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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