Leitura clínica
Comentário
O tenofovir dissoproxil fumarato (TDF) e o fumarato de alafenamida de tenofovir são profármacos do Tenofovir. É um inibidor de transcriptase reversa análogo de nucleotídeo (ITIN) com atividade antiviral contra o vírus da imunodeficiência humana (HIV-1) e o vírus da Hepatite B (VHB). Indicado no tratamento da infecção por HIV, da AIDS e da hepatite B crônica e na profilaxia pré-exposição HIV. Administração oral uma vez ao dia durante meses ou anos. Autorizado em HIV a partir dos dois anos e fora de bula em menores de 2 anos. É excretada no leite materno em quantidade clinicamente insignificante. (Pak 2024, Li 2023, Kayes 2022, Aebi 2022, Yang 2021, Li 2021, Bojun 2020, Erturk 2019, Bierhoff 2019, Mugwanya 2016, Palombi 2016, Benaboud 2011) Não foram observados problemas em bebês cujas mães a tomam (Li 2023, Kapito 2021, Wang 2019, Marcellin 2016, Ganne 2013, Gouraud 2012, Pan 2012), salvo algum caso de diarreia leve. (Mugwanya 2016) Não houve tampouco afetação dos marcadores de mineralização óssea (Floridia 2016 y 2016) nem dos índices de crescimento aos 6 e 12 meses. (Liotta 2016) Os níveis de tenofovir em plasma ou urina de ditos bebês foram indetectáveis ou muito baixos. (Pak 2024, Kayes 2022, Aebi 2022, Erturk 2021 y 2019, Waitt 2017 y 2018, Mugwanya 2016, Palombi 2016, Gouraud 2012) A profilaxia prévia à exposição (PPE) com tenofovir é aceitável para seu uso em mães que amamentam HIV negativas (Hodges 2019). Após a administração em forma de gel intravaginal, as concentrações em plasma e leite maternos e em plasma do bebê foram indetectáveis ou muito baixas e os efeitos secundários nos bebês leves ou inexistentes. (Noguchi 2016) Diversas sociedades médicas e consensos de especialistas consideram seguro o uso desta medicação durante a amamentação. (Pak 2024, Panel 2024, Li 2023, Hu 2019, Wong 2018, Mugwanya 2017, EASL 2017, Seidman 2017, Mofenson 2017, Terrault 2016, UNICEF 2016) Pode consultar abaixo a informação destes produtos relacionados: Hepatite B materna (Produto seguro e/ou a amamentação é a melhor opção.) HIV-AIDS materno. Infecção materna por HIV (Bastante seguro. Efeitos adversos leves ou pouco prováveis. Compatível em determinadas circunstâncias. Acompanhamento recomendado. Leia o Comentário.)
Encontrabilidade
Outros nomes e marcas
Sinônimos e grafias 5
- Fumarato de alafenamida de tenofovir (TAF). Fumarato de disoproxilo de tenofovir (TDF)
- τενοφοβίρη
- нофовир Дизопроксил Фумарат
- テノホビル ジソプロキシルフマル酸塩
- J05AF07
Marcas comerciais na fonte 33
- Atripla
- Biktarvy
- Cimduo
- Complera
- Descovy
- Emtenef
- Eviplera
- Leuzan
- Lisotyr
- Mivuten
- Odefsey
- Padviram
- Previd
- Remivir
- Ricovir
- Simplir
- Symfi
- Symtuza
- Tefala
- Telavir
- Tenof
- Tenozet
- Tenriltab (Тенрилтаб)
- Trastiva
- Tribuss
- Trivenz
- Truvada
- Vemlidy
- Vidara
- Virakam
- Viread
- Viread (Виреад)
- Viread (韦瑞德)
Dados da fonte
Farmacocinética
| Variável | Valor | Unidade |
|---|---|---|
| Biodisp. oral | 25 - 40 | % |
| Peso Molecular | 636 | daltons |
| Unión proteínas | 7 | % |
| Vd | 1.2 ± 0.4 | l/Kg |
| pKa | 3,75 | - |
| Tmax | 1.0 ± 0.4 | horas |
| T½ | 12 - 18 | horas |
| Índice L/P | 0,02 - 0,08 | - |
| Dosis Teórica | 0,0004 – 0,003 | mg/Kg/d |
| Dosis Relativa | 0,01 – 0,06 | % |
| Dosis Rel. Ped. | 0,01 – 0,04 | % |
Rastreabilidade
Bibliografia
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