Post-marketing experience proviron hair loss metabolic disorders and nutrition: rarely – lactic acidosis, the frequency is unknown – hypokalaemia Respiratory, thoracic and mediastinal disorders: very rarely – dyspnea.
On the part of the gastrointestinal tract: rarely – pancreatitis.
On the part of the hepatobiliary system: rarely – increased transaminases ; very rarely – hepatitis, the frequency is unknown – hepatic steatosis.
Skin and subcutaneous tissue disorders: rarely – rash. From the musculoskeletal system: the frequency is unknown – rhabdomyolysis, osteomalacia, muscle weakness, myopathy.
From the urinary system: rarely – acute renal failure, proximal renal tubulopathy (including Fanconi syndrome), hypercreatininemia; very rarely – acute tubular necrosis; the frequency is unknown – nephritis (including acute interstitial), nephrogenic diabetes insipidus.
General disorders and changes at the injection site: very rarely – fatigue.
In case of overdose, the patient should be examined for possible signs of intoxication. If necessary, use a standard maintenance therapy.
Tenofovir is efficiently removed by hemodialysis with an extraction coefficient of approximately 54%. After receiving 300 mg of tenofovir, 4-hour hemodialysis procedure results in the removal of approximately 10% of the dose of tenofovir.
Didanosine: an proviron hair loss increase in didanosine concentrations when used together; they must be used with caution and monitor manifestations of didanosine toxicity (eg, pancreatitis, neuropathy). The combination of tenofovir with didanosine is not recommended; if it is justified, it is necessary to consider dose reduction or discontinuation of didanosine therapy. Tenofovir combined with reduced-dose didanosine . On the other hand, such a low-dose proviron 25mg combination may be characterized by a low antiviral activity and lack of increase amounts lymphocytes, as indicated by the high incidence of treatment failure in the application of this combination with the addition of efavirenz or nevirapine
Atazanavir: reduction of atazanavir concentrations when used together and increasing concentrations. Be used only with atazanavir with an additional gain of the last ritonavir.
Lopinavir / ritonavir: increase tenofovir concentrations when used together.
Darunavir: increases tenofovir concentrations of 20-25%. The drugs should be used at standard doses, and the need to carefully monitor the nephrotoxic effects of tenofovir. Proviron hair loss is primarily excreted through the kidneys, the combined use of tenofovir with drugs that reduce renal function or reduce / stop active tubular secretion may increase serum concentrations of tenofovir and / or increase the concentration of other medications, displayed through the kidneys. Ganciclovir, valganciclovir, and cidofovir compete with tenofovir for active tubular secretion by the kidneys, resulting in increased levels of tenofovir, or at the same time used the drug; It requires vigilance against potential side effects. Nephrotoxic drugs can also increase the concentration of tenofovir in the blood serum.
Have been reported cases of lactic acidosis and severe hepatomegaly with steatosis, including fatal outcomes, with the use of nucleoside analogues.
First arose or progressive renal insufficiency may lead to acute renal failure and Fanconi syndrome. It is necessary to define creatinine clearance before starting treatment with tenofovir. Necessary to control serum phosphorus and creatinine clearance in patients with an increased risk of developing or progression of renal failure. It is necessary to avoid the use of tenofovir concurrently or after the recent treatment of nephrotoxic drugs.
It is necessary to exclude the application of tenofovir combined simultaneously with antiviral drugs, which are included in the tenofovir (such as Truvada, Atripla) and adefovir depivoksil. Tenofovir should be used only as part of an appropriate antiretroviral combination therapy in infected patients.
Density Decreased bone observed in HIV-infected patients. It is necessary to carry out the control of bone density in patients with pathological fracture history, as well as in patients with an increased risk of osteopenia. Redistribution / accumulation of body fat observed in HIV-infected patients receiving combination antiretroviral therapy. Immune reconstitution syndrome was observed in patients. It may necessitate further evaluation and treatment.
When using Tenofovir may develop a Fanconi syndrome accompanied by hypophosphatemia, hypouricemia, proteinuria, normoglycemic glycosuria; in some cases, acute renal failure may develop. In the early stages of the flow may be asymptomatic or accompanied by myalgia; in most cases, the symptoms disappear when you stop taking the drug. Risk factors include low body weight, and the presence of renal disease at the start of therapy. The incidence of nephrotoxic side effects is very low in patients with normal renal function.
Sensitivity is reduced in patients with three or more mutations of resistance to thymidine analogues, including Sensitivity is retained for other combinations of mutations and thymidine increased in the presence of proviron hair loss mutation.