Can't Find Tenofovir Disoproxil? Here Are Your Alternatives

If your pharmacy can't fill your Tenofovir Disoproxil prescription, you may be wondering: what are my options? Whether you take it for HIV treatment, HIV prevention (PrEP), or chronic hepatitis B, there are several alternative medications that work in similar ways.

Important: Never switch medications on your own. Always talk to your doctor before changing your treatment. This article is for informational purposes to help you have an informed conversation with your healthcare provider.

What Is Tenofovir Disoproxil and How Does It Work?

Tenofovir Disoproxil Fumarate (brand name Viread) belongs to a class of drugs called nucleotide reverse transcriptase inhibitors (NtRTIs). It's a prodrug — meaning your body converts it into its active form, tenofovir, after you take it.

Once active, tenofovir works by:

1. Entering cells infected with HIV or hepatitis B
2. Getting converted into tenofovir diphosphate
3. Blocking the virus's reverse transcriptase enzyme, which the virus needs to copy its genetic material
4. Stopping the virus from making new copies of itself

This mechanism makes Tenofovir Disoproxil effective against both HIV-1 and hepatitis B virus (HBV). For a detailed breakdown, see: How Does Tenofovir Disoproxil Work? Mechanism of Action Explained.

Alternative 1: Tenofovir Alafenamide (TAF)

Brand names: Vemlidy (for hepatitis B), also found in Descovy, Biktarvy, Genvoya, and Odefsey

Tenofovir Alafenamide is the closest alternative to Tenofovir Disoproxil. It's a newer prodrug of the same active compound (tenofovir) but is designed to deliver the drug more efficiently to cells, which means:

• Lower doses needed — TAF is given at 25 mg vs. 300 mg for TDF
• Less kidney toxicity — lower drug levels in the blood mean less stress on the kidneys
• Less bone density loss — studies show TAF causes fewer decreases in bone mineral density

Who it's for: TAF can replace Tenofovir Disoproxil for most patients with HIV or hepatitis B. For PrEP, Descovy (emtricitabine/TAF) is approved for at-risk adults, though it is not approved for PrEP in people assigned female at birth who have receptive vaginal sex — in that case, Tenofovir Disoproxil-based PrEP remains the standard.

Cost: Brand-name TAF products tend to be more expensive than generic Tenofovir Disoproxil. Descovy can cost $1,800+ per month without insurance, though manufacturer copay cards and patient assistance programs can reduce costs significantly.

Alternative 2: Entecavir (Baraclude)

For: Chronic hepatitis B only (not effective against HIV)

Entecavir is a nucleoside analog that's been a first-line treatment for hepatitis B for many years. It works similarly to Tenofovir Disoproxil by blocking the HBV polymerase enzyme.

• Highly effective at suppressing HBV viral load
• Well-tolerated with a favorable side effect profile
• Available as generic — typically costs $30–$80 per month with a discount card

Important note: Entecavir should not be used as a standalone treatment in patients co-infected with HIV and HBV, as it can promote HIV resistance. If you have both conditions, talk to your infectious disease specialist.

Alternative 3: Emtricitabine/Tenofovir Disoproxil (Truvada)

For: HIV treatment (in combination) and PrEP

If you're taking standalone Tenofovir Disoproxil for HIV, your doctor may recommend switching to the combination pill Truvada (or its generic equivalent), which contains both emtricitabine and Tenofovir Disoproxil Fumarate in one tablet.

• Convenient — combines two drugs in one pill
• Widely available as generic — often easier to find than standalone Tenofovir Disoproxil
• Affordable — generic Truvada costs approximately $30–$60 per month with discount cards

Generic emtricitabine/tenofovir disoproxil fumarate is one of the most commonly dispensed PrEP medications in the U.S. and may actually be easier to locate than standalone Tenofovir Disoproxil.

Alternative 4: Abacavir (Ziagen)

For: HIV treatment only

Abacavir is another nucleoside reverse transcriptase inhibitor (NRTI) used in HIV treatment. It's often given as part of combination therapy.

• Effective as part of multi-drug HIV regimens
• Available as generic
• Key consideration: Patients must be tested for the HLA-B*5701 allele before starting abacavir. Those who test positive are at high risk for a severe, potentially fatal hypersensitivity reaction and should not take this drug.

Abacavir is not used for PrEP or hepatitis B treatment.

How to Decide Which Alternative Is Right for You

The best alternative depends on several factors:

• Your diagnosis — HIV, hepatitis B, or both?
• Your kidney function — TAF may be preferred if you have kidney concerns
• Your bone health — TAF causes less bone density loss
• Cost and insurance — generic Tenofovir Disoproxil and Entecavir are the most affordable options
• Drug interactions — some alternatives interact differently with your other medications

Your doctor will consider all of these when recommending a switch. For more on Tenofovir Disoproxil interactions, see: Tenofovir Disoproxil Drug Interactions: What to Avoid.

Final Thoughts

Not being able to fill your Tenofovir Disoproxil prescription is stressful, but you have options. Several effective alternatives exist for HIV treatment, PrEP, and hepatitis B. The most important thing is to not stop treatment on your own — talk to your healthcare provider about the best next step.

In the meantime, check Medfinder to see if Tenofovir Disoproxil is available at a pharmacy near you. You may also find our guide helpful: How to Find Tenofovir Disoproxil in Stock Near You.