• See Also
  1. Chronic Hepatitis B Infection
  2. Nucleoside Reverse Transcriptase Inhibitor
  • Indications
  1. Chronic Hepatitis B Infection (HBV)
  • Precautions
  1. Risk of severe HBV exacerbation on discontinuation (in up to 25% of patients)
  2. Higher risk of induced HBV resistance
    1. Occurs in 8% of patients after 3 years, and 20% after 5 years
  3. Risk of induced HIV resistance in undiagnosed HIV coinfection
    1. HIV Test before use
    2. Do NOT use in monotherapy in HBV/HIV infected patients
  • Mechanism
  1. Nucleoside Reverse Transcriptase Inhibitor
  2. Adenosine 5-Monophosphate Nucleotide analog
  • Efficacy
  1. Lower efficacy than other nRTI agents (typically combined with other Antivirals, e.g. Lamivudine)
  • Dosing
  • Hepatitis B (Adults and Children age >12 years)
  1. Adefovir 10 mg orally daily
  2. Reduce dose in eGFR <50 ml/min
  3. Original regimens recommended taking with L-carnitine 500 mg supplement
  • Adverse Effects
  1. Nephrotoxicity
    1. Incidence in up to 30% of cases with high dose regimens (>30 to 60 mg) as was originally used for HIV
    2. Fanconi Syndrome like condition
  2. Nausea
  3. Diarrhea
  4. Abdominal Pain
  5. Asthenia
  6. Headache
  7. Liver Function Test abnormalities (hepatic Steatosis)
  8. Lactic Acidosis
  • Safety
  1. Preganancy Category C
  2. Avoid in Lactation
  • Resources
  1. Adefovir (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e047f3b2-feae-4c5e-9d07-1fefb4c0ec25
  • References
  1. (1998) Med Lett Drugs Ther 40(1041):115 [PubMed]
  2. (2013) Med Lett Drugs Ther 11(127): 19-30 [PubMed]
  3. (2009) Treat Guidel Med Lett 7(78): 11-22 [PubMed]