Vemlidy
Vemlidy (tenofovir alafenamide), also known as TAF, is a first-choice medication for treating hepatitis B virus (HBV) for adults and children ages 6 years and older weighing at least 55 lbs. Tenofovir alafenamide is also found in combination with other antiretrovirals in medications such as Biktarvy to treat human immunodeficiency virus (HIV). Vemlidy (tenofovir alafenamide) is taken by mouth, typically once daily. Some of the more common side effects of Vemlidy (tenofovir alafenamide) include headache, stomach pain, and cough.
What is Vemlidy (tenofovir alafenamide)?
What is Vemlidy (tenofovir alafenamide) used for?
Hepatitis B virus (HBV) in people ages 6 years and older weighing at least 55 lbs
How Vemlidy (tenofovir alafenamide) works
Vemlidy (tenofovir alafenamide) is a nucleoside reverse transcriptase inhibitor (NRTI). It works by inserting itself into HBV's genetic material. In doing so, it blocks the virus from making copies of itself. Vemlidy (tenofovir alafenamide) is designed to work at your liver, where the hepatitis B virus is spreading.
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What are the side effects of Vemlidy (tenofovir alafenamide)?
Common Side Effects
- Headache (12%)
- Stomach pain (9%)
- Cough (8%)
- Back pain (6%)
- Tiredness (6%)
- Nausea (6%)
Other Side Effects
- Joint pain
- Diarrhea
- Upset stomach
- Vomiting
- Rash
- Passing gas
Serious Side Effects
- Build up of lactic acid in the blood: feeling more tired and weak, stomach pain, muscle pain, breathing problems
- Inflammation of the pancreas: fever, nausea, vomiting, fast heartbeat, severe stomach pain that won't go away, low back pain
- Serious kidney problems: tiredness, confusion, nausea, urinating less than usual, swelling in your legs, ankles, or feet
- Serious liver problems: feeling confused, sleepiness, nausea, stomach pain, swollen belly, not feeling hungry, dark-colored urine, yellowing of the skin or whites of your eyes
Source: DailyMed
More on Vemlidy (tenofovir alafenamide) side effects
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- High lactic acid level—muscle pain or cramps, stomach pain, trouble breathing, general discomfort and fatigue
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Pros and cons of Vemlidy (tenofovir alafenamide)
Pros
A first-choice medication to treat hepatitis B
Only taken once a day
Not as harmful to your kidneys and bones compared to Viread (tenofovir disoproxil fumarate)
Can be taken by most people with kidney problems
Cons
Can't take Vemlidy (tenofovir alafenamide) alone if you're co-infected with both HIV and hepatitis B
Currently only available as brand-name medication
Must be taken with food
Can cause worsening of hepatitis B if stopped all of a sudden
Pharmacist tips for Vemlidy (tenofovir alafenamide)
You should take Vemlidy (tenofovir alafenamide) at the same time every day with food. Taking this medication without food can make this medication work less well for you because your body won't absorb enough medication.
There's a possibility that taking Vemlidy (tenofovir alafenamide) can put you at risk for kidney problems. While you're taking this medication, it's best to avoid taking nonsteroidal anti-inflammatory drug (NSAID), like ibuprofen (Advil) and naproxen (Aleve). Taking these medications with Vemlidy (tenofovir alafenamide) can raise your risk of kidney damage. Ask your provider what pain medication is best for you while you're taking Vemlidy (tenofovir alafenamide).
Vemlidy (tenofovir alafenamide) might weaken your bones. Ask your provider whether you need to take a calcium and vitamin D supplements and other ways to prevent bone problems.
Limited research shows that Vemlidy (tenofovir alafenamide) isn't likely to cause harm when taken by mothers during pregnancy. If you're pregnant or thinking about becoming pregnant, talk with your provider about the benefits and risks of taking Vemlidy (tenofovir alafenamide) during pregnancy. If you decide to take this medication, your provider can help you enroll in the pregnancy registry that monitors how you and your unborn baby are doing after taking Vemlidy (tenofovir alafenamide) during pregnancy.
There are some medications, such as certain seizure medications or antibiotics, that will lower the amount of Vemlidy (tenofovir alafenamide) in your body. Taking these medications together raises your risk for worsening HBV infection. Before starting any new medications, let your provider know you're taking Vemlidy (tenofovir alafenamide). Your provider might need to change your treatment plan depending on whether there are medication interactions with Vemlidy (tenofovir alafenamide).
Frequently asked questions about Vemlidy (tenofovir alafenamide)
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What are the risks and warnings for Vemlidy (tenofovir alafenamide)?
Vemlidy (tenofovir alafenamide) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Worsening of hepatitis B
Risk factors: Stopping Vemlidy (tenofovir alafenamide)
Don't stop taking Vemlidy (tenofovir alafenamide) without talking with your provider first. If you stop taking this medication suddenly, your hepatitis B infection can come back and become more difficult to treat. If your provider tells you to stop Vemlidy (tenofovir alafenamide) and switch to another ARV medication, they'll order blood work for you regularly to check your liver health. This is how your provider will monitor your liver and infection.
Hepatitis B and HIV coinfection
Risk factors: HIV infection
Vemlidy (tenofovir alafenamide) is only FDA-approved to treat HBV. While tenofovir alafenamide is an ingredient in combination medications to treat HIV, Vemlidy (tenofovir alafenamide) alone can't treat HIV. If you test positive for HIV, let your provider know right away. They'll need to change your treatment regimen and prescribe a medication that can treat both viruses. Taking Vemlidy (tenofovir alafenamide) alone for HIV can cause the virus to become resistant and more difficult to treat.
Kidney problems
Risk factors: History of kidney problems | Taking other medications known to harm kidneys
Some people taking Vemlidy (tenofovir alafenamide) have developed kidney problems. Sometimes it happens right after starting the medication. For others, the damage happens over time. It's unclear whether the kidney problems are caused by Vemlidy (tenofovir alafenamide) or other factors. To be safe, you're recommended to avoid taking other medications that can also harm the kidneys, like high doses of anti-inflammatory drugs called NSAIDs. Your provider might order blood work or urine tests regularly to check on your kidneys.
Liver problems
Risk factors: History of liver problems
Although rare, NRTIs like Vemlidy (tenofovir alafenamide) can cause a life-threatening liver problem called lactic acidosis with hepatic steatosis (fatty liver disease). Symptoms can include appetite loss, stomach pain, muscle pain, fast and shallow breathing, extreme tiredness, and sudden weakness. Stop taking Vemlidy (tenofovir alafenamide) and get medical help right away if this happens.
Vemlidy (tenofovir alafenamide) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 25mg | 30 tablets | $1476.12 | $49.20 |
Typical dosing for Vemlidy (tenofovir alafenamide)
The typical dose is 25 mg by mouth once daily with food.
How much does Vemlidy (tenofovir alafenamide) cost?
Vemlidy (tenofovir alafenamide) contraindications
Using Vemlidy (tenofovir alafenamide) alone (without other antivirals) for the treatment of HIV
What are alternatives to Vemlidy (tenofovir alafenamide)?
Hepatitis B virus (HBV) in people ages 6 years and older weighing at least 55 lbs
Treatment of HIV infection for people ages 3 months and older - brand and generic Epivir only
Treatment of chronic (long-term) hepatitis B for people ages 2 years and older - brand and generic Epivir HBV only
What is the latest news about Vemlidy (tenofovir alafenamide)?
Vemlidy (tenofovir alafenamide) images
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References
Best studies we foundCenters for Disease Control and Prevention. (n.d.). Viral hepatitis– Frequently asked questions for the public.
Centers for Disease Control and Prevention. (2022). Kidney testing: Everything you need to know.
Clinical Info HIV.gov. (n.d.). Guidelines for the use of antiretroviral agents in adults and adolescents with HIV.
Clinical Info HIV.gov. (n.d.). Nucleoside reverse transcriptase inhibitor (NRTI).
Clinical Info HIV.gov. (2021). HIV treatment– Drug resistance.
Gilead. (2016). U.S. Food and Drug Administration approves Gilead’s Vemlidy® (tenofovir alafenamide) for the treatment of chronic hepatitis B virus infection.
Gilead. (2022). U.S. Food and Drug Administration approves Vemlidy® (tenofovir alafenamide) for treatment of chronic hepatitis B virus infection in pediatric patients.
Gilead. (2024). FDA expands indication for Gilead's Vemlidy (tenofovir alafenamide) to treat chronic HBV infection in pediatric patients as young as six.
Gilead Sciences, Inc. (2024). VEMLIDY- tenofovir alafenamide tablet [package insert]. DailyMed.
GSK plc. (n.d.). GSK pregnancy registries.
National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Tenofovir. LiverTox.
Terrault, N. A., et al. (2018). Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology.
Vemlidy. (n.d.). VEMLIDY: An improved bone safety profile.
Vemlidy. (n.d.). What is VEMLIDY?
Wassner, C., et al. (2020). A review and clinical understanding of tenofovir: Tenofovir disoproxil fumarate versus tenofovir alafenamide. Journal of the International Association of Providers of AIDS Care.
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