II. Indications

III. 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

IV. Mechanism

V. Efficacy

  1. Lower efficacy than other nRTI agents (typically combined with other Antivirals, e.g. Lamivudine)

VI. 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

VII. 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

VIII. Safety

  1. Preganancy Category C
  2. Avoid in Lactation

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Related Studies

Ontology: adefovir (C0050175)

Definition (NCI) A nucleoside reverse transcriptase inhibitor analog of adenosine with activity against hepatitis B virus (HBV), herpes virus, and human immunodeficiency virus (HIV).
Definition (CSP) an adenine analog, antiviral agent; used for treating hepatitis, HIV and African swine fever virus infections.
Concepts Pharmacologic Substance (T121) , Nucleic Acid, Nucleoside, or Nucleotide (T114)
MSH C053001
SnomedCT 412073001, 412072006
LNC LP28549-1, MTHU013860
English 9-(2-phosphonylmethoxyethyl)adenine, 9-PMEA, 9-(2-phosphonomethoxyethyl)adenine, PMEA, Phosphonylmethoxyethyl-a, adefovir, adefovir [Chemical/Ingredient], 9-(2-phophonylmethoxyethyl)adenine, ADEFOVIR, 9-(2-Phosphonylmethoxyethyl)adenine, Adefovir (product), Adefovir (substance), Adefovir
Spanish adefovir (producto), adefovir (sustancia), adefovir

Ontology: adefovir dipivoxil (C0540694)

Definition (NCI) A dipivoxil formulation of adefovir, a nucleoside reverse transcriptase inhibitor analog of adenosine with activity against hepatitis B virus (HBV), herpes virus, and human immunodeficiency virus (HIV).
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C106812
SnomedCT 398898002, 409114008
English 9-(2-((-bis((pivaloyloxy)methoxy)phosphinyl)methoxy)ethyl)adenine, adefovir depivoxil, adefovir dipivoxil, Adefovir Dipivoxil, adefovir dipivoxil (medication), adefovir dipivoxil [Chemical/Ingredient], ADEFOVIR DIPIVOXIL, Adefovir dipivoxil (product), Adefovir dipivoxil, Adefovir dipivoxil (substance)
Spanish adefovir dipivoxil (producto), adefovir dipivoxil, adefovir dipivoxil (sustancia)

Ontology: Preveon (C0754613)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C106812
English Preveon