Tenofovir Disoproxil Fumarate (Viread): Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD

Tenofovir disoproxil fumarate (TDF), sold under the brand name Viread, is one of those quietly powerful medications that sits in a simple pill bottle while doing very big things in the background. It helps treat HIV-1 infection, controls chronic hepatitis B, and in combination products, helps prevent HIV in people at high risk. Not bad for a tiny tablet.

This guide walks you through how TDF works, its most important uses, side effects, interactions, warnings, and dosing basicsplus a bonus section on real-life experiences with the drug. Think of it as a friendly, slightly nerdy explainer you can read before you bombard your doctor with questions (which you absolutely should do).

Important: This article is for informational purposes only and does not replace medical advice. Always talk with your healthcare provider before starting, changing, or stopping any medication.

What Is Tenofovir Disoproxil Fumarate (Viread)?

Tenofovir disoproxil fumarate is an antiviral medication in the class of nucleotide reverse transcriptase inhibitors (NRTIs). It works by blocking an enzyme that viruses like HIV and hepatitis B need in order to copy their genetic material and multiply. When that enzyme is blocked, the virus can’t replicate as effectively, so the amount of virus (viral load) in your body goes down.

TDF is available as:

• Viread® – Tenofovir disoproxil fumarate as a single-ingredient drug.
• Part of combination pills, such as Truvada® (tenofovir DF + emtricitabine) and various HIV treatment “one-pill-a-day” regimens.

While the brand name Viread has been discontinued in some markets, generic tenofovir disoproxil fumarate is still widely used worldwide for both HIV and hepatitis B.

What Is Tenofovir Used For?

1. Treatment of HIV-1 Infection

Tenofovir is commonly used as part of a combination antiretroviral regimen to treat HIV-1 infection in adults and children. It is almost never used aloneHIV treatment always involves multiple medications to suppress the virus, reduce the risk of resistance, and help the immune system recover.

In HIV treatment regimens, TDF is usually paired with at least one other NRTI and another drug class (such as an integrase inhibitor). When taken consistently as prescribed, a modern combination regimen can reduce viral load to an undetectable level, which dramatically reduces the risk of transmission and protects long-term health.

2. Treatment of Chronic Hepatitis B

Tenofovir is also a first-line therapy for chronic hepatitis B virus (HBV) infection. Hepatitis B attacks the liver and can lead to cirrhosis, liver failure, or liver cancer over time. TDF helps by lowering the amount of hepatitis B virus in the blood, which can reduce liver inflammation and slow disease progression.

People with chronic HBV often need long-term or even lifelong therapy, so safety over many yearsespecially in the kidneys and bonesis an important consideration.

3. HIV Prevention (PrEP and PEP, in Combination Products)

While single-ingredient Viread is approved for treatment, tenofovir DF also shows up in combination pills that are used for HIV prevention:

• Pre-exposure prophylaxis (PrEP): Daily tenofovir DF plus emtricitabine (Truvada or generic equivalents) can reduce the risk of acquiring HIV from sex by about 99% when taken consistently.
• Post-exposure prophylaxis (PEP): TDF is part of many recommended PEP regimens when started within 72 hours after a high-risk exposure and continued for 28 days.

If you’re using tenofovir for prevention, your healthcare provider will typically monitor kidney function, HIV status, and other labs at regular intervals.

How Does Tenofovir Work?

At the microscopic level, tenofovir acts as a fake building block for viral DNA. The virus tries to use it while copying its genetic code, but once tenofovir gets inserted, the chain can’t be extended. It’s like giving someone a puzzle piece that almost fits but actually stops the whole puzzle from being finished.

Because human cells don’t rely on the same enzyme in the same way, tenofovir is relatively selective for viral replicationthough, as we’ll see, it can still affect other tissues, especially the kidneys and bones over time.

Common Side Effects of Tenofovir (Viread)

Not everyone experiences side effects, and many are mild and temporary, especially during the first few weeks of treatment. Commonly reported side effects include:​

• Nausea or upset stomach
• Diarrhea
• Headache
• Tiredness or weakness
• Rash
• Abdominal pain

These symptoms often improve as your body gets used to the medication. If they are persistent, severe, or interfere with daily life, your provider may adjust your regimen or offer ways to manage them.

Serious Side Effects and Warnings

1. Kidney (Renal) Problems

One of the most important long-term concerns with TDF is its effect on the kidneys. The drug is cleared by the kidneys and, in some people, can lead to decreased kidney function or more specific problems like Fanconi syndrome (a disorder of the kidney tubules).

Warning signs of kidney issues can include:

• New or worsening fatigue
• Swelling in the legs, ankles, or feet
• Noticeable changes in urination (much more or much less)
• Muscle cramps or weakness

Kidney function is usually monitored regularly with blood and urine tests. If you already have reduced kidney function or risk factors such as diabetes, high blood pressure, or older age, your provider may adjust your dose, switch to a related drug (like tenofovir alafenamide, or TAF), or choose a different regimen.

2. Bone Loss and Fracture Risk

Tenofovir DF has been associated with decreases in bone mineral density (BMD). Over time, this may increase the risk of osteopenia, osteoporosis, or fractures, particularly in people who already have bone health issues or other risk factors.

Your healthcare provider might recommend:

• Baseline and follow-up bone density scans in higher-risk patients
• Vitamin D and calcium supplementation, if appropriate
• Lifestyle steps such as weight-bearing exercise, smoking cessation, and moderation of alcohol
• Considering alternative medications in people with significant bone disease

3. Lactic Acidosis and Severe Liver Problems

Like other drugs in its class, TDF can rarely cause lactic acidosis (buildup of lactic acid in the blood) and serious liver toxicity. These are uncommon but potentially life-threatening and need urgent medical attention.

Seek emergency care if you develop symptoms such as:

• Deep, rapid breathing or trouble catching your breath
• Severe or persistent nausea, vomiting, or stomach pain
• Unusual muscle pain or extreme tiredness
• Yellowing of the skin or eyes (jaundice)
• Dark urine, light-colored stools, or loss of appetite

4. Hepatitis B Flares When Stopping Tenofovir

In people with chronic hepatitis B, stopping tenofovir can trigger a serious flare-up of liver inflammation. That’s why providers typically monitor liver function closely for several months after the medication is stopped and may plan an alternative treatment if needed.

Drug Interactions: What to Watch For

Tenofovir DF can interact with other medications, especially those that use the same kidney pathways or that also affect bone or kidney function. Key interaction categories include:​

• Other nephrotoxic drugs: High-dose NSAIDs, some antibiotics, certain antivirals, and other medications that stress the kidneys may increase the risk of kidney problems.
• Drugs that raise tenofovir levels: Some boosted HIV medications can increase TDF exposure, potentially increasing toxicity; dosing or regimen choices may be adjusted accordingly.
• Didanosine: Co-administration can increase didanosine levels and toxicity, so this combination is usually avoided in modern practice.

Always tell your healthcare provider and pharmacist about all medications and supplements you takeincluding over-the-counter pain relievers, herbal products, and vitaminsso they can check for interactions.

Dosing: How Is Tenofovir Usually Taken?

Do not self-dose. What follows is a simplified overview; your exact dose and schedule must come from your healthcare provider based on your health status, labs, other medications, and treatment goals.

Typical Adult Dosing

• For HIV-1 treatment: A common adult dose is 300 mg once daily, as part of a combination regimen.
• For chronic hepatitis B: The same 300 mg once daily dose is often used in adults with normal kidney function.

Tenofovir DF can be taken with or without food, but taking it with food may help some people with stomach upset. The powder formulation is usually mixed with soft food (not liquid) and consumed right away.

Kidney Function and Dose Adjustments

If your kidneys don’t work normally, the dosing interval may be extended (for example, every 48 hours instead of daily), or a different drug may be recommended. Dialysis patients have specific dosing schedules. These decisions should always be made by a clinician familiar with your lab results.

What Do Tenofovir Pills Look Like? (Pictures)

The appearance of your tenofovir DF tablet can vary depending on the manufacturer (brand vs. generic), strength, and country. Common features include:

• Oval or capsule-shaped tablets
• Colors such as light blue, white, or light green
• Imprinted codes or letters identifying the manufacturer and dose

You may see images of tenofovir pills on pharmacy sites and drug information platforms that show typical shapes and colors used by different manufacturers. If your pill looks different from what you expectedespecially after a refillask your pharmacist to confirm that it’s the correct medication and strength.

For website use, you might visually support the article with a labeled pill image such as:

<img src=”tenofovir-tablet-example.jpg” alt=”Example of a tenofovir disoproxil fumarate (Viread) tablet” />

(On your actual site, replace the file name with a real image hosted on your server and ensure you have the rights to use it.)

Who Should Use Tenofovir with Extra Caution?

Tenofovir DF may not be the best choiceor may require extra carein the following situations:

• Pre-existing kidney disease or a history of kidney injury
• Osteoporosis or significant risk for fractures
• Concurrent use of other drugs that strongly affect the kidneys
• People who cannot reliably attend follow-up visits and lab monitoring
• Individuals requiring long-term HBV treatment with borderline kidney or bone health

In such cases, providers sometimes prefer tenofovir alafenamide (TAF) or non-tenofovir regimens, which may have a more favorable bone and kidney safety profile in many patients.

When to Call Your Doctor or Seek Emergency Care

Contact your healthcare provider promptly if you experience:

• New or worsening fatigue, shortness of breath, or muscle weakness
• Swelling in your legs, ankles, or feet
• Persistent nausea, vomiting, or abdominal pain
• Yellowing of the skin or eyes
• Confusion, dizziness, or unusual changes in mood

Seek emergency care (or call your local emergency number) if you notice signs suggestive of lactic acidosis or severe liver or kidney injury, such as deep rapid breathing, severe weakness, chest discomfort, or sudden confusion.

Tenofovir Disoproxil Fumarate: Pros, Cons, and Overall Role

Pros:

• Highly effective in treating HIV-1 and chronic hepatitis B
• Long clinical track record and widely studied
• Backbone of many HIV treatment and prevention regimens

Cons:

• Potential for kidney and bone side effects, particularly with long-term use
• Requires regular lab monitoring
• Not ideal for people with pre-existing renal impairment or advanced osteoporosis

For many people, especially those with good kidney and bone health, tenofovir DF remains a reliable and powerful tool against HIV and hepatitis B. For others, newer options may offer similar viral control with less impact on the kidneys and bones. The “best” choice is very individual and should always be personalized.

Real-Life Experiences with Tenofovir (Extra 500-Word Deep Dive)

Reading about side effect rates and clinical trial outcomes is useful, but real-world experiences often matter just as much. While every person is different and online stories are not a substitute for data, they can give you a sense of what it’s actually like to live on tenofovir disoproxil fumarate.

Adjusting to the First Few Weeks

Many people describe the first couple of weeks on TDF as a “getting to know you” phase. Some report mild nausea, loose stools, or a lingering headache. Others feel a bit more tired than usual. For a lot of patients, these symptoms fade as their body adjusts.

A typical story might sound like this: a person starting HIV treatment or PrEP takes their first dose nervous about side effects, experiences a bit of stomach rumbling and fatigue for a week or two, then realizes one day that they no longer notice anything at all. Their viral load is suppressed or their HIV tests remain negative, and the medication simply becomes part of their daily routinelike brushing their teeth, but with more lab work.

Living with Long-Term Therapy

For people using tenofovir DF over many yearsfor example, someone with chronic hepatitis B or long-term HIV treatmentroutine blood and, sometimes, bone density tests become part of life. Some patients never show meaningful changes in kidney function or bone density, while others start to see subtle shifts in lab values over time.

In practice, this might look like a patient whose kidney function remains perfectly stable for several years, then gradually drifts downward. Their doctor notices the trend and discusses a switch to a TAF-based or non-tenofovir regimen. The patient may not feel anything physically, but the lab results prompt a proactive change before serious problems arise. That’s the quiet power of regular monitoring.

When Tenofovir Isn’t the Right Fit

There are also individuals who simply don’t tolerate TDF well. Maybe they experience persistent stomach upset that doesn’t go away. Maybe they develop significant bone loss or clear kidney issues. For them, the story often involves trial and error, switching to a different NRTI or to tenofovir alafenamide (TAF), which can be easier on the kidneys and bones for many people.

The good news is that modern HIV and HBV treatment options are broad enough that most people can find a regimen that works for them both medically and practically. The key is honest communication with the care teamdescribing symptoms, sharing concerns, and sticking with follow-up visits even when you feel fine.

Emotional and Practical Benefits

On the positive side, many patients describe a profound psychological benefit from being on an effective regimen that includes tenofovir. Someone living with HIV might feel a huge sense of relief and empowerment when their viral load becomes undetectable. A person with chronic hepatitis B may feel more at ease knowing their liver is being protected.

For people using tenofovir-based PrEP, there is often a combination of freedom and responsibility: freedom from the constant fear of HIV infection, paired with the responsibility of taking a daily pill and attending regular checkups. Some describe it as “one small habit that unlocks a lot of peace of mind.”

Putting It All Together

Tenofovir disoproxil fumarate is not perfectno medication isbut it has transformed the landscape of HIV and hepatitis B care over the last two decades. If you and your doctor are considering TDF, think of the decision as a balancing act between benefits and risks, guided by your medical history, lab results, lifestyle, and preferences.

If you’re already taking tenofovir, keep asking questions. Ask about your latest kidney and liver labs. Ask whether your bone health needs attention. Ask what other options might be available now or in the future. Your medication is not just a pill; it’s a partnership between you, your virus, your body, and your healthcare teamand you deserve to understand every part of that partnership.

Conclusion

Tenofovir disoproxil fumarate (Viread) remains a cornerstone medication for HIV-1 and chronic hepatitis B, and a crucial component of many HIV prevention strategies. Understanding its uses, side effects, interactions, warnings, and dosing helps you have informed, confident conversations with your healthcare provider. With appropriate monitoring and individualized decision-making, TDF can be a powerful ally in protecting your health for the long term.

Again, this article is informational only. For decisions about starting, continuing, or changing tenofoviror any other medicationconsult your doctor or another qualified healthcare professional.