Comprehensive Patient & Clinician Guide to Tenof 300mg Tablet (Tenofovir Disoproxil Fumarate)
Tenof 300mg Tablet is an antiretroviral medication prescribed under clinical supervision for the treatment and prevention of Human Immunodeficiency Virus type 1 (HIV-1), as well as the management of Chronic Hepatitis B Virus (HBV) infection.
Manufactured by Hetero Healthcare Ltd., each film-coated tablet contains 300 mg of Tenofovir Disoproxil Fumarate (TDF), equivalent to 245 mg of tenofovir disoproxil.
As a foundational nucleotide analog, Tenof 300mg is widely utilized in combined antiretroviral therapy (cART) and as a core component of HIV Pre-Exposure Prophylaxis (PrEP).
What is Tenof 300 mg and How Does It Work?
Tenofovir disoproxil fumarate is a prodrug that, once ingested, is absorbed and converted by cellular enzymes into its active metabolite: tenofovir diphosphate.
Mechanism of Action in HIV-1
Tenofovir diphosphate functions as a Nucleotide Reverse Transcriptase Inhibitor (NtRTI):
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Targeted Inhibition: Tenofovir diphosphate interferes with deoxyadenosine 5′-triphosphate, which acts as a natural substrate for incorporation in viral DNA with the help of reverse transcriptase of HIV-1.
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Chain Termination: As soon as it gets incorporated into the growing chain of viral DNA, tenofovir does not have a 3′-OH group needed for the addition of another nucleotide. Thus, chain termination occurs.
Mechanism of Action in Chronic Hepatitis B
In patients with Chronic Hepatitis B, tenofovir diphosphate inhibits HBV polymerase, preventing viral replication in liver tissue, lowering circulating HBV DNA levels, and slowing liver inflammation and fibrosis.
Approved Therapeutic Indications
Tenof 300mg Tablet is indicated for adult and adolescent patients across three main clinical scenarios:
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HIV-1 Treatment: Used in combination with other antiretroviral agents (such as emtricitabine, lamivudine, or efavirenz) for the management of HIV-1 infection.
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HIV-1 Pre-Exposure Prophylaxis (PrEP): Prescribed in combination with emtricitabine or lamivudine for uninfected individuals at high risk of HIV acquisition to significantly reduce the risk of acquiring HIV-1 infection.
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Chronic Hepatitis B Virus (HBV) Infection: Used as a single agent or combined therapy to suppress viral load in adults and pediatric patients (12 years and older) with compensated or decompensated chronic liver disease.
Standard Dosage and Administration Guidelines
Tenofovir 300 mg must be taken strictly according to medical instructions.
Standard Adult Dosage
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HIV-1 Treatment & PrEP: The standard dose for adults and adolescents weighing at least 35 kg is one 300 mg tablet taken orally once daily.
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Chronic Hepatitis B: One 300 mg tablet taken orally once daily.
- 1 Tablet(300 mg) Daily: Take with or without food. Space 24 hours apart
Key Administration Rules
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Administration with Food: Tenof 300 mg can be taken with or without food. However, taking it with a meal may slightly increase its absorption and help reduce mild stomach upset.
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Swallow Whole: Swallow the tablet whole with a full glass of water. Do not crush, split, or chew the tablet.
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Daily Consistency: To maintain stable viral suppression and prevent viral resistance, take Tenof at the same time every day.
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Missed Dose Instructions: If you miss a dose by less than 12 hours, take it as soon as you remember and resume your normal schedule. If you are more than 12 hours late, skip the missed dose and resume your regular timing the next day. Never take a double dose.
Specific Guidance for HIV Pre-Exposure Prophylaxis (PrEP)
When used as part of a PrEP regimen (in combination with another antiretroviral like emtricitabine or lamivudine):
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HIV Status Verification: Before initiating PrEP and every 3 months during therapy, patients must be confirmed HIV-negative using a high-sensitivity HIV test. Taking PrEP while harboring an undetected HIV infection can lead to drug-resistant HIV strains.
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Strict Adherence: Daily adherence is critical. PrEP reaches maximum protection in rectal tissue after approximately 7 days of daily use, and in vaginal tissue and blood after approximately 21 days of daily use.
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Comprehensive Prevention: PrEP protects against HIV-1 acquisition but does not protect against other Sexually Transmitted Infections (STIs) like syphilis, gonorrhea, or chlamydia. Regular STI screening and barrier protection (condoms) remain necessary.
Alternatives and Related Product
Potential Side Effects and Management Strategies
While generally well tolerated, Tenof 300mg can cause side effects that require monitoring.
Common Side Effects
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Gastrointestinal Effects: Mild nausea, diarrhea, abdominal pain, flatulence, or loss of appetite.
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Central Nervous System: Mild headache, dizziness, or fatigue.
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Dermatological: Rash or mild skin itching.
Serious Adverse Reactions (Seek Immediate Medical Care)
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Renal Impairment & Fanconi Syndrome: Tenofovir can affect kidney function, causing increased serum creatinine or Fanconi syndrome (damage to the renal tubules leading to protein and phosphate wasting).
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Severe Exacerbation of Hepatitis B: Patients co-infected with HIV and HBV who discontinue Tenof abruptly may experience severe, acute flare-ups of hepatitis B. Do not stop taking Tenof without consulting your doctor.
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Bone Mineral Density (BMD) Reduction: Decrease in bone mineral density can occur, particularly in the hip and spine, increasing the risk of osteopenia or fractures.
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Lactic Acidosis & Severe Hepatomegaly with Steatosis: Rare but life-threatening metabolic complications marked by severe nausea, rapid breathing, deep fatigue, yellowing skin (jaundice), or abdominal enlargement.
Precautions and Baseline Monitoring
Due to the renal and bone effects of tenofovir disoproxil fumarate, routine lab monitoring is essential throughout treatment.
Essential Clinical Baseline & Routine Testing
| Test Category | Recommended Frequency | Purpose |
| Renal Function (eGFR / CrCl) | Baseline, then every 3–6 months | Assesses kidney clearance. Dosing interval adjustments are required if creatinine clearance drops below 50 mL/min. |
| Serum Phosphate & Proteinuria | Baseline, then every 3–6 months | Detects early signs of proximal renal tubulopathy (Fanconi syndrome). |
| HIV-1 & Hepatitis B Screening | Baseline; HIV testing every 3 months for PrEP | Confirms HIV status before PrEP and evaluates for HBV co-infection. |
| Bone Mineral Density (DXA) | Baseline for patients with a history of bone fractures | Evaluates bone density in patients at risk for osteoporosis. |
Drug & Substance Interactions
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Nephrotoxic Drugs: Avoid co-administration with other medications that affect kidney function, such as NSAIDs (high-dose ibuprofen, naproxen), aminoglycosides, amphotericin B, or vancomycin.
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Didanosine: Tenofovir significantly increases blood levels of didanosine, which can lead to severe toxicity (pancreatitis and neuropathy). Co-administration is not recommended.
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Ledipasvir / Sofosbuvir (Hepatitis C Therapies): Can increase tenofovir concentrations, raising the risk of renal toxicity.
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Atazanavir: Tenofovir decreases blood concentrations of atazanavir while atazanavir increases tenofovir levels. Combined use requires therapeutic monitoring and specific boosted dosing.
Special Population Guidelines
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Pregnancy: Tenofovir disoproxil fumarate has been evaluated extensively during pregnancy. Large registries show no increase in birth defect risks compared to the general population. It may be used during pregnancy when clinically indicated under expert guidance.
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Lactation: Tenofovir passes into human breast milk in low concentrations. In resource-rich settings where safe water and formula are accessible, mothers living with HIV are advised not to breastfeed to avoid viral transmission.
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Pediatric Use: Approved for children 12 years and older (weighing ≥ 35 kg) under specialized pediatric dosing guidelines.
Storage and Handling Protocols
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Room Temperature Storage: Store Tenof 300mg Tablets between 20°C and 25°C (68°F to 77°F).
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Protect from Moisture: Keep tablets in their original container with the desiccant packet to shield them from ambient moisture.
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Keep Out of Reach: Keep away from children and pets.
Frequently Asked Questions (FAQs)
Q1: What happens if I stop taking Tenof 300mg suddenly?
If you have Hepatitis B (or HIV/HBV co-infection), stopping Tenof abruptly can trigger a severe, life-threatening flare-up of your liver disease. Always consult your doctor before making any changes to your medication schedule.
Q2: Can Tenof 300 mg cure HIV or Hepatitis B?
No. Tenof 300mg does not cure HIV or Chronic Hepatitis B. However, it suppresses the viral load to undetectable levels, allowing your immune system to rebuild and preventing transmission to others.
Q3: How long does it take for Tenof to become effective when used for PrEP?
For protection during receptive anal intercourse, daily PrEP reaches effective tissue concentrations in about 7 days. For protection during receptive vaginal intercourse or insertive sex, maximum protection requires approximately 21 days of daily use.
Medical Disclaimer
This guide is strictly for educational and informational purposes and should not replace professional medical advice, diagnosis, or treatment. Always consult a qualified infectious disease specialist, gastroenterologist, or healthcare professional regarding antiretroviral therapy and prescription medications.
References
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National Center for Biotechnology Information (NCBI):
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StatPearls Review: Tenofovir Disoproxil Fumarate Pharmacology and Clinical Profile. https://www.ncbi.nlm.nih.gov/books/NBK538182/
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PMC Clinical Studies: Tenofovir-based PrEP Efficacy and Renal Safety Outcomes. https://pmc.ncbi.nlm.nih.gov/articles/PMC3832811/
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U.S. Food and Drug Administration (FDA):
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VIREAD (tenofovir disoproxil fumarate) Prescribing Information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/021356s058lbl.pdf
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MedlinePlus Drug Information (US National Library of Medicine):
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Tenofovir Monograph. https://medlineplus.gov/druginfo/meds/a602018.html
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World Health Organization (WHO):
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WHO Guidelines on Pre-Exposure Prophylaxis (PrEP) & HIV Treatment. https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/prevention/pre-exposure-prophylaxis
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