What is the difference between Vemlidy and Viread?
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 and pediatric patients 12 years of age and older 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:
|
| 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:
*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:
*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 |
References
- Food and Drug Administration (FDA). Vemilidy. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/208464s014lbl.pdf. [Accessed November 7, 2022]
- Food and Drug Administration (FDA). Viread. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/021356s058,022577s014lbl.pdf. [Accessed April 9, 2021].
- Gilead. U.S. Food and Drug Administration Approves Gilead’s Vemlidy® (Tenofovir Alafenamide) for the Treatment of Chronic Hepatitis B Virus Infection. November 10, 2016. Available from: https://www.gilead.com/news-and-press/press-room/press-releases/2016/11/us-food-and-drug-administration-approves-gileads-vemlidy-tenofovir-alafenamide-for-the-treatment-of-chronic-hepatitis-b-virus-infection. [Accessed April 9, 2021].
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