Adefovir dipivoxil
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 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
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
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