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What is the difference between Vemlidy and Viread?

Medically reviewed by N. France, BPharm. Last updated on April 12, 2021.

Official Answer

by Drugs.com

Vemlidy (tenofovir alafenamide) and Viread (Tenofovir disproxil fumarate) are antiviral medications marketed by Gilead Sciences.

Vemlidy and Viread are both prodrugs of tenofovir, which means that after they are taken they are converted into the active drug tenofovir in the body. But there are some differences between the two drugs in the following areas outlined in the table below.

Vemlidy Viread
Active ingredient Tenofovir alafenamide fumarate Tenofovir disproxil fumarate
Generic versions available No Yes
Used to treat Chronic hepatitis B virus (HBV) infection in adults with compensated liver disease Chronic HBV in adults and pediatric patients 2 years and older weighing at least 10kg

+

HIV-1 infection in adults and pediatric patients 2 years and older weighing at least 10kg
FDA Approved in 2015 2001
Dosage form Tablet - 25mg Tablet - 150, 200, 250 and 300mg

Oral powder - 40mg per 1g

Dosing schedule One 25mg tablet taken once daily with food

Renal impairment: Vemlidy is not recommended for use in people with estimated creatinine clearance (CrCL) below 15ml per minute who are not receiving chronic hemodialysis. Vemlidy is administered after hemodialysis
Patients weighing at least 35kg: One 300mg tablet taken once daily with or without food

Patients weighing at least 17kg: One 150, 200, 250 or 300mg tablet - based on bodyweight - taken once daily with or without food

Patients weighing at least 10kg: 8mg/kg oral powder (up to a maximum of 300mg) taken once daily with food

Renal impairment:
  • CrCl 30-49 ml/min: 300mg every 48 hours
  • CrCl 10-29 ml/min: 300mg every 72-96 hours
  • Hemodialysis: 300mg every 7 days or after about 12 hours of dialysis
Mechanism of action / How it works HBV nucleoside analog reverse transcriptase inhibitor HBV reverse transcriptase inhibitor

+

A nucleotide analog HIV-1 reverse transcriptase inhibitor
Side effects / adverse events The most common (≥ 10%, all grades) adverse reaction is headaches The most common (≥ 10%, grades 2-4) adverse reactions in adults with HIV-1 infection are headaches, rash, diarrhea, nausea, pain, depression and asthenia

The most common (9%, all grades) adverse reaction in adults with HBV infection and compensated liver disease is nausea

The most common (≥ 10%, all grades) adverse reactions in adults with HBV infection and decompensated liver disease are abdominal pain, nausea, insomnia, pruritus, vomiting, dizziness and pyrexia
Efficacy Vemlidy and Viread are similar in terms of their effectiveness, however, Vemlidy achieves similar results to Viread at a dose less than one-tenth that of Viread

Vemlidy has greater plasma stability, enabling it to deliver tenofovir to hepatocytes more efficiently
Warnings and precautions Vemlidy is effective at a lower dose than Viread, resulting in less tenofovir in the bloodstream and improved renal and bone laboratory safety parameters compared with Viread Immune reconstitution syndrome, and bone loss and mineralization defects have been observed in patients with HIV-1 infection
Drug interactions Known or potentially significant* drug interactions include:
  • Anticonvulsants including carbamazepine, oxcarbazepine, phenobarbital, phenytoin
  • Antimycobacterials including rifabutin, rifampin and rifapentine
  • St. John’s wort
  • Ethinyl estradiol
  • Ledipasvir/sofosbuvir
  • Midazolam
  • Norgestimate
  • Sertraline
  • Sofosbuvir
  • Sofosbuvir/velpatasvir
  • Sofosbuvir/velpatasvir/voxilaprevir
  • Drugs that inhibit P-glycoprotein and BCRP (breast cancer resistance protein) may increase the absorption and plasma concentration of Vemlidy

*List not all inclusive. Both Vemlidy and Viread are primarily removed by the kidneys and the elimination of these drugs may also be affected by taking other drugs that reduce renal function or are eliminated in the same way

Known or potentially significant* drug interactions include:
  • Didanosine
  • HIV-1 protease inhibitors including atazanavir, lopinavir/ritonavir, atazanavir/ritonavir, darunavir/ritonavir
  • Hepatitis C antiviral agents including sofosbuvir/velpatasvir, sofosbuvir/velpatasvir/voxilaprevir, ledipasvir/sofosbuvir

*Both Vemlidy and Viread are primarily removed by the kidneys and the elimination of these drugs may also be affected by taking other drugs that reduce renal function or are eliminated in the same way

Special patient populations Liver impairment: Vemlidy is not recommended in people with decompensated (Child-Pugh B or C) hepatic impairment
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