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Viread (tenofovir) Disease Interactions

There are 4 disease interactions with Viread (tenofovir):

Major

Nrtis (Includes Viread) ↔ Hepatotoxicity

Severe Potential Hazard, Moderate plausibility

Applies to: Alcoholism, Liver Disease

Hepatotoxicity including lactic acidosis, severe hepatomegaly with steatosis, fulminant hepatitis, and hepatic failure has rarely been associated with the use of nucleoside reverse transcriptase inhibitors (NRTIs) alone or in combination with other antiretroviral agents. Therapy with NRTIs should be administered cautiously in patients with preexisting liver disease, a history of alcohol abuse, or hepatitis. Therapy should be suspended if clinical or laboratory findings suggestive of lactic acidosis or pronouced hepatotoxicity occur.

References

  1. Dolin R, Lambert JS, Morse GD, et al "2',3'-dideoxyinosine in patients with AIDS or AIDS-related complex." Rev Infect Dis 12 (1990): s540-51
  2. Montaner JSG, Rachlis A, Beaulieu R, Gill J, Schlech W, Phillips P, Auclair C, Boulerice F, Schindzielorz A, Smaldone L, Wainber "Safety profile of didanosine among patients with advanced HIV disease who are intolerant to or deteriorate despite zidovudine therapy: results of the canadian open ddi treatment program." J Acquir Immune Defic Syndr 7 (1994): 924-30
  3. "Product Information. Viread (tenofovir)." Gilead Sciences, Foster City, CA.
  4. "Product Information. Retrovir (zidovudine)." Glaxo Wellcome, Research Triangle Park, NC.
  5. Lai KK, Gang DL, Zawacki JK, Cooley TP "Fulminant hepatic failure associated with 2',3'-dideoxyinosine (ddI)." Ann Intern Med 115 (1991): 283-4
  6. Chen SC, Barker SM, Mitchell DH, et al "Concurrent zidovudine-induced myopathy and hepatoxicity in patients treated for human immunodeficiency virus (HIV) infection." Pathology 24 (1992): 109-11
  7. Pike IM, Nicaise C "The didanosine Expanded Access Program: safety analysis." Clin Infect Dis 16 (1993): S63-8
  8. Yarchoan R, Mitsuya H, Pluda JM, et al "The National Cancer Institute phase I study of 2',3'-dideoxyinosine administration in adults with AIDS-related complex: analysis of activity and toxicity profiles." Rev Infect Dis 12 (1990): s522-33
  9. Shriner K, Goetz MB "Severe hepatoxicity in a patient receiving both acetaminophen and zidovudine." Am J Med 93 (1992): 94-6
  10. Gradon JD, Chapnick EK, Sepkowitz DV "Zidovudine-induced hepatitis." J Intern Med 231 (1992): 317-8
  11. Boubaker K, Flepp M, Sudre P, et al. "Hyperlactatemia and Antiretroviral Therapy: The Swiss HIV Cohort Study." Clin Infect Dis 33 (2001): 1931-7
  12. Pai VB, Koranyi K, Nahata MC "Acute hepatitis and bleeding possibly induced by zidovudine and ritonavir in an infant with HIV infection." Pharmacotherapy 20 (2000): 1135-40
  13. Miller KD, Cameron M, Wood LV, Dalakas MC, Kovacs JA "Lactic acidosis and hepatic steatosis associated with use of stavudine: report of four cases." Ann Intern Med 133 (2000): 192-6
  14. Dubin G, Braffman MN "Zidovudine-induced hepatotoxicity." Ann Intern Med 110 (1989): 85-6
  15. "Product Information. HIVID (zalcitabine)." Roche Laboratories, Nutley, NJ.
  16. Shintaku M, Nasu K, Shimizu T "Fulminant hepatic failure in an AIDS patient: possible zidovudine- induced hepatotoxicity." Am J Gastroenterol 88 (1993): 464-6
  17. Coghlan ME, Sommadossi JP, Jhala NC, Many WJ, Saag MS, Johnson VA "Symptomatic lactic acidosis in hospitalized antiretroviral-treated patients with human immunodeficiency virus infection: a report of 12 cases." Clin Infect Dis 33 (2001): 1914-21
  18. "Product Information. Videx (didanosine)." Bristol-Myers Squibb, Princeton, NJ.
  19. Kronenberg A, Riehle HM, Gunthard HF "Liver failure after long-term nucleoside antiretroviral therapy." Lancet 358 (2001): 759-601
  20. Lonergan JT, Behling C, Pfander H, Hassanein TI, Mathews WC "Hyperlactatemia and hepatic abnormalities in 10 human immunodeficiency virus-infected patients receiving nucleoside analogue combination regimens." Clin Infect Dis 31 (2000): 162-6
  21. "Product Information. Ziagen (abacavir)." Glaxo Wellcome, Research Triangle Pk, NC.
  22. Lhouri S, Cushing H "Lactic acidosis secondary to nucleoside analog antiretroviral therapy." Infect Med 17 (2000): 547-54
View all 22 references
Major

Tenofovir (Includes Viread) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Tenofovir is primarily eliminated by the kidney via glomerular filtration and active tubular secretion. Renal impairment, including acute renal failure and Fanconi syndrome, has been reported with tenofovir use. Close monitoring of renal function and lengthening the dosing interval are recommended for patients with creatinine clearance less than 50 mL/min. Creatinine clearance should be calculated in all patients before starting tenofovir treatment and during treatment when clinically appropriate. Routine monitoring of serum creatinine and phosphorus is recommended for patients at risk of or with a history of renal dysfunction. Safety and effectiveness have not been evaluated in patients with renal insufficiency using dose adjustments; therefore, the benefit of tenofovir treatment should be weighed against the risk of renal toxicity. Tenofovir should be avoided in patients who are currently using or have recently used nephrotoxic drugs.

References

  1. "Product Information. Viread (tenofovir)." Gilead Sciences, Foster City, CA.
Moderate

Tenofovir (Includes Viread) ↔ Bone Toxicity

Moderate Potential Hazard, Moderate plausibility

Applies to: Osteoporosis, Vitamin D Deficiency

Osteomalacia and reduced bone mineral density have been reported in animal toxicology studies involving tenofovir exposures 6- to 12-fold those observed in humans. The mechanism of bone toxicity has not been established, and it is not known if long-term use of tenofovir disoproxil fumarate will cause bone abnormalities in humans.

References

  1. "Product Information. Viread (tenofovir)." Gilead Sciences, Foster City, CA.
Moderate

Tenofovir (Includes Viread) ↔ Liver Disease

Minor Potential Hazard, Low plausibility

Applies to: Liver Disease

There are no data concerning the use of tenofovir disoproxil fumarate in patients with hepatic impairment. Tenofovir and tenofovir disoproxil are not metabolized by liver enzymes. However, since tenofovir is not entirely eliminated by the kidney (70% to 80%), tenofovir pharmacokinetics may be altered in patients with impaired hepatic function.

References

  1. "Product Information. Viread (tenofovir)." Gilead Sciences, Foster City, CA.

Viread (tenofovir) drug Interactions

There are 232 drug interactions with Viread (tenofovir)

Viread (tenofovir) alcohol/food Interactions

There is 1 alcohol/food interaction with Viread (tenofovir)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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