Hepbest tablets are required to prevent for HIV-1 infections, now it is also indicated in the condition like hepatitis B viral infection Tenofovir Alafenamide is an active most predominant component which is present in Hepbest tablet. An ideal activity of Hepbest tablet is; Anti-HIV or Anti-retroviral activity Anti-hepaciviral activity Hepbest is not a curable medicine; it may prevent transmission of virus to others and reduce the exposure
Hepbest tablets are used for
Hepbest tablet are majorly indicated in the conditions like; Now-a-days Hepbest is used to treat chronic hepatitis B viral infection in adolescent patients with compensated (child Pugh A) liver disease.
Hepbest strength availability
Hepbest is available in the form of tablet containing 25mg of tenofovir Alafenamide as an active ingredient
Hepbest tablet consist as tenofovir Alafenamide, which is prodrug converted in in-vivo as an active form. Tenofovir Alafenamide is lipophilic in nature has cell penetrable effect, which permeates into liver cells by passive diffusion method.
After that, TAF is altered into tenofovir by undergoing hydrolysis with the help of carboxylesterase-1 which is present in liver cells.
Tenofovir is phosphorylated into tenofovir diphosphate intracellularly using cellular kinase enzyme. The pharmacologically active metabolite tenofovir diphosphate is expels anti-hepaciviral activity by obstructing hepatitis B viral multiplication through infusion of this metabolite by reverse transcriptase enzyme into viral DNA
The absorption of Hepbest tablet is occurs rapidly, the peak plasma time occurs in 0.48 hours
The effect of Hepbest with food (high fat meal) is occurs as 1.65 (0.51, 1.81) compared to fasted state.
The human plasma protein bound to Hepbest tablet is occurs nearly at 80% The blood to plasma ration of Hepbest tablet is attains at 1.0
Hepbest tablet is metabolized into active form by carboxylesterase-1, cathepsin A (PBMC’s) The major route of elimination of tenofovir Alafenamide metabolites occurs through urine <1%; feces 31.7% The terminal half life period of Hepbest tablet is reaches in 0.51 hours
Before starting the therapy
Hepbest has some serious life-threatening conditions, to control this problems patient should be counsel about the exposure of risk associated with Hepbest therapy
Before initiating the therapy with Hepbest tablets, patient must be investigating by measuring the count of HBV antigen & HBV core anti-body Examine the patients for HIV-1 infection, if test is positive Hepbest should not be used alone, combined with other anti-retroviral medicines The recommended dosage of Hepbest tablet is 25mg of tablet should be taken as a single dose with food Hepbest is used as single dose therapy In renal and hepatic impairment patients, dosage adjustment is not suggested In decompensated cirrhosis condition, Hepbest is not recommended
If over dosage occurred in the patients who are receiving Hepbest , should be observed for affirmation of toxicity and monitor the symptoms occur. The other route to control the over dose of tenofovir is hemodialysis, used to eradicate the tenofovir content from the body by separating at the range of 54%
Serious adverse effects
Risk of severe acute worsening of hepatitis B viral infection Aggression of renal impairment Lactic acidosis or hepatomegaly with steatosis
Common side effects
Headache, Fatigue, Abdominal pain, Nausea, Back pain, Cough, Glycosuria, Pancreatitis, Amylase and lipase elevation
Hepbest tablet should be used carefully in the conditions like
Kidney related problems, HIV infected patients (used in combination with anti-retroviral drugs), Hepatic problems, Bone problems, Pancreatitis In severe acute aggravation of HBV infection, to avoid this problem patients should be monitored frequently with their clinical rating and symptoms before going to start the treatment
Exposure of development of HIV resistance in patients who are having HIV-1/HBV co infection
To prevent this condition patients should be investigate by measuring antibody counting New outbreak or aggravation of renal problems, to control these problems avoid concomitant of drugs depleting the renal functions with Hepbest tablets or monitored the laboratory levels periodically Lactic acidosis or hepatomegaly with steatosis, treatment should be discontinued
Limitations involved in Hepbest tablet
The major drawback of Hepbest tablets are followed as; After discontinuation of treatment, serious conditions like hepatomegaly with steatosis or lactic acidosis occurs Severe aggravation of acute hepatitis B infection