HEPBEST drug 25mg treat chronic hepatitis B virus infection (30 tablets)

Dosage form Box of 30 tablets
Specifications Tenofovir alafenamide

Ingredient

Composition information	Content
Tenofovir alafenamide	25mg

Uses

indications

HEPBEST 25 mg is indicated in the following case:

Tenofovir Alafenamide is indicated for the treatment of chronic hepatitis B virus in patients with compensation. Tenofovir Alafenamide is a fat -loving cell that goes into liver cells by passive diffusion and thanks to the absorption agents in OATP1B1 and OATP1B3 liver.

Tenofovir Alafenamide is then converted into Tenofovir through hydrolyzed mainly by the 1 (CES1) enzyme (CES1) in primary liver cells. The intracellular tenofovir is then phosphorylation chemical by cell kinase into metabolic substances with pharmacological activity is Tenofovir Diphosphate. Tenofovir Diphosphate inhibits HBV's copy through a combination of DNA of the virus by HBV's reverse copy enamel, leading to the end of the virus DNA chain.

Tenofovir Diphosphate is a weak inhibitor of DNA polymerases of mammals, including mitochondrial polymerase DNA and there is no evidence of toxicity for mitochondria in cell culture.

pharmacokinetics

absorption - distribution

The drug reaches the peak concentration after 0.48 hours. The drug is attached to plasma proteins about 80%.

Metabolism

Maximum metabolic drugs through CES 1 of liver cells, protease cathepsin A (PBMCS) and less metabolic through the CYP3A enzyme system.

Elimination

The sale time of the drug is 0.51 hours. Less than 1% of the drug is eliminated through urine and 31.7% excreted in feces.

Before taking HEPBEST drug 25mg treat chronic hepatitis B virus infection (30 tablets)

How to use

Take the tablet with water, should take medicine during meals.

Dosage

Before starting treatment with Tenofovir Alafenamide, it is advisable to determine if the patient is infected with HIV - 1. Unit alone alafenamide should not be used for HIV -infected patients - 1.

Should test serum, blood phosphorus, creatinine clearance, urinary glucose, proteinuria before and during treatment with tenofovir alafenamide.

recommended dose is 1 tablet of 25 mg, 1 time/day, taken or not accompanied by food.

No dose adjustment in the elderly over 65 years old.

No dose adjustment in patients with mild and medium renal failure. It is not recommended to use drugs for patients with end -stage renal impairment (CLCR

No dose adjustments in patients with mild liver failure (Child - PUGH A). The drug is not recommended for patients with loss of cirrhosis (Child - Pugh B, C).

The effectiveness and safety of drugs have not been studied in children under 18 years old.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What do

do when overdose? General support measures include monitoring of survival signs as well as the patient's clinical status. Tenofovir can be effectively eliminated by hemolysis with approximately 54%.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Do not drink twice as prescribed.

Side Effects

When using HEPBEST 25 mg, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Nervous system: headache.

Digestive system: Nausea, vomiting, diarrhea, abdominal pain, flatulence. all body: tired.

DA: rash.

Muscle muscle: back pain.

liver: Liver enzyme (ALT, AST).

Blood lipid disorders: increased LDL - Cholesterol.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

HEPBEST 25 mg is contraindicated in the following cases:

Hypersensitivity to the ingredients of the drug.

Be cautious when used

There have been reports on lactic acidosis and serious liver enlargement with fatty, some deaths when using similar substances nucleoside (Tenofovir disoproxil fumarate ...) in combination with antiviral drugs. Most of this case is in women. Prolonged nucleoside obesity and exposure are risk factors.

Be careful when using nucleoside similar substances, especially in patients with risk factors for liver disease. Condensing Tenofovir Alafenamide in patients with clinical signs or tests that suggest lactic acidosis or obvious liver poisoning (may include large liver and fattyness even without increasing transaminase).

Discontinuation of anti -hepatitis B treatment can lead to serious acute hepatitis B. After stopping Tenofovir Alafenamide, patients should be carefully monitored for clinical signs and tests regularly for at least a few months. If necessary, it is necessary to continue treating hepatitis b.

Due to the risk of HIV -1 resistance development, it is not recommended to use a single -tenofenamide tenofenamide in patients with HIV -1 infection.

Renal failure (including acute renal failure and fanconi syndrome - Kidney lesions with severe hypotension) have been reported when using Tenofovir In Vivo and in human testing. Clinically, Tenofovir Alafenamide does not cause these unwanted effects.

In patients using Tenofovir Pharmacy and other kidney poison (NSAIDs ...) increases the risk of renal function.

Should test serum, blood phosphorus, creatinine clearance, urinary glucose, proteinuria before and during treatment with tenofovir alafenamide.

The ability to drive and operate machinery

No report.

Pregnancy

There is no adequate data on pregnant women. In Vivo, there is no adverse effect on the development of the fetal organs when using the recommended doses of Tenofovir Alafenamide for a long time (up to 51 times). There is no impact on the fetus in mice and rabbits when using the daily dose Tenofovir Alafenamide.

The period of breastfeeding

unknown tenofovir alafenamide and its metabolites can be through breast milk, whether it affects the production of milk in humans or the effect of breastfed babies. However, there was a drug that was excreted through mouse milk and monkeys.

Drug interaction

Tenofovir Alafenamide is the substrate of P - Glycoprotein (P - GP) and BCRP. The induction drugs of P - GP work reduce the absorption and reduce the concentration of Tenofovir Alafenamide in the blood, affecting the effectiveness of treatment. Active inhibitors P - GP and BCRP increases the concentration of Tenofovir Alafenamide in the blood, increasing toxicity.

Tenofovir is excreted mainly through the kidneys (through glomerular filtration and positive excretion in the renal tubules). Used in combination with drugs that reduce the activity of the kidneys or the positive excretion competition in the renal tubules (Acyclovir, Cidofovir, Ganciclovir, Valacyclovir, Valganciclovir, Aminoglycoside, high doses of NSAIDs ...) can increase the level of tenofovir in blood, leading to increased toxicity.

Carbamazepine (carbamazepine, oxcarbazepine, phenobarbital, phenytoin), anti -tuberculosis (rifabutin, rifampin), St. John’s World reduces the concentration of Tenofovir Alafenamide in the blood. Tenofovir alafenamide should be increased to 2 25 mg/day when combined with carbamazepine. The remaining coordinates are not recommended.

Do not use 25 mg hepbest with drugs containing Tenofovir Alafenamide, Tenofovir Disoproxil Fumarate, Adenovir Dipivoxil.

Storage

Store drugs at temperatures below 30 ° C.

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