VIREAD

Viread is a brand name for a generic antiviral medication: Tenofovir Disoproxil Fumarate. It is a prescription drug that got FDA approval in 2001 for the treatment of HIV/ AIDS and chronic Hepatitis B infection in adults and pediatric patients aged 2 years and above who weigh at least 22 pounds (10kg). The approval for the manufacture and trade of this medication was given to a company named Gilead Sciences Inc.

Viread contains Tenofovir Disoproxil Fumarate as its active ingredient. Tenofovir Disoproxil Fumarate is a white to off-white, crystalline, fumaric acid salt of bis-isopropoxycarbonyloxymethyl- an ester derivative of tenofovir. Its chemical name is 9-[(R) 2[[bis[[(isopropoxy carbonyl)oxy]methoxy]phosphinyl]methoxy]propyl] adenine fumarate (1:1). When Viread enters the system, tenofovir disoproxil fumarate gets converted into tenofovir- a nucleotide analog of adenosine 5’-monophosphate and acts against HIV-1 reverse transcriptase.

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Viread belongs to the pharmacological class: NRTIs (Nucleoside Reverse Transcriptase Inhibitors). NRTIs inhibit the activity of reverse transcriptase enzymes present in retroviruses like HIV (Human Immunodeficiency Virus) and Hepatitis B. With the help of reverse transcriptase, the retrovirus is known to replicate and cause infection. Reverse transcription is the process where the RNA of the virus gets converted into DNA. This occurs after the entry of the virus into the CD4 cells or T cells of the immune system.

NRTIs are generally activated by the phosphorylation process with the help of cellular enzymes- viral reverse transcriptase. In triphosphate form, the NRTIs compete with existing cellular triphosphates, which are the substrates for proviral DNA.

Viread tablets comes in four strengths:

• 150mg of tenofovir disoproxil fumarate (equivalent to 123 mg tenofovir disoproxil)
• 200mg of tenofovir disoproxil fumarate (equivalent to 163 mg tenofovir disoproxil)
• 250mg of tenofovir disoproxil fumarate (equivalent to 204 mg tenofovir disoproxil)
• 300mg of tenofovir disoproxil fumarate (equivalent to 245 mg tenofovir disoproxil)

Viread oral powder is available in single strength- 40mg of tenofovir disoproxil fumarate per gram of oral powder. This is equivalent to 33mg of tenofovir disoproxil.

Viread can treat the following medical conditions:

• HIV-1 infection (AIDS): Human Immunodeficiency Virus Type 1 is a retrovirus having an RNA genome and a reverse transcriptase enzyme to multiply itself and cause AIDS- Acquired Immunodeficiency Syndrome. HIV-1 infection occurs when the white blood cell (CD4) count drops to 200-500. AIDS is the end stage of HIV infection where the CD4 count lowers to less than 200 and thus the immune system is no longer competent in fighting any infection or disease.
• Chronic HBV infection (Hepatitis B): Hepatitis B virus is a retrovirus known to cause Hepatitis B infection that results in liver inflammation. The symptoms of Hepatitis B include nausea, fatigue, jaundice, dark urine, vomiting, and light stools. HBV infection becomes chronic when these symptoms show up for 6 months or longer. This viral infection is avoidable with the HBV vaccine.

The prescribed dose of Viread drug:

• Suggested Viread tablet dosage in adults and children weighing at least 35 kg: One 300 mg tablet.
• Suggested Viread tablet dosage for patients who can swallow whole tablets and weigh at least 17 kg: One tablet of prescribed strength, based on their body weight.
• Suggested Viread oral powder dosage for patients who cannot swallow whole tablets and weigh at least 10 kg: 8mg per gram of Viread oral powder, up to a maximum of 300mg.
• Suggested Viread dosage for renal-impaired adult patients: 300mg at different timings: Every 48 hours (if creatinine clearance is 30-49mL/min); Every 72-96 hours (if Creatinine clearance is 10-29mL/min); and Every week (after approximately 12 hours of hemodialysis).

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Viread is available in two forms of oral administration:

• Viread tablets come in a solid form and are designed to be swallowed with water. Each tablet contains the active ingredient tenofovir disoproxil fumarate along with inactive ingredients such as magnesium stearate, pregelatinized starch, croscarmellose sodium, microcrystalline cellulose, and lactose monohydrate. These tablets are formulated to provide a controlled release of the medication within the body, ensuring consistent and effective dosing.
• Viread powder offers an alternative option for administration. The powder is typically mixed with a suitable liquid to create a suspension before consumption. Each packet of Viread powder contains the active ingredient tenofovir disoproxil fumarate, along with inactive ingredients such as mannitol, silicon dioxide, ethylcellulose, and hydroxypropyl cellulose. This form of Viread provides convenience for those who may have difficulty swallowing tablets or prefer a different method of administration.

Both the tablets and the powder form of Viread contain the same active ingredient, tenofovir disoproxil fumarate, which is crucial for the treatment of HIV infection and chronic hepatitis B. The choice between tablet and powder forms can be discussed with a healthcare professional based on individual preferences and needs.

Common side effects include:

• Nausea
• Diarrhea
• Depression
• Headache
• Pain
• Weakness
• Rash

Patients with chronic Hepatitis B, usually report the following side effects of taking Viread:

• Fever
• Vomiting
• Dizziness
• Aching stomach
• Sleeping problems
• Itching

Some of the rare side effects are:

• Immune Reconstitution Syndrome
• New kidney problems or worsening of existing kidney problems including kidney failure
• Bone softening, thinning or pain
• Allergic reactions
• Signs of new infections
• Lactic acidosis- too much lactic acid production in the blood
• Severe liver problems.

Some drugs known to cause interactions with Viread include:

• Lithium-based drugs.
• Other HIV or AIDS medications.
• Antiviral drugs
• Drugs to treat ulcerative Colitis.
• Type IV antibiotics.
• Pain relievers or arthritis medications.
• Methotrexate
• Injectable medications to treat bone problems like Paget's disease or osteoporosis.

Viread tablets or oral powder is not safe for use by:

• People who are known to be hypersensitive to any of the ingredients of Viread medication or have any other allergies.
• Infants
• Lactating mothers
• Patients suffering from liver or kidney disease.
• HIV patients taking Viread for treatment of Hepatitis B.
• Individuals having a low mineral density.

• If a Hepatitis B patient goes for HIV antibody testing before starting therapy with Viread.
• If pregnant or lactating, inform the doctor before initiating treatment with Viread.
• Avoid changing the prescribed dose or stopping it without telling or asking the doctor.
• Do not miss a dose or overdose.
• Avoid foods/drug/disease interactions with Viread by sharing information about your current intake of drugs, illnesses (if any), and diet plan with your doctor.

• Store Viread tablets or powder at controlled room temperature, preferably at 25℃, not out of the range of 15-30℃.
• Keep the medication tightly closed in its original packaging protected from heat and moisture and out of reach of small children.

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