II. Indications
III. Precautions
- Risk of severe HBV exacerbation on discontinuation (in up to 25% of patients)
- Higher risk of induced HBV resistance
- Occurs in 8% of patients after 3 years, and 20% after 5 years
- Risk of induced HIV resistance in undiagnosed HIV coinfection
- HIV Test before use
- Do NOT use in monotherapy in HBV/HIV infected patients
IV. Mechanism
- Nucleoside Reverse Transcriptase Inhibitor
- Adenosine 5-Monophosphate Nucleotide analog
V. Efficacy
- Lower efficacy than other nRTI agents (typically combined with other Antivirals, e.g. Lamivudine)
VI. Dosing: Hepatitis B (Adults and Children age >12 years)
- Adefovir 10 mg orally daily
- Reduce dose in eGFR <50 ml/min
- Original regimens recommended taking with L-carnitine 500 mg supplement
VII. Adverse Effects
- Nephrotoxicity
- Incidence in up to 30% of cases with high dose regimens (>30 to 60 mg) as was originally used for HIV
- Fanconi Syndrome like condition
- Nausea
- Diarrhea
- Abdominal Pain
- Asthenia
- Headache
- Liver Function Test abnormalities (hepatic Steatosis)
- Lactic Acidosis
VIII. Safety
- Preganancy Category C
- Avoid in Lactation