Tenofovir Disoproxil Glenmark
Antiviral medicine for HIV-1 infection and chronic hepatitis B
Quick facts about Tenofovir Disoproxil Glenmark
Key takeaways about Tenofovir Disoproxil Glenmark
- Dual indication: Treats both HIV-1 infection (always in combination with other antiretrovirals) and chronic hepatitis B (can be used alone)
- Never stop abruptly: Stopping tenofovir disoproxil without medical supervision can cause severe hepatitis B flare-ups, even in patients co-infected with HIV
- Kidney monitoring essential: Regular blood tests to check kidney function are needed before and during treatment, as tenofovir can affect the kidneys
- Bone health consideration: Long-term use may lead to decreased bone mineral density; discuss risk with your doctor, especially if you have osteoporosis
- Take with food: Always take the tablet with a meal or snack to ensure adequate absorption
What Is Tenofovir Disoproxil Glenmark and What Is It Used For?
Tenofovir disoproxil Glenmark is an antiviral medicine containing tenofovir disoproxil, a nucleotide reverse transcriptase inhibitor (NRTI) used to treat HIV-1 infection and chronic hepatitis B. For HIV, it is always used in combination with other antiretroviral medicines. The standard dose is one 245 mg tablet taken once daily with food.
Tenofovir disoproxil Glenmark belongs to a class of medicines known as nucleotide reverse transcriptase inhibitors (NRTIs). It works by interfering with the normal function of enzymes that viruses need to reproduce. In HIV infection, it inhibits the enzyme reverse transcriptase, while in hepatitis B, it inhibits HBV DNA polymerase. By blocking these enzymes, tenofovir disoproxil prevents the virus from making copies of itself, thereby reducing the viral load in the body.
This medicine is approved for the treatment of HIV-1 (human immunodeficiency virus) infection in adults and adolescents aged 12 to under 18 years who have already been treated with other HIV medicines that are no longer fully effective due to the development of resistance or that have caused side effects. For HIV, tenofovir disoproxil must always be used in combination with other antiretroviral medicines – it should never be used alone to treat HIV.
Tenofovir disoproxil Glenmark is also used for the treatment of chronic hepatitis B, an infection caused by the hepatitis B virus (HBV). It is suitable for adults and adolescents aged 12 to under 18 years. You do not need to have HIV to be treated with tenofovir disoproxil for hepatitis B. In chronic hepatitis B, tenofovir disoproxil can be used as a standalone treatment.
Tenofovir disoproxil Glenmark does not cure HIV infection or hepatitis B. While taking this medicine, you may still develop infections or other conditions associated with HIV. You can also still transmit HBV or HIV to others, so it is essential to continue practising safe behaviours to prevent transmission, including safe sex practices and not sharing needles.
How does tenofovir disoproxil work in the body?
After you take a tablet, tenofovir disoproxil is absorbed in the gut and converted into its active form, tenofovir diphosphate, inside the cells. Tenofovir diphosphate competes with the natural building block deoxyadenosine 5′-triphosphate for incorporation into the viral DNA chain. Once incorporated, it acts as a chain terminator, meaning the virus can no longer extend the DNA strand it needs to replicate. This mechanism effectively halts viral reproduction.
Tenofovir disoproxil has a long intracellular half-life, which supports once-daily dosing. The drug is primarily eliminated through the kidneys, which is why kidney function monitoring is critical during treatment. Its effectiveness against both HIV and HBV makes it a versatile component of antiviral therapy, recognised by the World Health Organization (WHO) as an essential medicine.
What Should You Know Before Taking Tenofovir Disoproxil Glenmark?
Do not take tenofovir disoproxil if you are allergic to tenofovir disoproxil or any of its ingredients. Before starting treatment, inform your doctor about any kidney problems, bone conditions, or liver disease. Kidney function should be tested before and regularly during treatment. This medicine does not prevent transmission of HIV or HBV to others.
Contraindications
You must not take Tenofovir Disoproxil Glenmark if you are allergic (hypersensitive) to tenofovir, tenofovir disoproxil, or any of the other ingredients in the tablets. If this applies to you, inform your doctor immediately and do not take the medicine. An allergic reaction may manifest as skin rash, itching, swelling of the face, lips, tongue or throat, or difficulty breathing.
Do not take this medicine together with other products that contain tenofovir disoproxil or tenofovir alafenamide. Do not use it in combination with adefovir dipivoxil, another medicine used to treat chronic hepatitis B.
Warnings and precautions
Talk to your doctor or pharmacist before taking Tenofovir Disoproxil Glenmark in the following situations:
Kidney disease: If you have a history of kidney disease or if tests have shown kidney problems, tell your doctor. Tenofovir disoproxil should not be given to adolescents with existing kidney problems. Before starting treatment, your doctor will order blood tests to assess kidney function. During treatment, your doctor will continue to monitor your kidneys with regular blood tests. If you are an adult with reduced kidney function, your doctor may advise you to take the tablets less frequently. Do not reduce the prescribed dose unless your doctor tells you to do so.
Bone health: Tenofovir disoproxil may cause loss of bone mineral density. The most pronounced bone loss was observed in clinical studies when patients were treated with tenofovir disoproxil in combination with a boosted protease inhibitor. If you have osteoporosis, a history of bone fractures, or bone problems, inform your doctor. Bone problems, including persistent or worsening bone pain that sometimes leads to fractures, can also occur due to damage to kidney tubular cells. The long-term effects of tenofovir disoproxil on bone health and future fracture risk in both adults and children remain uncertain.
Liver disease: If you have or have had liver disease, including hepatitis, tell your doctor. Patients with liver disease, including chronic hepatitis B or C, who are treated with antiretroviral medicines have an increased risk of severe and potentially fatal liver complications. If you have hepatitis B, your doctor will carefully select the best treatment for you and may order blood tests to monitor liver function.
Infections and immune reconstitution: If you have advanced HIV infection (AIDS) and have an infection, you may develop symptoms of infection and inflammation, or worsening of existing infection symptoms, when you start treatment with tenofovir disoproxil. These symptoms may indicate that your body’s improved immune system is fighting the infection (immune reconstitution inflammatory syndrome, or IRIS). Watch for signs of inflammation or infection during the first weeks after starting treatment and inform your doctor immediately if you notice any. Additionally, autoimmune disorders (conditions where the immune system attacks healthy body tissue) may occur months after starting HIV treatment.
Lactic acidosis (excess lactic acid in the blood) is a rare but potentially fatal side effect. Seek immediate medical attention if you experience deep rapid breathing, drowsiness, nausea, vomiting, and abdominal pain – these may be signs of lactic acidosis.
Elderly patients: Tenofovir disoproxil has not been studied in patients over 65 years. If you are older than 65 and are prescribed this medicine, your doctor will monitor you more closely.
Children and adolescents
Tenofovir Disoproxil Glenmark is suitable for HIV-1-infected adolescents aged 12 to under 18 years weighing at least 35 kg who have already been treated with other HIV medicines that are no longer fully effective. It is also suitable for HBV-infected adolescents aged 12 to under 18 years weighing at least 35 kg. This medicine is not suitable for children under 12 years of age for either HIV-1 or HBV infection.
Pregnancy and breastfeeding
If you are pregnant, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. If you have taken tenofovir disoproxil during pregnancy, your doctor may request regular blood tests and other tests to monitor the infant’s development. For children whose mothers took NRTIs during pregnancy, the benefit of HIV protection outweighs the risk of side effects.
If you are a mother with HBV and your infant has received hepatitis B prophylaxis at birth, you may be able to breastfeed, but talk to your doctor first. Breastfeeding is not recommended for women living with HIV, as the virus can be transmitted to the child through breast milk.
Driving and using machines
Tenofovir disoproxil may cause dizziness. If you feel dizzy while taking this medicine, do not drive, cycle, or operate machinery. You are responsible for assessing your fitness to perform tasks requiring alertness.
This medicine contains lactose monohydrate and phosphate (46 mg per tablet). If you have been told by your doctor that you have an intolerance to certain sugars, or if you are on a phosphate-restricted diet, contact your doctor before taking this medicine.
How Does Tenofovir Disoproxil Glenmark Interact with Other Drugs?
Tenofovir disoproxil can interact with several medicines, particularly those that are toxic to the kidneys (nephrotoxic drugs), didanosine, and hepatitis C direct-acting antivirals. Tell your doctor about all medicines you are taking, including over-the-counter products and herbal supplements. Never stop any HIV medicine without medical advice.
Drug interactions are an important consideration when taking tenofovir disoproxil. Some interactions can reduce the effectiveness of your treatment, while others can increase the risk of side effects, particularly kidney damage. Always inform your doctor or pharmacist about all medicines you are taking, have recently taken, or might take.
Major interactions
The following interactions are clinically significant and require careful management or avoidance:
| Interacting Drug | Effect | Recommendation |
|---|---|---|
| Didanosine | Increased didanosine blood levels, decreased CD4 count; rare cases of pancreatitis and lactic acidosis (some fatal) | Use with extreme caution; dose adjustment needed; close monitoring required |
| Adefovir dipivoxil | Overlapping mechanism; increased kidney toxicity risk | Do not use together |
| Other tenofovir products | Double dosing; increased toxicity risk | Do not take with other products containing tenofovir disoproxil or tenofovir alafenamide |
| Aminoglycosides | Additive kidney toxicity | Avoid combination or monitor kidney function weekly |
| Amphotericin B | Additive kidney toxicity | Avoid combination or monitor kidney function weekly |
Other important interactions
| Interacting Drug | Effect | Recommendation |
|---|---|---|
| Ledipasvir/sofosbuvir | May increase tenofovir levels | Inform your doctor; enhanced kidney monitoring |
| Sofosbuvir/velpatasvir | May increase tenofovir levels | Inform your doctor; enhanced kidney monitoring |
| NSAIDs (e.g. ibuprofen, naproxen) | Additive kidney toxicity risk | Use with caution; monitor kidney function |
| Foscarnet, ganciclovir, cidofovir | Additive kidney toxicity | Avoid or monitor kidney function weekly |
| Tacrolimus | Additive kidney toxicity | Monitor kidney function closely |
| Interleukin-2 | Potential kidney toxicity | Monitor kidney function |
If you are taking any of these medicines, or if you cannot avoid them, your doctor will monitor your kidney function at least once a week. Always tell your doctor about all medicines you use, including over-the-counter medicines, vitamins, and herbal supplements.
What Is the Correct Dosage of Tenofovir Disoproxil Glenmark?
The recommended dose for adults and adolescents (aged 12+, weighing at least 35 kg) is one 245 mg tablet once daily, taken with food. If you have kidney problems, your doctor may adjust the dosing frequency. Always take the dose exactly as prescribed to prevent viral resistance.
Always take this medicine exactly as your doctor or pharmacist has told you. Do not change the dose unless your doctor instructs you to do so. Taking the correct dose consistently is crucial to ensure the medicine works effectively and to reduce the risk of the virus developing resistance to treatment.
Adults
Standard adult dose
1 tablet (245 mg) once daily, taken with food (a meal or snack). If you have kidney problems, your doctor may advise you to take the tablets less frequently. Do not reduce the prescribed dose without medical advice.
Adolescents (12 to under 18 years)
Adolescent dose (weighing at least 35 kg)
1 tablet (245 mg) once daily, taken with food. The same dose as adults applies to adolescents who meet the weight requirement.
Children under 12 years
Not recommended
Tenofovir Disoproxil Glenmark tablets are not suitable for children under 12 years of age.
Patients with kidney impairment
If you are an adult with reduced kidney function, your doctor may adjust the dosing interval (e.g. every 48 or 72 hours instead of daily). This is based on your creatinine clearance. Your doctor will determine the appropriate schedule through regular blood tests. Tenofovir disoproxil should not be given to adolescents who already have kidney problems.
If you have particular difficulty swallowing, you can crush the tablet using the tip of a spoon. Mix the powder with approximately 100 ml (half a glass) of water, orange juice, or grape juice, and drink the mixture immediately.
Missed dose
It is important not to miss any dose of tenofovir disoproxil. If you miss a dose:
- Less than 12 hours late: Take the missed dose as soon as possible, then take the next dose at its regular time
- More than 12 hours late: Skip the missed dose entirely and take the next dose at the regular time
- Do not take a double dose to make up for a forgotten tablet
If you vomit within 1 hour of taking the tablet, take another tablet. If vomiting occurs more than 1 hour after taking the dose, you do not need to take another tablet.
Overdose
If you accidentally take too many tablets, contact your doctor or nearest emergency department for advice. Keep the packaging with you so you can easily describe what you have taken. An overdose may increase the risk of the side effects described in this article.
If you have hepatitis B (with or without HIV co-infection), stopping tenofovir disoproxil abruptly can cause a severe flare-up of hepatitis. Some patients have experienced worsening of their hepatitis when treatment was stopped. You may need blood tests for several months after stopping treatment. In patients with advanced liver disease or cirrhosis, stopping treatment is not recommended. Always talk to your doctor before discontinuing this medicine.
What Are the Side Effects of Tenofovir Disoproxil Glenmark?
The most common side effects of tenofovir disoproxil include diarrhoea, vomiting, nausea, dizziness, rash, and weakness (affecting more than 1 in 10 people). Serious but rare side effects include lactic acidosis, kidney damage, and liver problems. Report any unusual symptoms to your doctor promptly.
Like all medicines, tenofovir disoproxil can cause side effects, although not everybody gets them. Some side effects can be serious and require immediate medical attention, while others are mild and often improve with continued treatment.
During HIV treatment, weight gain and increased levels of lipids and glucose in the blood may occur. This is partly related to restored health and lifestyle, but for blood lipids there may sometimes be a link to the HIV medicines themselves. Your doctor will test for such changes during your treatment.
Very Common
May affect more than 1 in 10 people
- Diarrhoea
- Vomiting
- Nausea
- Dizziness
- Rash
- Weakness / feeling of weakness
- Decreased blood phosphate levels (shown in tests)
Common
May affect up to 1 in 10 people
- Headache
- Abdominal pain
- Fatigue
- Bloating
- Flatulence (gas)
- Loss of bone mineral density
- Liver problems (shown in tests)
Uncommon
May affect up to 1 in 100 people
- Abdominal pain caused by pancreatitis (inflammation of the pancreas)
- Kidney tubular cell damage
- Muscle breakdown (rhabdomyolysis)
- Muscle pain or muscle weakness
- Decreased blood potassium levels
- Increased blood creatinine levels
Rare
May affect up to 1 in 1,000 people
- Lactic acidosis (excess lactic acid in the blood) – potentially fatal
- Kidney inflammation, excessive urination, feeling thirsty
- Changes in urine and back pain due to kidney problems, including kidney failure
- Reduced bone hardness (leading to bone pain and sometimes fractures) due to kidney tubular cell damage
- Fatty liver
- Swelling of the face, lips, tongue, or throat
- Abdominal pain caused by liver inflammation
- Deep, rapid breathing
- Drowsiness
- Nausea, vomiting, and abdominal pain
Lactic acidosis is rare but can be fatal. If you think you may have lactic acidosis, contact your doctor immediately or go to the nearest emergency department.
Bone and muscle effects
Some adult patients with HIV receiving combination antiretroviral therapy may develop a bone condition called osteonecrosis (bone tissue death due to loss of blood supply to the bone). Risk factors include long-term combination antiretroviral therapy, use of corticosteroids, alcohol consumption, severe immune suppression, and higher body mass index. Signs of osteonecrosis include joint stiffness, aches and pains (especially in the hips, knees, and shoulders), and difficulty moving. If you experience any of these symptoms, tell your doctor.
Muscle breakdown, reduced bone hardness, muscle pain, muscle weakness, and decreased potassium or phosphate levels in the blood may occur due to damage to kidney tubular cells. If you develop persistent bone or muscle pain, inform your doctor as this may require further investigation.
Immune reconstitution syndrome
In patients with advanced HIV, infections or autoimmune disorders may appear or worsen shortly after starting antiretroviral treatment, including tenofovir disoproxil. This is known as immune reconstitution inflammatory syndrome (IRIS) and occurs because the immune system is recovering. Autoimmune conditions may emerge months after starting treatment. Symptoms to watch for include muscle weakness, weakness starting in the hands and feet that moves towards the trunk, palpitations, tremor, or hyperactivity. Report any such symptoms to your doctor immediately.
How Should You Store Tenofovir Disoproxil Glenmark?
Store Tenofovir Disoproxil Glenmark at or below 25°C (77°F). Keep the tablets in the original container with the desiccant sachets. Keep out of the sight and reach of children. Do not use after the expiry date on the label.
Proper storage is essential to maintain the effectiveness and safety of your medicine. Follow these guidelines carefully:
- Temperature: Store at or below 25°C (77°F). Do not freeze.
- Container: Keep the tablets in the original white plastic bottle. Each bottle contains two desiccant sachets with silica gel to protect the tablets from moisture.
- Desiccant: The sachets must remain in the bottle to protect the tablets. Do not swallow the desiccant sachets.
- Children: Keep this medicine out of the sight and reach of children.
- Expiry date: Do not use this medicine after the expiry date stated on the label and carton (after EXP). The expiry date refers to the last day of the stated month.
- Disposal: Do not throw away medicines via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures help to protect the environment.
What Does Tenofovir Disoproxil Glenmark Contain?
Each film-coated tablet contains tenofovir disoproxil phosphate equivalent to 245 mg tenofovir disoproxil. The tablets are blue, oval, biconvex, marked with “T1” on one side, and approximately 16.7 × 9.3 mm in size.
Active ingredient
The active substance is tenofovir disoproxil. Each film-coated tablet contains tenofovir disoproxil phosphate equivalent to 245 mg tenofovir disoproxil.
Inactive ingredients (excipients)
The other ingredients are:
- Tablet core: Microcrystalline cellulose, croscarmellose sodium, stearic acid, lactose monohydrate
- Film coating: Hypromellose (E464), titanium dioxide (E171), triacetin, indigo carmine aluminium lake (E132)
Appearance and packaging
Tenofovir Disoproxil Glenmark 245 mg tablets are blue, oval, biconvex film-coated tablets marked with “T1” on one side, with no marking on the other side. They measure approximately 16.7 × 9.3 mm.
The tablets are supplied in white plastic bottles. Each bottle contains two desiccant sachets with silica gel (do not swallow). Available pack sizes include outer cartons containing 1 bottle of 30 tablets or 3 bottles of 30 tablets each. Not all pack sizes may be marketed in your country.
Marketing authorisation holder: Glenmark Arzneimittel GmbH, Industriestr. 31, 82194 Gröbenzell, Germany.
Manufacturers: Glenmark Pharmaceuticals s.r.o., Czech Republic; Pharmadox Healthcare Ltd, Malta.
Frequently Asked Questions About Tenofovir Disoproxil Glenmark
Medical References and Sources
This article is based on current medical research, regulatory information, and international guidelines. All claims are supported by scientific evidence from peer-reviewed sources.
- European Medicines Agency (EMA). "Tenofovir disoproxil – Summary of Product Characteristics." EMA product information. Official EU regulatory information for tenofovir disoproxil products.
- World Health Organization (WHO) (2024). "Consolidated Guidelines on HIV Prevention, Testing, Treatment, Service Delivery and Monitoring." International guidelines for HIV treatment including tenofovir-based regimens.
- European AIDS Clinical Society (EACS) (2024). "EACS Guidelines, Version 12.0." European guidelines for clinical management of HIV-positive persons.
- European Association for the Study of the Liver (EASL) (2024). "Clinical Practice Guidelines on the Management of Hepatitis B Virus Infection." Journal of Hepatology. Evidence-based guidelines for hepatitis B treatment including tenofovir disoproxil.
- U.S. Food and Drug Administration (FDA). "Viread (tenofovir disoproxil fumarate) – Prescribing Information." FDA-approved prescribing information for the reference product.
- Marcellin P, et al. (2008). "Tenofovir Disoproxil Fumarate versus Adefovir Dipivoxil for Chronic Hepatitis B." New England Journal of Medicine. 359(23):2442-55. Landmark randomised controlled trial demonstrating superiority of tenofovir over adefovir in chronic HBV.
Evidence grading: This article uses the GRADE framework (Grading of Recommendations Assessment, Development and Evaluation) for evidence-based medicine. Content is aligned with WHO, EMA, and FDA regulatory standards.
iMedic Editorial Standards
Peer Review Process
All medical content is reviewed by at least two licensed specialist physicians before publication.
Fact-Checking
All medical claims are verified against peer-reviewed sources and international guidelines.
Update Frequency
Content is reviewed and updated at least every 12 months or when new research emerges.
Corrections Policy
Any errors are corrected immediately with transparent changelog.
Medical Editorial Board: iMedic has an independent medical editorial board consisting of specialist physicians in infectious disease, virology, hepatology, and clinical pharmacology.