I have been experiencing yellowing skin and eyes, the eyes are barely noticeable, but the skin is definitely not in its normal skin tone. I recently got result from my gastro and they were normal ok for the AST and ALT, however bilirubin total was at 1.5 which was high. Did a CAT scan and my liver appears normal with no inflammation present. There is however after the CAT scan they noticed a thickness in my stomach lining, which upon getting an endoscopy, gastritis was found. Had H. Pylori, but that has already cleared with treatment. I still have food sensitivities to yeast and sugar though and breaking out in rashes on face and scalp when i ingest such foods.
I am on Viread and my viral load is low at detectable below 20.
What could the issue be? Could it be the gastritis causing the problem for the liver? Im on famotidine for my gastritis. Could this be causing the mild jaundice?PLEASE HELP!!
you might have an allergy to medication.. When I was on ETV 1mg daily, I had those rashes appear sometimes with after stress.
Did they check you for Candida? That could also cause rashes.
Whatever they have noticed in your stomach during endoscopy they could have biopsied as well.
I am here is the deal.. If they cannot locate anything by blood, and think this is do an infection have them do WBC Indium scan.. That will find a hot spot. You may have a not completely resolved H. Pylori still. That stuff is tough to treat. You may need to continue treatment..
Also have then check you for allergy.. And if you can stop Viread for one week see if rashes go away, if they do then you can reduce the dose or take half a tablet. That is what some people do. Or take it every other day...
I am looking for articles that support TDF every other day or half dose. Can you provide links? As TDF was an HIV drug, they didn't really test dosing for HBV and just assumed same dose is fine. I believe that a lower dose may be just as effective, but I'd like to see if anyone has published on this.
I am not a doctor. Generally, as with antibiotics, reducing dosage or changing dosing interval should not be undertaken without consulting your doctor, as it may reduce efficacy and also may also increase the risk of drug resistance.
Please note Tenofovir is principally cleared through the kidney and dosing adjustments due to renal impairment have not been clinically tested.
The followings are extracts from the label information for Tenofovir:
2.3 Dose Adjustment for Renal Impairment in Adults
Significantly increased drug exposures occurred when VIREAD was administered to subjects with moderate to severe renal impairment [See Clinical Pharmacology (12.3)]. Therefore, the dosing interval of VIREAD tablets 300 mg should be adjusted in patients with baseline creatinine clearance below 50 mL/min using the recommendations in Table 3. These dosing interval recommendations are based on modeling of single-dose pharmacokinetic data in non-HIV and non-HBV infected subjects with varying degrees of renal impairment, including end-stage renal disease requiring hemodialysis. The safety and effectiveness of these dosing interval adjustment recommendations have not been clinically evaluated in patients with moderate or severe renal impairment, therefore
clinical response to treatment and renal function should be closely monitored in these patients [See Warnings and Precautions (5.3)]. There are no data to recommend use of VIREAD tablets 150, 200 or 250 mg or VIREAD oral powder in patients with renal impairment.
No dose adjustment of VIREAD tablets 300 mg is necessary for patients with mild renal impairment (creatinine clearance 50–80 mL/min). Routine monitoring of calculated creatinine clearance and serum phosphorus should be performed in patients with mild renal impairment [See Warnings and Precautions (5.3)].
5.3 New Onset or Worsening Renal Impairment
Tenofovir is principally eliminated by the kidney. Renal impairment, including cases of acute renal failure and Fanconi syndrome (renal tubular injury with severe hypophosphatemia), has been reported with the use of VIREAD [See Adverse Reactions (6.2)].
It is recommended that creatinine clearance be calculated in all patients prior to initiating therapy and as clinically appropriate during therapy with VIREAD. Routine monitoring of calculated creatinine clearance and serum phosphorus should be performed in patients at risk for renal impairment, including patients who have previously experienced renal events while receiving HEPSERA®.
Dosing interval adjustment of VIREAD and close monitoring of renal function are recommended in all patients with creatinine clearance below 50 mL/min [See Dosage and Administration (2.3)]. No safety or efficacy data are available in patients with renal impairment who received VIREAD using these dosing guidelines, so the potential benefit of VIREAD therapy should be assessed against the potential risk of renal toxicity.
VIREAD should be avoided with concurrent or recent use of a nephrotoxic agent.
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