Trade name : Hepbest
Active ingredient : Tenofovir Alafenamide
Strength : 25MG
Manufactured by : Mylan Pharmaceuticals
Pack : 28 tablets in a container
Category : Anti-hepaciviral & Anti-retroviral drug
Tenofovir Alafenamide is an anti-hepaciviral & anti-retroviral medicine. In HIV infected patients, Hepbest is not used alone and it may combine with some other anti-retroviral drugs like Emtricitabine, cobicistat, or darunavir. At first, Hepbest is belongs to anti-retroviral (nucleoside reverse transcriptase inhibitor), now Hepbest has anti-hepaciviral property which is used against hepatitis B viral infection
Prior usage of Hepbest tablet, used in HIV-1 infection Hepbest tablet is also indicated for the treatment of hepatitis B viral infection, by reducing the advancement of virus Hepbest used in chronic hepatitis B infection, is non-curable but it can able to prevent the viral transmission
The usual dosage of Hepbest tablet is, one tablet containing 25mg of Tenofovir Alafenamide should be taken as a single dose Hepbest tablet should be administered with food In creatinine clearance range <15ml/min, Hepbest is not recommended In decompensated cirrhosis: Hepbest should not be recommended Before initiating the therapy: Patients should examine HIV-1 infection for recommending combination of other anti-retroviral drugs in HIV-1 positive patients.
Hepbest-Tenofovir Alafenamide (TAF) TAF is a prodrug of tenofovir (parent drug) At first, TAF is penetrating into hepatic cells because it has lipophilic cell permeable capacity. After enters into the cells, TAF undergoes hydrolysis by using carboxylesterase-1 and to formed as tenofovir. Tenofovir involved in intracellular metabolism, which is phosphorylated into tenofovir triphosphate. Tenofovir triphosphate is considered as an active metabolite which has anti-viral property and integrated into viral DNA by hepatitis B reverse transcriptase enzyme and leads to inhibits viral production thus results as termination of viral chain.
How the body works for Hepbest tablets
After an oral administration, absorption of Hepbest tablet occurs rapidly. The peak plasma time occurs within 0.48 hours The effect of food while taking Hepbest tablet is includes as; With high fat meal, the effect of Tenofovir Alafenamide is 1.65 Hepbest is highly bound to human plasma protein nearly 80% The blood plasma ration is 1.0 Metabolism of Tenofovir Alafenamide is occurs with the aid of cathepsin A, carboxylesterase-1 The half life period of Tenofovir Alafenamide is 0.51 hour Excretion occurs through urine <1%; feces 31.7%
WARNING & PRECAUTION
1. After cessation of anti-hepatitis B therapy by using with Hepbest tablet, concluded in serious intense aggravation of hepatitis B infection.
To avoid this adverse condition in the patients, liver function should be observed frequently.
2. Exposure of reinforcement of HIV-1 antagonism in HBV/HIV-1 co infected patients In HIV infected patients, combinational therapy is suggested for avoiding this condition in co-infected patients. Check the HIV antibody in all HBV infected patients before starting the therapy.
3. New commencement and worsening of renal damage Patient with low renal function capability, stop the Hepbest tablet therapy immediately and monitored the serum phosphorus, serum creatinine, urine protein, urine glucose and creatinine clearance frequently
4. Lactic acidosis or serious hepatomegaly with steatosis If this condition occurred in the patients, immediately discontinue the therapy and provide safety measures
Hepbest combined with P-gp or BCRP strong inhibitors, results as alteration of absorption of Tenofovir Alafenamide P-gp or BCRP inducers, combined with Hepbest tablets leads to cause loss of therapeutic effect of Hepbest Hepbest with P-gp or BCRP moderate inhibitors results as absorption elevation thus causes plasma concentration of Tenofovir Alafenamide Hepbest tablets combined with anti-convulsants (phenytoin, carbamazepine, or Phenobarbital), anti-mycobacterials (rifampin, rifapentine, or rifabutin) or herbal products (st Johns wort) causes depletion in effect of concentration of Hepbest
In over dosage condition, two steps follows :
1. Examine the deposition of toxicity and symptoms occurred due to over dosage
2. Hemodialysis, a method involved in eradicating the over dosage of Hepbest with separation coefficient of 54%
Once missed dose occurred, patient must consult with medical practitioner and follow the instruction. On another way, missed dose should be skipped and proceed from regular dosing schedule.
Important adverse effects;
Lactic acidosis or severe hepatomegaly with steatosis
Reactivation of hepatitis B viral infection in worsening condition after the therapy
Renal damage occurs
Some of undesirable effects;
Reduction in bone mineral density
Creatine kinase elevation
Amylase lipase elevated.