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Tenofovir alafenamide oral

Updated 2 Feb 2023 | Hepatitis B


Tablets containing tenofovir alafenamide.

Drugs List

  • tenofovir alafenamide 25mg tablets
  • VEMLIDY 25mg tablets
  • Therapeutic Indications


    Chronic hepatitis B



    25mg once daily.


    Children aged 12 years and older with a body weight of at least 35kg
    25mg once daily.

    Additional Dosage Information

    In HBeAg positive patients without cirrhosis, treatment should be administered for at least 6 to 12 months after confirmed HBe seroconversion, or until a loss of efficacy, or until HBS seroconversion.

    In HBeAg negative patients without cirrhosis, treatment should be administered for at least until HBs seroconversion or loss of efficacy. Treatment duration past 2 years requires regular assessment for appropriateness of treatment.

    Haemodialysis patients should take tablet after haemodialysis session.


    Children under 12 years
    Weight below 35kg

    Precautions and Warnings

    Decompensated liver disease
    Glucose-galactose malabsorption syndrome
    Hepatic cirrhosis
    Lactose intolerance
    Renal impairment - creatinine clearance below 30 ml/minute
    Severe hepatic impairment - Child-Pugh score greater than or equal to 10

    Cirrhosis: Monitor for signs and symptoms of hepatic decompensation
    Haemodialysis patients: administer drug after dialysis
    Not recommended in pts with CrCl <15mL/min not receiving haemodialysis
    Therapy cessation not recommended in decompensated liver disease/cirrhosis
    Treatment does not prevent risk of transmission of Hepatitis B
    If unknown HIV status,antibody testing should be offered prior to treatment
    Treatment to be initiated by specialist
    Contains lactose
    Monitor renal function before treatment and regularly during treatment
    Evaluate renal function if signs of proximal renal tubulopathy occur
    Hepatitis B:Monitor liver function for at least 6months after discontinuing
    Monitor closely patient with Child-Pugh C hepatic impairment
    On discontinuation, may cause recurrence of hepatitis B
    Prolonged use may lead to nephrotoxicity
    Raised ALTs may be due to HBV clearance
    Discontinue if renal function deteriorates
    Advise patient not to take St John's wort concurrently

    Pregnancy and Lactation


    Use tenofovir alafenamide with caution in pregnancy.

    The manufacturer recommends that the use of tenofovir alafenamide may be consider during pregnancy, if necessary. At the time of writing there is limited published information regarding the use of tenofovir alafenamide during pregnancy. Studies using tenofovir disoproxil fumarate, indicate no neonatal toxicity or malformations when used in pregnant women. Animal studies do not indicate any reproductive toxicity effects.


    Tenofovir alafenamide is contraindicated in breastfeeding.

    The manufacturer does not recommend the use of tenofovir alafenamide during breastfeeding. At the time of writing there is limited published information regarding the use of tenofovir alafenamide during breastfeeding, the risk to the infant cannot be excluded. It is unknown if tenofovir alafenamide is secreted into human breast milk. Animal studies show that tenofovir is secreted into milk.


    If dose is missed by less than 18 hours, patient should take missed dose as soon as possible and resume normal dosing schedule afterwards.

    If dose is missed by more than 18 hours, patient should not take missed dose and resume normal dosing schedule.

    If patient vomits within 1 hour of taking tablet, patient should take another tablet.

    Tablets to be swallowed whole with food.

    Advise patient not to take St John's Wort concurrently.

    Side Effects

    Abdominal distension
    Abdominal pain
    Increase in ALT level


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: August 2019.

    Reference Sources

    Summary of Product Characteristics: Vemlidy 25mg film coated tablets. Gilead Sciences Limited. Revised January 2021.
    Summary of Product Characteristics: Vemlidy 25mg film coated tablets (Northern Ireland). Gilead Sciences Limited. Revised September 2020.

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
    Available at:
    Tenofovir Last revised: 07 February 2019
    Last accessed: 07 August 2019.

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    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

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    FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.