Viread is a medication in the class of drugs called “nucleoside / nucleotide reverse transcriptase inhibitors” (NRTIs), which stop HIV from making copies of itself early in the viral life cycle. Viread is used for the treatment and prevention of HIV in combination with other drugs. Viread is also used to treat chronic hepatitis B. Viread was approved by the U.S. Food and Drug Administration (FDA) in United States in 2001, and became available as a generic medication in 2017.
How often is Viread taken?
Viread is normally taken orally once a day as a 300 mg pill, ideally with a meal (but it’s not required). The most important thing is to try to take it at the same time every day. Some adults who have issues with their kidneys may be instructed to take Viread less frequently. Always follow your medical provider’s instructions for how and when to take Viread.
Does Viread have any side effects I should worry about?
Viread is usually very well tolerated. The most common side effects of Viread are headache, nausea, and diarrhea. Tell your medical provider if you develop any side effects.
What anti-HIV pills contain Viread?
Viread is a part of seven different fixed-dose combination pills used to fight HIV (fixed-dose combinations contain multiple HIV drugs in one pill): Atripla, Cimduo, Complera, Delstrigo, Stribild, Symfi Lo, and Truvada. Truvada is used not only for HIV treatment, for also for HIV prevention as a pre-exposure prophylaxis (PrEP) regimen.
Viread (generic name: tenofovir disoproxil fumarate; often abbreviated as TDF) is an anti-HIV medication taken as one pill once a day in combination with other medications. Viread is in a class of drugs called “nucleoside / nucleotide reverse transcriptase inhibitors” (NRTIs), which stop HIV from making copies of itself.
Viread is available as a stand-alone drug, but it is usually used in combination with other drugs. Viread is included in a fixed-dose combination (FDC) pill called Truvada, which also includes an HIV drug called Emtriva (emtricitabine, FTC). Viread is also part of several other FDCs, including these single-dose treatment regimens (STRs) for HIV:
Atripla (TDF + FTC + Sustiva [efavirenz])
Complera (TDF + FTC + Edurant [rilpivirine])
Stribild (TDF + FTC + elvitegravir + cobicistat)
Viread was first approved by the U.S. Food and Drug Administration as a treatment for HIV in 2001. Generic versions of Viread are available in the U.S., and are included in a number of FDCs and STRs.
How to Take Viread
Viread is generally taken by adults as a single 300 mg pill orally once a day. Although the drug will work just as well whether it’s taken with or without food, taking Viread on an empty stomach can lead to abdominal pain or discomfort.
Some adults who have issues with their kidneys may be instructed to take Viread less frequently. Always follow your medical provider’s instructions for how and when to take Viread.
For children who weigh at least 22 lbs (10 kg) and cannot swallow a tablet, Viread is also available in a powder form.
How Much Does Viread Cost in the U.S.?
The price of brand-name Viread at the 300 mg dose taken by most adults is about $1,300 for a month’s supply. For generic Viread (a.k.a. tenofovir disoproxil fumarate), the full price of a month’s supply of the 300 mg dose costs about $1,200; discount cards and coupons, however, may lower the cost to the consumer.
If you have health insurance, monthly copays for Viread can typically run between $50 and $100, depending on the plan. Check to see if your insurance can provide a three-month supply, which may reduce the cost.
If you don’t have insurance, or your insurance will not cover most of the cost of Viread, there is a patient assistance program that can help reduce or eliminate the cost, depending on your financial situation.
We walk you through the basics on how HIV medications work, what side effects they can cause, how they've improved over the years, the causes and solutions of drug resistance, and what the future holds in store.
Viread is usually very well tolerated. As with many antiretroviral regimens, however, there is the potential for mild side effects with Viread, particularly when first starting treatment or when switching from a previous regimen to one containing Viread.
The most common side effects of Viread are headache, nausea, and diarrhea. In clinical trials, other common side effects were rash, pain, depression, and physical weakness or lack of energy (a condition called “asthenia”).
Very rarely, Viread has been linked to a potentially dangerous buildup of lactic acid in the blood (called lactic acidosis) or an enlarged liver (known as hepatomegaly) accompanied by a buildup of fat in the liver (called steatosis or fatty liver disease). New or worsening fever, abdominal pain, nausea, vomiting, or unusual muscle aches may be signs of these conditions, so tell your medical provider if any of these symptoms occur when you start taking Viread.
Also rarely, Viread has been linked with new or worsening kidney problems, including kidney failure. While later stages of kidney disease may be associated with symptoms including fatigue, nausea, vomiting, swollen ankles or feet, and frequent urination (especially at night), there are usually no signs in the early stages of kidney damage. If you are taking Viread, your medical provider will include laboratory tests of kidney function (urine and blood) as part of your routine follow-up.
Viread has also sometimes been linked with long-term development of bone problems, including bone pain, bone softening (called osteoporosis), or thinning of bones, which may lead to fractures. People taking Viread, like those taking any medication, should alert their medical provider if they experience any unusual signs or symptoms, especially when they first start taking a new medication. It’s also wise for people considering Viread to let their provider know if they have a family history of osteoporosis, or if they have any other medical condition that may require taking steroids (which can also cause bone problems).
Research has shown that bone issues caused by Viread can often be reversed by switching from Viread to another HIV medication.
Viread and Pregnancy
Viread appears to be safe for use during pregnancy. There is no evidence that Viread use by people who are pregnant increases the risk of birth defects, and there is no link between Viread and low birth weight or smaller-than-usual fetuses (a condition called “small for gestational age”).
While there is some concern about a possible link between Viread use in pregnancy and preterm (premature) birth, the scientific evidence is mixed, and more studies need to be done to clarify the role of other medications and other factors that might be involved in any risk of preterm birth among birthing parents taking Viread.
There is also mixed evidence regarding any link between a birthing parent’s use of Viread and small delays in growth during the first year of a baby’s life. In addition, the evidence is unclear regarding a possible impact of a birthing parent’s Viread use on infant bone health; this needs more study over longer periods of time.
As with other safety concerns, talk to your medical provider if you are pregnant (or may become pregnant) and are either taking Viread or considering starting Viread.
Taking Viread if You Have Hepatitis B
Viread is one of a small number of HIV medications that also has an ability to fight hepatitis B (HBV). This makes it more likely that, if you’re living with both HIV and active HBV infection (i.e., you have HIV/HBV coinfection), you’ll be prescribed a regimen containing Viread. This is also why, before being prescribed Viread, your medical provider will also likely test you for HBV.
Though it is not common, people living with both HIV and HBV who take Viread may have a flare-up (worsening) of their HBV if they stop taking Viread.
Viread interacts with a number of other medications. For most people, this is not likely to be a problem; but it’s wise to ensure your medical provider is always aware of all medications you are taking, including new medications that you start taking while you are already on Viread.
The most commonly used drugs that Viread may interact with are pain medications called nonsteroidal anti-inflammatory drugs (NSAIDs). These include the common over-the-counter drugs Advil (ibuprofen) and Aleve (naproxen), as well as some prescription NSAIDs.
There is not likely to be any problem when NSAIDS are taken at usual doses; but while taking Viread, avoid taking NSAIDs at high doses, taking more than one NSAID at a time, or taking NSAIDs for long periods of time. Doing so may result in kidney damage. To be safe, ask your medical provider or pharmacist about possible interactions between Viread and any pain medication you take.
Another type of medication Viread interacts with is a class of antibiotics called aminoglycosides, which are typically given intravenously in hospitals. It’s important to note that these are not oral antibiotics that you would likely be prescribed for common infections.
There is also a risk of kidney damage when taking Viread with certain other antiviral drugs—but these are medications that would be prescribed by your medical provider, who would know about their potential interactions with Viread. These drugs include an antibiotic combination known by the brand name Bactrim or Sulfatrim, which contains sulfamethoxazole and trimethoprim. Bactrim is often prescribed to people living with HIV who have a low CD4 T-cell count (to help prevent pneumonia), and may be prescribed for ear infections, sinus infections, or urinary tract infections.
Again, always make sure your medical providers is aware of all the medications you are taking. If you want to double-check whether any specific drugs interact with Viread, use the University of Liverpool’s Interaction Checker.
What’s the Verdict on Viread for HIV Treatment and Prevention?
Although Viread is a very common, tried-and-true medication, it has also been around for about 20 years, and is increasingly being replaced by newer medications. This process has accelerated in recent years thanks to the approval of Vemlidy (a.k.a. tenofovir alafenamide, or TAF) in 2016; Vemlidy was developed to overcome the concerns about the safety and side effects of Viread for kidneys and bones.
We are less likely to see new formulations that include brand-name Viread now that Vemlidy is around. Case in point: In 2016, the FDA approved Descovy for HIV treatment. Descovy is FDC that contains Vemlidy and Emtriva, which was created by the drugmaker to replace Truvada (Viread + Emtriva). In 2019, Descovy was also approved for HIV prevention (a.k.a. PrEP), making it only the second PrEP drug ever approved (after Truvada).
Here’s another reason people may be taking Viread less often: Generic versions of TDF are becoming increasingly available. In 2020, the FDA granted approval for the first generic versions of Truvada (TDF + FTC) and Atripla (EFV + TDF + FTC) to be made available in the U.S. The generic version of Truvada is approved for PrEP as well as for HIV treatment.
In summary, generics are poised to displace brand-name Viread, while Vemlidy is likely to be included in any new regimens that previously would have included Viread. Nevertheless, TDF, whether as brand-name Viread or in generic versions, continues to be a generally safe, effective, and convenient choice for many people seeking HIV treatment or HIV prevention (PrEP).