ritonavir (Kaletra)

The HIV drugs below all contain tenofovir. Taking these medications together with tenofovir will increase the amount of tenofovir you’re getting. Getting too much of the drug can increase your risk of side effects. Some of these side effects could be serious, such as kidney damage.

Examples of these drugs include:

  • efavirenz/emtricitabine/tenofovir (Atripla)
  • bictegravir/emtricitabine/tenofovir alafenamide (Biktarvy)
  • emtricitabine/rilpirivine/tenofovir (Complera)
  • emtricitabine/tenofovir (Descovy)
  • elvitegravir/cobicistat/emtricitabine/tenofovir (Genvoya)
  • emtricitabine/rilpirivine/tenofovir (Odefsey)
  • elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild)
  • emtricitabine/tenofovir (Truvada)
  • doravirine/lamivudine/tenofovir (Delstrigo)
  • efavirenz/lamivudine/tenofovir (Symfi, Symfi Lo)

Hepatitis C virus drugs

Taking certain hepatitis C drugs with tenofovir may increase the levels of tenofovir in your body. This can cause more side effects from the drug. Examples of these drugs include:

  • ledipasvir/sofosbuvir (Harvoni)
  • sofosbuvir/velpatasvir/voxilaprevir (Vosevi)

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Drug forms and strengths

Generic: Tenofovir

  • Form: oral tablet
  • Strengths: 150 mg, 200 mg, 250 mg, 300 mg

Brand: Viread

  • Form: oral tablet
  • Strengths: 150 mg, 200 mg, 250 mg, 300 mg

Brand: Vemlidy

  • Form: oral tablet
  • Strengths: 25 mg

Dosage for HIV infection (Viread and generic only)

Adult dosage (ages 18 years and older who weigh at least 77 lb. [35 kg])

The typical dosage is one 300-mg tablet per day.

Child dosage (ages 12–17 years who weigh at least 77 lb. [35 kg])

The typical dosage is one 300-mg tablet per day.

Child dosage (ages 2–11 years or weigh less than 77 lb. [35 kg])

Your child’s doctor will provide a dosage based on your child’s specific weight.

Child dosage (ages 0–23 months)

Dosage for people younger than 2 years has not been established.

Dosage for chronic hepatitis B virus infection (Viread and generic only)

Adult dosage (ages 18 years and older who weigh at least 77 lb. [35 kg])

The typical dosage is one 300-mg tablet per day.

Child dosage (ages 12–17 years who weigh at least 77 lb. [35 kg])

The typical dosage is one 300-mg tablet per day.

Child dosage (ages 12–17 years and weigh less than 77 lb. [35 kg])

Dosage has not been established for children who weigh less than 77 lb. (35 kg).

Child dosage (ages 0–11 years)

Dosage for people younger than 12 years has not been established.

Dosage for chronic hepatitis B virus infection (Vemlidy only)

Adult dosage (ages 18 years and older)

The typical dosage is one 25-mg tablet per day.

Child dosage (ages 0–17 years)

Dosage for people younger than 18 years has not been established.

Special dosage considerations

For seniors: If you’re 65 years or older, your doctor may adjust your dosage. You may have changes such as decreased kidney function, which may cause you to need a lower drug dosage.

For people with kidney disease: Talk to your doctor before taking tenofovir. This drug is removed from your body by your kidneys. Kidney disease can increase drug levels in your body, resulting in serious side effects. Your doctor may prescribe a lower dosage for you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

FDA warning: For people with hepatitis B virus infection

  • This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). Black box warnings alert doctors and patients about drug effects that may be dangerous.
  • If you have hepatitis B virus infection and take tenofovir but then stop taking it, your hepatitis B could flare up and become worse. Your doctor will need to monitor your liver function closely if you stop treatment. You may need to start treatment for hepatitis B again.

Other warnings

Worsening kidney function warning

This drug may cause new or worsening kidney function. Your doctor should monitor your kidney function before and during treatment with this drug.

Warning for people with kidney disease

Tenofovir is filtered through your kidneys. If you have kidney disease, taking it may cause even more damage to your kidneys. Your dosage may need to be reduced.

Other HIV drugs warning

Tenofovir shouldn’t be used with combination drug products that already contain tenofovir. Combining these products with tenofovir could cause you to get too much of the drug and result in more side effects. Examples of these combination drugs include:

  • Atripla
  • Complera
  • Descovy
  • Genvoya
  • Odefsey
  • Stribild
  • Truvada

Warning for pregnant women

Tenofovir is a pregnancy category B drug. That means two things:

  1. Studies of the drug in pregnant animals have not shown risk to the fetus.
  2. There aren’t enough studies done in pregnant women to show the drug poses a risk to the fetus

There have not yet been sufficient studies on the effect of tenofovir in pregnant women. Tenofovir should only be used during pregnancy if it’s clearly needed.

Warning for women who are breastfeeding

The Centers for Disease Control and Prevention says that if you have HIV you should not breastfeed, because HIV may be passed through breast milk to your child. In addition, tenofovir is passed through breast milk and could have serious side effects on a child who is breastfed.

Warning for seniors

If you’re aged 65 years or older, your body may process this drug more slowly. Your doctor may start you on a lowered dosage to make sure that too much of this drug does not build up in your body. Too much of the drug in your body can be dangerous.

When to call the doctor

See your doctor right away if you have the following symptoms while taking this drug:

  • increased fever
  • headache
  • muscle aches
  • sore throat
  • swollen lymph glands
  • night sweats

These symptoms can indicate that your medication isn’t working and may need to be changed.

Tenofovir is used for long-term treatment of HIV infection. Chronic hepatitis B virus infection typically requires long-term treatment. There can be very serious health consequences if you don’t take this drug exactly how your doctor tells you.

If you stop, miss doses, or don’t take it on schedule: To keep your HIV under control, you need a certain amount of tenofovir in your body all the time. If you stop taking your tenofovir, miss doses, or don’t take it on a regular schedule, the amount of medication in your body changes. Missing a few doses is enough to allow HIV to become resistant to this drug. This can lead to serious infections and health problems.

In order to control your hepatitis B infection, the medication needs to be taken regularly. Missing multiple doses can decrease how well the drugs works.

Taking your drug at the same time every day increases your ability to keep both HIV and hepatitis C under control.

If you miss a dose: If you forget to take your dose, take it as soon as you remember. If it’s just a few hours until your next dose, wait to take a single dose at the usual time.

Take just one dose at a time. Never try to catch up by taking two doses at once. This could result in dangerous side effects, such as kidney damage.

How to tell if the drug is working: If you’re using this drug for HIV, your doctor will check your CD4 count to determine if the drug is working. CD4 cells are white blood cells that fight infection. An increased level of CD4 cells is a sign that the drug is working.

If you’re using this drug for chronic hepatitis B virus infection, your doctor will check the amount of the virus’s DNA in your blood. A reduced level of the virus in your blood is a sign that the drug is working.

Keep these considerations in mind if your doctor prescribes tenofovir for you.

General

  • You can take generic tenofovir tablets and Viread tablets with or without food. However, you should always take Vemlidy tablets with food.
  • You can cut or crush tenofovir tablets.

Storage

  • Store tenofovir tablets at room temperature: 77°F (25°C). They can be stored for brief periods of time at temperatures of 59°F to 86°F (15°C to 30°C).
  • Keep the bottle tightly closed and away from light and moisture.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t harm your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

During your treatment with tenofovir, your doctor may do the following tests:

  • Bone density test: Tenofovir might reduce your bone density. Your doctor might do special tests such as a bone scan to measure your bone density.
  • Kidney function test: This drug is removed from your body through your kidneys. Your doctor will check your kidney function before treatment and may check it during treatment to determine if you need any dosage adjustments.
  • Other lab tests: Your progress and treatment effectiveness can be measured through some lab tests. Your doctor may check virus levels in your blood or measure white blood cells to evaluate your progress.

Availability

  • Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.
  • If you only need a few tablets, you should call and ask if your pharmacy dispenses only a small number of tablets. Some pharmacies can’t dispense only part of a bottle.
  • This drug is often available from specialty pharmacies through your insurance plan. These pharmacies operate like mail-order pharmacies and ship the drug to you.
  • In larger cities, there will often be HIV pharmacies where you can have your prescriptions filled. Ask your doctor if there’s a HIV pharmacy in your area.

Hidden costs

While you take tenofovir, you may need extra lab testing, including:

  • bone density scan (performed once a year or less often)
  • kidney function tests

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription. Your doctor may have to do some paperwork, and this can delay your treatment for a week or two.

There are several alternative treatments for HIV and chronic hepatitis B. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.