Adefovir dipivoxil

CLINICAL USE

Treatment of chronic hepatitis B infection

DOSE IN NORMAL RENAL FUNCTION

10 mg once daily

PHARMACOKINETICS

  • Molecular weight                           :
    501.5
  • %Protein binding                           :
    <4
  • %Excreted unchanged in urine     :
    45
  • Volume of distribution (L/kg)       :
    0.4
  • half-life – normal/ESRD (hrs)      :
    7/15

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : 10 mg every 48 hours
  • 10 to 20     : 10 mg every 72 hours
  • <10           :
    10 mg every 72 hours

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :
    Unknown dialysability. Dose as in
    GFR <10 mL/min
  • HD                     :
    Dialysed. 10 mg weekly or after
    a cumulative total of 12 hours
    dialysis. See ‘Other Information’
  • HDF/high flux   :
    Dialysed. Dose as in GFR
  • <10           : mL/
    min
  • CAV/VVHD      :
    Unknown dialysability. Dose as in
    GFR 10 to 20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • Use with caution in combination withother nephrotoxins

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

  • Nephrotoxic in higher IV doses, but riskis lower with oral doses; although cases
    of raised creatinine and ARF have been
    reported
  • Discontinue treatment if any of thefollowing occur: lactic acidosis, rapid
    increase in aminotransferase, progressive
    hepatomegaly or steatosis
  • 35% of dose is removed with a 4 hourdialysis session
  • Administered as a prodrug converted toadefovir
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