TAF renal dosing

[mwpharm]

I have learnt that Vemlidy (tenofovir alafenamide) does not need renal dosage adjustment.

Did anyone see in their practice that doctor prescribe TAF 1 tab alternative day?

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[rxkrafted]

I haven't seen this drug yet but are you saying the doctor is prescribing 1 tab to be taken every other day? Is the patient on a dialysis schedule?

 

[bacillus1]

Per Lexi:

CrCl ≥15 mL/minute: No dosage adjustment necessary.

CrCl <15 mL/minute: Use is not recommended.

ESRD requiring hemodialysis: No dosage adjustment necessary; administer postdialysis on hemodialysis days.

The only dose reduction I could find is as follows (from UptoDate):
"When TAF is combined within a pharmacokinetic boosting agent (eg, cobicistat or ritonavir) as in EVG/c/FTC/TAF, the reduced dose of 10 mg is used. When TAF is not given with a pharmacokinetic booster, as in RPV/FTC/TAF and BIC/FTC/TAF, the dose is 25 mg. Pharmacologic boosting agents (eg, cobicistat, ritonavir) inhibit intestinal P-glycoprotein, thereby increasing TAF bioavailability and tenofovir plasma concentrations; the reduced TAF dose of 10 mg is used to manage this interaction. The long-term safety of TAF at the 25 mg dose given with a pharmacokinetic booster has not been established."

Still, every other day is incorrect.

 

[TimeZero]

If the prescriber does not specialize in ID/HIV, you may want to verify that it is not being confused with the other tenofovir salt, which does require renal dosage adjustment.

 

[bacillus1]

If the prescriber does not specialize in ID/HIV, you may want to verify that it is not being confused with the other tenofovir salt, which does require renal dosage adjustment.

Even if they do specialize, you should check. I've called ID out on dosing before multiple times.