Sunday, September 2, 2012

All About Tenofovir


A lot of PLHIV’s when I say that I am taking tenofovir, would comment that I should take a lot of water everyday when taking it to minimize its side effects. My doctor never told me anything about it before so I made my research instead.




Tenofovir disoproxil fumarate  belongs to a class of antiretroviral drugs known as reverse transcriptase inhibitors (NRTI) which block reverse transcriptase, an enzyme crucial to viral production. It is indicated in combination with other antiretroviral agents for the treatment of HIV infection in adults and pediatric patients 2 years of age and older. Tenofovir is not a cure and may not decrease the number of HIV-related illnesses. Tenofovir does not prevent the spread of HIV to other people.

HOW TO USE IT

Tenofovir comes as a tablet to take by mouth. It is usually taken once a day with a meal. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take tenofovir exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Continue to take tenofovir even if you feel well. Do not stop taking tenofovir without talking to your doctor.

PRECAUTIONS

Before taking tenofovir,
  • tell your doctor and pharmacist if you are allergic to tenofovir or any other medications.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: antiviral medications such as acyclovir (Zovirax), cidofovir (Vistide), ganciclovir (Cytovene, Vitasert), valacyclovir (Valtrex), and valganciclovir (Valcyte); aspirin and other nonsteroidal antiinflammatory medications (NSAIDs) such as indomethacin (Indocin); didanosine (Videx); diuretics ('water pills'); penicillin (Pen Vee K, Veetids, others); and probenecid (Benemid). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • if you are taking didanosine (Videx), take it 1 hour before or 2 hours after tenofovir.
  • in addition to the condition listed in the IMPORTANT WARNING section, tell your doctor if you have or have ever had kidney disease.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking tenofovir, call your doctor. You should not breastfeed while taking tenofovir.
  • you should be aware that your body fat may increase or move to different areas of your body, such as your breasts and your upper back.

ANY SPECIAL DIETARY PRECAUTIONS TO FOLLOW?

Unless your doctor tells you otherwise, continue your normal diet.

SIDE EFFECTS

  • upset stomach
  • diarrhea
  • vomiting
  • gas
  • loss of appetite
  • headache
  • trouble sleeping
Some people may experience worsening of a previous medical condition (such as an old infection) as their immune systems improve, or develop new conditions because their immune systems have become overactive. This reaction may occur at any time (soon after starting HIV treatment or many months later). Tell your doctor right away if you have any serious side effects, including
  1. unexplained weight loss
  2. persistent muscle aches/weakness
  3. joint pain
  4. numbness/tingling of the hands/feet/arms/legs
  5. severe tiredness
  6. vision changes
  7. severe/persistent headaches
  8. signs of infection (such as fever, chills, trouble breathing, cough, non-healing skin sores)
  9. signs of an overactive thyroid (such as irritability, nervousness, heat intolerance, fast/pounding/irregular heartbeat
  10. bulging eyes
  11. unusual growth in the neck/thyroid known as a goiter)
  12. signs of a certain nerve problem known as Guillain-Barre Syndrome (such as difficulty breathing/swallowing/moving your eyes, drooping face, paralysis, slurred speech).
Tell your doctor immediately if any of these unlikely but serious side effects occur: mental/mood changes (such as depression, anxiety, confusion).

Tell your doctor immediately if any of these rare but serious side effects occur: 
1. signs of kidney problems (such as a change in the amount of urine)
2. unusual thirst
3. bone pain
4. easily broken bones. 

Tenofovir can cause acute renal failure, Fanconi syndrome, proteinuria or tubular necrosis. These side effects are due to the accumulation of the drug in proximal tubules. 

Changes in body fat may occur while you are taking this medication (such as increased fat in the upper back and stomach areas, decreased fat in the arms and legs). The cause and long-term effects of these changes are unknown. Discuss the risks and benefits of treatment with your doctor, as well as the possible use of exercise to reduce this side effect.

Tenofovir can commonly cause a rash that is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of a severe reaction. Therefore, seek immediate medical attention if you develop any rash.

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

DRUG INTERACTIONS

The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.

To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor's approval.

Some products that may interact with this drug include: other drugs besides tenofovir that may affect the kidneys (including acyclovir, adefovir, cidofovir, ganciclovir, NSAIDs such as ibuprofen/naproxen).
Do not take this medication with other products that contain tenofovir.

Some other drugs to treat HIV infection (including atazanavir, didanosine) may also interact with tenofovir. Tenofovir can decrease the effectiveness of atazanavir (by decreasing blood levels). If you are taking atazanavir with this product, you may need to also take another medication (ritonavir). Consult your doctor or pharmacist for more details. Your doctor will adjust your medications and monitor your treatment to reduce the risk of side effects.

IMPORTANT WARNING:

Tenofovir can cause serious side effects, including:

1. Build-up of an acid in your blood (lactic acidosis): 

Lactic acidosis can happen in some people who take tenofovir or similar (nucleoside analog) medicines. Lactic acidosis is a serious medical emergency that can lead to death. Lactic acidosis can be hard to identify early, because the symptoms could seem like symptoms of other health problems.

**Call your healthcare provider right away if you get the following  symptoms which could be signs of lactic acidosis: feeling very weak or tired, have unusual muscle pain, have trouble breathing, have stomach pain with nausea/vomiting, feel cold, especially in your arms and legs, feel dizzy or lightheaded, have a fast or irregular heartbeat.

2. Severe liver problems: 

Severe liver problems can happen in people who take tenofovir or similar medicines. In some cases these liver problems can lead to death. Your liver may become large (hepatomegaly) and you may develop fat in your liver (steatosis) when you take tenofovir. 

**Call your healthcare provider right away if you have any of the following symptoms of liver problems: Your skin or the white part of your eyes turn yellow (jaundice), dark “tea-colored” urine, light-colored bowel movements, loss of appetite for several days or longer, nausea, stomach pain.

You may be more likely to get lactic acidosis or severe liver problems if you are female, very overweight (obese), or have been taking tenofovir or a similar medicine for a long time

3. Worsening of your Hepatitis B infection: 

Your hepatitis B virus (HBV) infection may become worse (flare up) if you take VIREAD and then stop it. A “flare-up” is when your HBV infection suddenly returns in a worse way then before. Do not let your tenofovir run out. Do not stop taking tenofovir without first talking to your healthcare provider. If you stop taking tenofovir, your healthcare provider will need to check your health often and do regular blood tests to check your HBV infection. 

ALWAYS consult your doctor when you feel something while taking tenofovir. It is best to us to be always be vigilant about our health.




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