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Medicinal products that may affect tenofovir alafenamide: Tenofovir alafenamide is transported by P-gp and breast cancer resistance protein (BCRP). Medicinal products that are P-gp inducers (e.g., rifampicin, rifabutin, carbamazepine, phenobarbital or St. John's wort) are expected to decrease plasma concentrations of tenofovir alafenamide, which may lead to loss of therapeutic effect of Tenofovir alafenamide. Co-administration of such medicinal products with Tenofovir alafenamide is not recommended. Co-administration of Tenofovir alafenamide with medicinal products that inhibit P-gp and/or BCRP may increase plasma concentration of tenofovir alafenamide. Co-administration of strong inhibitors of P-gp with Tenofovir alafenamide is not recommended. Tenofovir alafenamide is a substrate of OATP1B1 and OATP1B3. The distribution of tenofovir alafenamide in the body may be affected by the activity of OATP1B1 and/or OATP1B3.
Effect of tenofovir alafenamide on other medicinal products: Tenofovir alafenamide is not an inhibitor of CYP1A2, CYP2B6, CYP2C8, CYP2C9, CYP2C19, or CYP2D6. It is not an inhibitor of CYP3A. Tenofovir alafenamide is not an inhibitor of human uridine diphosphate glucuronosyltransferase (UGT) 1A1. It is not known whether tenofovir alafenamide is an inhibitor of other UGT enzymes.
Drug interaction information for Tenofovir alafenamide with potential concomitant medicinal products is summarised in Table 2 as follows (increase is indicated as "↑", decrease as "↓", no change as "↔"; twice daily as "b.i.d.", single dose as "s.d.", once daily as "q.d."; and intravenously as "IV"). (See Tables 2A, 2B and 2C.)
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