Comprehensive medication guide to Vemlidy including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$50–$200+/month specialty tier copay for most commercial plans; many plans require prior authorization. Commercially insured patients enrolled in Gilead's Support Path Co-Pay Program typically pay $0, with up to $6,000/year in savings. Medicare Part D patients: Tier 5, subject to standard Part D cost-sharing; $2,000 annual OOP cap applies since 2025.
Estimated Cash Pricing
$1,500–$1,800 per month at retail for brand-name Vemlidy 25 mg (30-tablet supply); approximately $1,469 with GoodRx Gold. No US-marketed generic available as of early 2026.
Medfinder Findability Score
65/100
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Vemlidy (tenofovir alafenamide, or TAF) is a prescription antiviral medication manufactured by Gilead Sciences. It is FDA-approved to treat chronic hepatitis B virus (HBV) infection in adults and pediatric patients 6 years of age and older who weigh at least 25 kg (55 lbs) and have compensated liver disease. Vemlidy comes as a 25 mg oral tablet taken once daily with food.
Tenofovir alafenamide is also found as a component in several combination HIV medications (Biktarvy, Descovy, Genvoya, Symtuza) — but Vemlidy as a standalone drug is specifically approved only for hepatitis B treatment, not HIV.
Vemlidy is recommended as a preferred first-line treatment for chronic hepatitis B by the American Association for the Study of Liver Diseases (AASLD) and the European Association for the Study of the Liver (EASL). Eight-year clinical data show that 91–97% of patients maintained undetectable HBV DNA, with no resistance emerging.
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Vemlidy belongs to a drug class called nucleotide reverse transcriptase inhibitors (NtRTIs). It is a targeted prodrug of tenofovir — meaning it is inactive when swallowed and only activates once it enters liver cells (hepatocytes). This targeted delivery is what makes Vemlidy safer on kidneys and bones than its predecessor, tenofovir disoproxil fumarate (TDF).
Once inside a liver cell, the enzyme carboxylesterase 1 (CES1) converts TAF to tenofovir, which is then phosphorylated to tenofovir diphosphate (TFV-DP) — the active form. TFV-DP competes with natural building blocks of viral DNA and acts as a chain terminator, blocking the HBV reverse transcriptase enzyme and stopping the virus from replicating.
At 25 mg, TAF achieves equivalent antiviral efficacy to TDF at 300 mg — ten times the dose — with significantly lower blood concentrations of tenofovir. This results in less kidney and bone exposure, making Vemlidy the preferred tenofovir option for patients with renal or bone concerns.
25 mg — tablet
One tablet taken orally once daily with food. Same dose for adults and pediatric patients ≥6 years weighing ≥25 kg.
Vemlidy is not listed on the FDA Drug Shortage Database — there is no manufacturing or supply chain shortage. However, it is a specialty medication priced at $1,500–$1,800/month, which means most retail pharmacies do not keep it in stock. Patients are often surprised to find that major chain pharmacies either don't carry it or need to special-order it with a 3–5 day delay.
Specialty pharmacies (CVS Specialty, Walgreens Specialty, Accredo) reliably stock Vemlidy and are the recommended fill point for most patients. Mail-order through your insurance's specialty pharmacy network is also a highly reliable option for ongoing refills. 340B pricing is available at qualifying FQHCs and safety net hospitals.
If you're having trouble locating Vemlidy near you, medfinder calls pharmacies in your area to find which ones have it in stock and can fill your prescription — so you're not spending hours on hold.
Vemlidy is not a controlled substance and carries no special DEA prescribing requirements. Any licensed prescriber in the US can write a prescription for Vemlidy. However, because chronic hepatitis B requires ongoing monitoring and management, it is most appropriately prescribed by clinicians experienced in viral hepatitis.
Gastroenterologists — Most common prescribers; manage HBV as part of GI practice
Hepatologists — Liver disease specialists; preferred for complex or advanced liver disease
Infectious disease specialists — Especially for HBV/HIV coinfection management
Primary care physicians (PCPs) — Family medicine and internal medicine doctors with HBV experience
Pediatricians / pediatric gastroenterologists — For patients ages 6–17 receiving Vemlidy
Nurse practitioners (NPs) and physician assistants (PAs) — Can prescribe in most states, often managing stable HBV patients in specialty practices
Telehealth options are available for Vemlidy prescriptions. Because TAF is not a controlled substance, telehealth providers in most states can evaluate and prescribe Vemlidy — a valuable option for patients in rural areas or those who have difficulty accessing in-person specialist care.
No. Vemlidy (tenofovir alafenamide) is not a controlled substance and is not assigned a DEA schedule. It has no recognized abuse or dependence potential. There are no special controlled substance prescribing requirements — any licensed physician, nurse practitioner, or physician assistant can prescribe it.
Because Vemlidy is not a controlled substance, it can be prescribed via telehealth in most states without additional restrictions. The primary access barriers are insurance prior authorization requirements and specialty pharmacy routing — not controlled substance regulations.
Vemlidy is generally well-tolerated. The most common side effect reported in clinical trials (occurring in ≥10% of patients) is headache. Other common side effects include:
Headache
Nausea (reduced by taking with food, as required)
Fatigue
Cough
Abdominal pain
Diarrhea
Vemlidy carries FDA boxed warnings for:
Post-treatment severe acute exacerbation of hepatitis B — stopping Vemlidy abruptly can cause dangerous HBV rebound. Never stop without medical supervision.
Lactic acidosis and severe hepatomegaly with steatosis — rare but potentially fatal; seek immediate care for unexplained fatigue, muscle weakness, or breathing difficulty.
Renal impairment — including acute renal failure, proximal renal tubulopathy, and Fanconi syndrome; monitor kidney function regularly.
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Viread (tenofovir disoproxil fumarate / TDF)
Same active drug at 300 mg (10x higher dose); generic widely available at $30–$100/month; greater renal and bone effects; appropriate for patients without renal or bone concerns.
Baraclude (entecavir)
First-line alternative in a different drug class; generic available; no nephrotoxicity; must be taken on empty stomach; preferred when tenofovir is contraindicated.
Pegasys (pegylated interferon alfa-2a)
Injectable once-weekly immunomodulatory agent; 48-week finite treatment course; higher side effect burden; appropriate for selected patients under specialist guidance.
Epivir HBV (lamivudine)
Older oral antiviral; rarely used as first-line today due to high resistance rates (up to 70% at 5 years); very low cost; occasionally used in specific circumstances.
Prefer Vemlidy? We can find it.
Rifampin (Rifadin)
majorPotent P-gp/BCRP inducer; significantly reduces TAF levels and can cause treatment failure. Concurrent use not recommended.
Rifabutin / Rifapentine
majorP-gp/BCRP inducers similar to rifampin; concurrent use not recommended as they reduce Vemlidy levels.
Phenobarbital
majorPotent P-gp inducer (anticonvulsant); can significantly reduce TAF absorption. Concurrent use not recommended.
Phenytoin (Dilantin)
majorP-gp inducer (anticonvulsant); reduces TAF levels. Concurrent use not recommended.
Oxcarbazepine (Trileptal)
majorP-gp/BCRP inducer (anticonvulsant/mood stabilizer); reduces TAF levels. Concurrent use not recommended.
St. John's Wort
majorHerbal P-gp inducer; significantly reduces Vemlidy absorption. Do not use with Vemlidy.
Other tenofovir-containing products (Viread, Biktarvy, Descovy, Truvada, etc.)
majorDuplicate tenofovir exposure increases kidney and bone toxicity risk. Do not co-administer.
Cyclosporine
moderateP-gp/BCRP inhibitor; may increase TAF exposure. Monitor closely if coadministered.
NSAIDs (ibuprofen, naproxen, high-dose aspirin)
moderateIncreased nephrotoxicity risk with tenofovir products. Avoid regular or high-dose use; consider acetaminophen instead.
Tepotinib
majorP-gp inhibitor (cancer drug); may increase TAF levels. Avoid or adjust dose per prescribing information.
Vemlidy (tenofovir alafenamide) is a highly effective, well-tolerated treatment for chronic hepatitis B that represents a meaningful advance over older tenofovir-based medications. Its targeted prodrug mechanism delivers exceptional antiviral control — 91–97% viral suppression maintained at 8 years, with no resistance — while minimizing kidney and bone side effects.
The primary challenge with Vemlidy is not clinical — it's access. The $1,500–$1,800/month price tag, lack of a US generic, and specialty pharmacy routing requirements create real barriers for patients. However, Gilead's co-pay assistance program brings costs to $0 for most commercially insured patients, and the Advancing Access program provides free medication to qualifying uninsured individuals.
If you are taking Vemlidy and having trouble finding it in stock at your local pharmacy, medfinder can help you find a pharmacy in your area that has it available. Remember: never stop taking Vemlidy without consulting your doctor — hepatitis B rebound is a serious and preventable risk.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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