Precautions and warnings

Pregnancy, the elderly, children, and renal or hepatic impairment are all factors to consider. Because untreated HIV infection might lead to resistance, HIV antibody testing should be done before starting treatment. Hepatotoxicity is more likely in females, obese people, and those who have been on treatment for a long time. Every three months, check renal function; every six months, check hepatitis B biochemical, viral, and serological markers; and every three months, check LFTs. If liver function worsens, severe hepatomegaly, steatosis, or unexplained metabolic or lactic acidosis develops, stop taking the medication. Patients whose anti-hepatitis medicine is stopped should have their hepatic function monitored for several months since acute hepatitis exacerbations can occur.

Drug Interactions

Nephrotoxic medicines, such as aminoglycosides, ciclosporin, NSAIDs, vancomycin, and tacrolimus, increase the risk of nephrotoxicity. Ibuprofen boosts adefovir's bioavailability.

Contraindications

Adefovir Dipivoxil is contraindicated in patients with previously demonstrated hypersensitivity to any of the components of the product.

Mode of actions

Adefovir dipivoxil is a reverse transcriptase inhibitor-based on acyclic nucleosides. The diester function is hydrolyzed, and the active adefovir diphosphate is then phosphorylated. HBV DNA polymerase (reverse transcriptase) is inhibited by the active metabolite, which prevents viral replication. It can be used to treat lamivudine-resistant hepatitis B patients.

Dosage & Administration

Adult: PO: The recommended dose of Adefovir for the treatment of chronic hepatitis B in adolescent & adults (age > 12 year) with adequate renal function is 10 mg, once daily, taken orally, without regard to food.

Renal impairment: Haemodialysis patients: 10 mg every 7 days after dialysis.
CrCl (ml/min)
20-49 10 mg every 48 hr.
10-19 10 mg every 72 hr.


Dose Adjustment in Renal Impairment: Significantly increased drug exposures are seen when Adefovir Dipivoxil is administered to patients with renal impairment. Therefore, the dosing interval of Adefovir Dipivoxil should be adjusted in patients with baseline creatinine clearance < 50 mL/min using the following suggested guidelines- Dosing interval adjustment of Adefovir in patients with renal impairment Creatinine clearance (mL/min) > 50 20 to 49 10 to 19 < 10 Hemodialysis or CAPD Recommended dose and dosing interval 10 mg every 24 hours 10 mg every 48 hours 10 mg every 72 hours 10 mg every 7 days.

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required despite potential risks.

Mothers with a newborn baby who have used this drug during the last 3 months of pregnancy may seldom create symptoms including drowsiness, muscle stiffness or shakiness, feeding or breathing troubles, constant crying. If you notice any of these symptoms of your baby's particularly during their first month, tell the doctor immediately.

This medicine passes into breast milk. Talk to your doctor before breastfeeding.

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