Adefovir dipivoxil

CLINICAL USE

Treatment of chronic hepatitis B infection

DOSE IN NORMAL RENAL FUNCTION

10 mg once daily

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
501.5

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
<4

%Excreted unchanged in urine &nbsp &nbsp :
45

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :
0.4

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :
7/15

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : 10 mg every 48 hours

10 to 20 &nbsp &nbsp : 10 mg every 72 hours

<10 &nbsp &nbsp &nbsp &nbsp &nbsp :
10 mg every 72 hours

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:
Unknown dialysability. Dose as in
GFR <10 mL/min

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
Dialysed. 10 mg weekly or after
a cumulative total of 12 hours
dialysis. See ‘Other Information’

HDF/high flux &nbsp :
Dialysed. Dose as in GFR

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL/
min

CAV/VVHD &nbsp &nbsp &nbsp:
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 with

other nephrotoxins

ADMINISTRATION

Reconstition

–

Route

Oral

Rate of Administration

–

Comments

–

OTHER INFORMATION

Nephrotoxic in higher IV doses, but risk

is lower with oral doses; although cases
of raised creatinine and ARF have been
reported

Discontinue treatment if any of the

following occur: lactic acidosis, rapid
increase in aminotransferase, progressive
hepatomegaly or steatosis

35% of dose is removed with a 4 hour

dialysis session

Administered as a prodrug converted to

adefovir

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