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Precautions and Warnings With Tenofovir

Precautions and warnings with tenofovir should be reviewed with your healthcare provider before beginning treatment. Tell him or her about any existing medical conditions you have and all the medications you are taking. Other precautions and warnings with tenofovir include the safety of taking the medication if you have liver disease and the risk of lactic acidosis and hepatic steatosis or kidney damage.

Tenofovir: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking tenofovir disoproxil fumarate (Viread®) if you have:
  • Kidney disease, including kidney failure (renal failure)
  • Liver disease, such as liver failure or cirrhosis
  • Osteoporosis or other bone problems
  • Anemia, neutropenia, or any other low blood count or blood disorder
  • Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
You should also be sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Tenofovir

Warnings and precautions to be aware of prior to taking tenofovir include the following:
  • In rare cases, the medication can cause a condition called lactic acidosis and hepatic steatosis. It is caused by damage to the liver and can be very dangerous. You are at higher risk for this side effect if you have liver disease.
  • Stopping tenofovir may make a hepatitis B infection worse. If you have hepatitis B and stop taking tenofovir, you may need to be monitored more closely to make sure that your infection is not getting worse.
  • Tenofovir can change the distribution of fat on your body. You may gain fat in areas that are not typical for you, such as in the abdomen or at the back of the neck (a "buffalo hump"), and may lose weight in other areas.
  • The kidneys help remove tenofovir from the blood, and the medication can damage the kidneys. Let your healthcare provider know if you have any kidney problems, as you may need a lower tenofovir dosage (and you may be at a higher risk for kidney damage as a result).
  • Tenofovir can decrease bone density, which increases the risk of osteoporosis and broken bones. Your healthcare provider should check your bone density while you are taking the medication, especially if you have had a broken bone in the past. Ask your healthcare provider if you should take calcium and vitamin D, as this may help strengthen your bones.
  • Tenofovir is not a cure for hepatitis B, HIV, or AIDS. You should always use safer sex practices, whether or not you are taking medications.
  • As with all HIV medications, it is important that you take tenofovir exactly as prescribed. Missing doses may increase the chance of the virus becoming resistant to HIV medications.


  • When you first start taking this medication and your immune system begins to recover, a group of problems known as immune reconstitution syndrome may occur. Your immune system may start aggressively reacting to any infections you may have and may cause extreme inflammation. There have even been cases of autoimmune disorders (such as Graves' disease, polymyositis, and Guillain-Barré syndrome) possibly caused by this problem. 


  • Tenofovir can interact with a number of different medications (see Drug Interactions With Tenofovir).
  • Tenofovir is considered a pregnancy Category B medication. This means that it is probably safe for use during pregnancy, although the full risks are not known (see Viread and Pregnancy).
  • It is not known if tenofovir passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Viread and Breastfeeding). It is important to understand that the HIV virus can be transmitted through breast milk and that breastfeeding is usually not recommended in women with HIV or AIDS.

Tenofovir HIV Medication

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