An antiretroviral (HIV) medicine

Tenofovir

An antiretroviral that helps control HIV and hepatitis B, and is a core part of HIV pre-exposure prophylaxis (PrEP).

What is Tenofovir?

Tenofovir is an antiretroviral medicine (a reverse transcriptase inhibitor) used as part of combination treatment for HIV, and also for chronic hepatitis B and HIV PrEP. It does not cure HIV but, taken every day exactly as prescribed, it keeps the virus under control. It works best as one ingredient in a multi-medicine HIV regimen.

Education and reference only. This is a plain-language guide to Tenofovir — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.

Written by Meds Global Health Clinical Team · Clinically reviewed by Dr Muhammad Suffyan, MB BS, Founder & Clinical Director · Last reviewed · How we review
Class: Antiretrovirals (HIV) → Brands: Viread
Tenofovir (Antiretrovirals (HIV)) — Meds Global Health reference card with 2D molecular structure
Tenofovir — Antiretrovirals (HIV). The image shows the active ingredient's 2D molecular structure.

What it is

Tenofovir is a nucleotide reverse transcriptase inhibitor used to treat HIV and chronic hepatitis B. In the UK it is almost always used alongside other antiretrovirals as part of a combination regimen, and it is also a key ingredient of HIV pre-exposure prophylaxis (PrEP). It comes in two forms (tenofovir disoproxil and tenofovir alafenamide) that differ in how they affect the kidneys and bones.

How it works

HIV uses an enzyme called reverse transcriptase to copy its genetic material so it can multiply. Tenofovir mimics one of the building blocks the virus needs and jams this copying process, stopping HIV from making new copies of itself. By lowering the amount of virus in the body, it protects the immune system and reduces the risk of passing HIV on; a very low viral load means HIV is untransmittable.

Company & origin

Originated / developed by: Originally developed by Gilead Sciences; now also available as a generic medicine..

Approved for HIV in the early 2000s and widely used in the UK as part of combination antiretroviral therapy.

Practical use

How to take Tenofovir

General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.

  • Take it every day, at around the same time, exactly as prescribed.
  • Swallow the tablet with water; some forms are best taken with food.
  • Keep taking it alongside the other medicines in your HIV regimen, even when you feel well.
  • Do not stop or skip doses, as this can let the virus become resistant.
  • If you miss a dose, take it as soon as you remember unless the next one is near, then skip it; never double up.
  • If you also have hepatitis B, do not stop without your prescriber's advice, as your liver disease can flare.

Weighing it up

Advantages & disadvantages of Tenofovir

Advantages

  • A long-established, effective backbone of HIV combination therapy.
  • Active against both HIV and hepatitis B, which is useful when both are present.
  • Also used in PrEP to help prevent HIV in people who are at risk.

Disadvantages

  • Can affect the kidneys and reduce bone density, so needs regular monitoring (the alafenamide form is gentler on both).
  • Must be taken every single day; missed doses risk resistance and loss of control.
  • Stopping it can trigger a hepatitis B flare in people who carry that virus.

Practical use

Good to know

Tenofovir must be taken every day, exactly as prescribed, to keep the virus suppressed and prevent drug resistance. It is not a cure. If you also have hepatitis B, stopping tenofovir suddenly can cause your hepatitis to flare, so never stop without medical advice. Your prescriber will keep an eye on your kidneys and bones while you take it.

Who should not take it / use with caution

  • People who are allergic to tenofovir.
  • People with significant kidney impairment may need a different form or close supervision.
  • Anyone should tell their prescriber about bone problems, kidney disease or hepatitis B before starting.

Monitoring

  • Kidney function through blood and urine tests before and during treatment.
  • Bone health where there is concern, particularly with long-term use.
  • HIV viral load and CD4 count to confirm the regimen is working.

Side effects

  • Nausea, diarrhoea, headache and tiredness, especially early on.
  • Effects on the kidneys, shown by changes in blood and urine tests.
  • Gradual loss of bone density with the older (disoproxil) form.

Key interactions

  • Other medicines that can affect the kidneys may increase the risk of kidney problems.
  • Some other antivirals and HIV medicines interact and need careful regimen choice.
  • Always share a full medicines list, including over-the-counter and herbal products, with your HIV team.

Available as: Available as tablets, often combined with other antiretrovirals in a single pill.

Answers

Tenofovir: frequently asked questions

Does tenofovir cure HIV?

No. It controls HIV and keeps the virus suppressed, but it does not remove it from the body, so it must be taken continuously as part of your regimen.

Why do I need kidney and bone tests?

Tenofovir can affect the kidneys and, over time, bone density. Regular tests let your team spot any changes early and adjust treatment if needed.

Can tenofovir be used for hepatitis B?

Yes. It is active against hepatitis B as well as HIV, which is helpful when someone has both infections, but stopping it can flare hepatitis B.

Is tenofovir used in PrEP?

Yes. It is a core ingredient of HIV pre-exposure prophylaxis, taken by people who do not have HIV to lower their risk of catching it.

What if I miss a dose?

Take it as soon as you remember unless your next dose is almost due, then skip the missed one. Never take a double dose, and tell your team if you miss doses often.

The wider class

About Antiretrovirals (HIV)

Tenofovir belongs to the antiretrovirals (hiv) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.

AntiretroviralsCombination drugs that suppress HIV so the virus becomes undetectable and untransmittable — taken lifelong and managed by specialists. EmtricitabineAn antiretroviral that forms part of combination treatment for HIV and is a key ingredient…DolutegravirAn integrase inhibitor that is a preferred, potent part of modern HIV combination therapy.…LamivudineA well-established antiretroviral used in combination treatment for HIV and also for chron…EfavirenzAn HIV antiretroviral that blocks the virus from copying itself, always used as part of a …RaltegravirAn HIV antiretroviral that stops the virus inserting itself into human cells, used as part…AbacavirAn HIV antiretroviral that needs a genetic test first because of a serious hypersensitivit…AtazanavirAn HIV protease inhibitor used in combination therapy, which can cause harmless yellowing …RitonavirAn antiretroviral used mainly as a 'booster' to make other medicines work better, with a v…DarunavirAn HIV medicine taken as part of combination treatment, always with a booster, to keep the…ZidovudineAn HIV medicine used as part of combination treatment, and to help prevent mother-to-baby …EtravirineAn HIV medicine taken with other HIV medicines as part of combination treatment, after foo…MaravirocAn HIV medicine that blocks the virus from entering cells, used in combination treatment a…LopinavirAn HIV protease inhibitor, always combined with ritonavir (as Kaletra), used as part of co…NevirapineAn HIV medicine used as part of combination treatment to keep the virus under control.…CobicistatA 'booster' medicine that raises the levels of certain HIV medicines but has no antiviral …StavudineAn older HIV medicine (a nucleoside reverse transcriptase inhibitor) once used in combinat…DidanosineAn older HIV medicine (a nucleoside reverse transcriptase inhibitor) once used in combinat…IndinavirAn older HIV protease inhibitor used in combination therapy, well known for causing kidney…SaquinavirAn older HIV protease inhibitor, always given boosted, now rarely used partly because it c…EnfuvirtideAn injectable HIV medicine (a fusion inhibitor) used as part of combination therapy when H…NelfinavirAn older HIV protease inhibitor used in combination therapy, best known for causing diarrh…TipranavirA boosted HIV protease inhibitor used, as part of combination therapy, for HIV that is res…FosamprenavirA boosted HIV protease inhibitor used as part of combination therapy to control HIV.…BictegravirAn HIV integrase inhibitor used, as part of combination therapy, usually in a single-table…ElvitegravirA boosted HIV integrase inhibitor used, as part of combination therapy, in a single-tablet…RilpivirineAn HIV NNRTI used, as part of combination therapy, taken with a meal and away from acid-re…DoravirineA newer HIV NNRTI used, as part of combination therapy, that is generally well tolerated.…CabotegravirA long-acting HIV integrase inhibitor given by injection, with rilpivirine for treatment o…LenacapavirA long-acting HIV medicine, mostly given by injection, used for difficult-to-treat HIV and…

Browse by body system

InfectionsAntibiotics, antifungals, antivirals and other medicines that treat and prevent infection.…

Authoritative sources

  • BNF
  • NICE CKS

Building a medicines information resource?

We create evidence-led, dose-free drug and formulary references for teams.

Talk to us ☎ +44 7448 439750
☎ Call Get a Proposal