Viread

Viread is a very well-tolerated medication with minimal side effects. The most commonly reported side effects are diarrhea, nausea, asthenia (muscle weakness), headache, depression, and abdominal pain. Other, more rarely reported side effects include rash, excessive gas, and generalized pain and achiness, including back pain. Nervous system side effects include depression, insomnia, peripheral neuropathy, and dizziness. Viread may lead to decreases in bone mineral density (BMD); patients should be monitored for osteoporosis or osteopenia. Viread is processed by the kidneys, so there is risk of kidney toxicity, including acute renal failure. Before starting treatment, patients should have their creatinine clearance (CrCl) assessed. Routine monitoring of glucose and protein in the urine, and of serum phosphorus should be standard of care, too. If you experience any pain in the extremities, persistent or worsening bone achiness/pain, or fractures with or without muscular pain, consult your medical provider immediately. There are two potential serious side effects when taking Viread: (1) Lactic acidosis: The buildup of lactic acid in the blood that could be fatal. Signs and symptoms of lactic acidosis include feeling very weak or excessively fatigued, difficulty breathing, stomach pain with nausea and vomiting, feeling cold and chills (especially in arms and legs), dizziness and light-headedness, fast or irregular heartbeat, or unusual muscle pain. If you experience any of these symptoms contact your medical provider immediately; (2) Two liver conditions, hepatomegaly (enlarged liver) or steatosis (fatty liver), may occur. Signs and symptoms of these liver conditions include yellowing of the eyes and/or skin (jaundice), dark colored urine, light colored stools, nausea, loss of appetite, and pain, achiness or tenderness of the liver (lower right side of the belly, below the ribcage and next to the belly button).

Be sure to tell your medical provider or pharmacist about all the medications, supplements, and herbs you take, whether they are prescribed, over-the-counter, or illicit, before starting this regimen; report any changes as they happen. Do not take Viread with the HBV treatment Hepsera. Viread cannot be taken with any of the following HIV combination medications, as they contain tenofovir DF: Atripla, Biktarvy, Cimduo, Complera, Delstrigo, Descovy, Odefsey, Stribild, Symfi, Symfi Lo, Symtuza, Genvoya, or Truvada. Viread reduces the level of Reyataz, meaning that Reyataz 300mg must be boosted with Norvir 100 mg or Tybost 150 mg (taken with food) when used together. Kaletra, Prezista/Norvir, and Reyataz/Norvir increase Viread levels, but do not require dose adjustments. This interaction may increase Viread-related side effects; patients should be monitored for them and for kidney disorders. Viread should be avoided with any medications that could negatively affect the kidneys, including chronic use or high doses of NSAIDS (non-steroidal anti-inflammatory drugs, such as Advil, Aleve, ibuprofen, naproxen, or Motrin). Viread is safe to take with HCV DAAs, but monitor for side effects if used with Epclusa, Harvoni, or Vosevi.

Viread (and its related drug Vemlidy) are also HIV medications. Before starting Viread, you should be tested for HIV. If you are co-infected with HBV/HIV, you should not treat HBV without also treating your HIV. Another HIV medication—Epivir—also works against both HIV and HBV, and while it is an option for treatment, it’s not preferred compared to several other choices. If you have HBV/HIV, and need to switch from any Viread-containing regimens, there is a risk of HBV flare-up with signs and symptoms of acute HBV infection. For individuals with HBV/HCV co-infection, or those at risk of HBV reactivation while undergoing HCV DAA treatment, Viread is one of the medications you could be prescribed to prevent this from happening. Viread is safe to use in children age 2 and older, weighing at least 22 pounds (10kg) or more. Dose adjustments may be needed, and should be done in consultation with an experienced medical provider. For people with kidney disease, there may also be a need for dose adjustments. See the chart below for recommendations, and make sure you are routinely monitored by your medical provider while taking this treatment:

Dosage interval adjustment for adults with altered creatinine clearance