Viread vs. Zerit for HIV Treatment: Important Differences and Potential Risks.

Key takeaways

Tenofovir disoproxil fumarate (Viread) and stavudine (Zerit) are both antiretroviral (ARV) medications used to treat HIV in combination with other antiretrovirals. They belong to the same subclass called nucleoside reverse transcriptase inhibitors (NRTIs). However, tenofovir disoproxil fumarate (Viread) is also FDA-approved for treating chronic hepatitis B, while stavudine (Zerit) is not. Tenofovir disoproxil fumarate (Viread) is available as an oral tablet and powder, whereas stavudine (Zerit) is no longer available in the U.S. due to its serious side effects and lack of demand. Common side effects of tenofovir disoproxil fumarate (Viread) include rash, diarrhea, and headache, while stavudine (Zerit) was known for causing severe side effects, which contributed to its discontinuation. Tenofovir disoproxil fumarate (Viread) can interact with certain medications for hepatitis C and HIV, so it's important to discuss all your medications with your provider.

Tenofovir disoproxil fumarate

(Viread)

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Stavudine

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Summary for Viread

Prescription only

Tenofovir disoproxil fumarate (Viread), also known as TDF, is a first-choice medication that's used as part of an antiretroviral (ARV) regimen for treating human immunodeficiency virus (HIV) infections. It's also a preferred medication used for treating hepatitis B virus (HBV). Tenofovir disoproxil fumarate, the active ingredient in Viread, is also found in Truvada, a combination medication commonly used for HIV PrEP. Tenofovir disoproxil fumarate (Viread) is available as both an oral tablet and a powder that's mixed with soft food. Common side effects include rash, diarrhea, and headache.

Indications for Viread

Treatment of HIV infection - people ages 2 years and older
Treatment of chronic (long-term) hepatitis B - Brand Viread for people ages 2 years and older; generic for people ages 12 years and older

Pros and Cons for Viread

Pros

Can treat both HIV and HBV infections
Only taken once a day
Available in a powder form that can be mixed with soft foods for people who have difficulty swallowing pills
Tablet form is available as a lower-cost generic medication

Cons

Requires regular blood work and lab tests to make sure your liver and kidneys are healthy
Can worsen hepatitis B if stopped all of a sudden
More likely to cause bone problems compared to similar medications
Interacts with certain medications for hepatitis C and HIV, such as atazanavir (Reyataz) and Harvoni (ledipasvir / sofosbuvir)

Common Side Effects for Viread

Higher cholesterol levels (19-22%)
Rash (5-18%)
Diarrhea (9-16%)
Headache (5-14%)
Pain (3-13%)
Higher creatine kinase (CK) levels, suggesting muscle damage (9-12%)
Feeling depressed (4-11%)
Nausea (8-11%)
Lack of energy (6-11%)

Please note: The side effects above were reported by people taking this medication for HIV infection.

Warnings for Viread

Worsening of hepatitis B infection
Kidney problems
Overactive immune system
Bone problems
Liver problems and lactic acidosis
Interaction with other medications

Summary for Zerit

Discontinued

Stavudine was one of the first HIV antiretroviral (ARV) medications approved by the FDA. It has a lot of serious side effects that have limited its use in recent years and is no longer available in the U.S.