Medication · nrti

Supplements and Tenofovir alafenamide.

Not yet catalogued in the Distil interactions database. We surface that distinction explicitly.

Tenofovir alafenamide, sold under the brand name Vemlidy, is a nucleoside reverse transcriptase inhibitor (NRTI): it terminates the growing viral DNA chain. NRTIs are cleared renally or by glucuronidation rather than by cytochrome P450.

Tenofovir alafenamide is a nucleoside reverse transcriptase inhibitor (NRTI). The class terminates the growing viral DNA chain and forms the backbone that an integrase inhibitor or an NNRTI is built on, so almost nobody takes one on its own. ⚠️ The supplement rules for this class are inherited rather than intrinsic, and it is worth being precise about why. Unlike the protease inhibitors and the NNRTIs, NRTIs are not cleared by cytochrome P450 at all: tenofovir disoproxil, emtricitabine and lamivudine are eliminated renally, largely unchanged, and abacavir goes through alcohol dehydrogenase and glucuronidation. A supplement that inhibits or induces CYP3A4 therefore has no route to the NRTI itself. What it does have a route to is the partner drug sitting in the same tablet or the same regimen, and that partner is what the exclusions protect. So curcumin, quercetin, resveratrol, schisandra, berberine, boswellia, bergamot and St John's Wort are excluded here on the strength of the regimen rather than of this molecule. The one genuine class-level signal is tenofovir alafenamide, which is a P-glycoprotein substrate, and St John's Wort lowers it by inducing P-glycoprotein rather than CYP3A4. Immune-active herbs (echinacea, andrographis, elderberry, cordyceps, astragalus) are excluded as a precaution on antiretroviral therapy regardless of CD4 count. The HIV team signs off any new supplement rather than community pharmacy.

We have not yet completed an explicit assessment of supplement interactions with Tenofovir alafenamide in the Distil database. That is different from saying nothing exists. We surface this distinction deliberately: the Distil checker tells you when we have explicitly assessed a pair and when we have not, because both are useful information. If you take Tenofovir alafenamide alongside a supplement, the checker below will surface anything already in our database, and the missing-item form at the bottom of the page routes uncatalogued pairs into our next curation pass.

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP or pharmacist, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.

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The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.

what your diet already covers, so you are not adding a capsule for something food is already handling
which evidence-graded compounds are worth considering for your goals, and which were considered but left out
what to keep, change or stop from what you already take, plus the order to introduce anything new
how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment

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Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.