Adefovir

Name: Adefovir

Why is this medication prescribed?

Adefovir is used to treat chronic (long-term) hepatitis B infection (swelling of the liver caused by a virus) in patients who have symptoms of the disease. Adefovir is in a class of medications called nucleotide analogs. It works by decreasing the amount of hepatitis B virus (HBV) in the body. Adefovir will not cure hepatitis B and may not prevent complications of chronic hepatitis B such as cirrhosis of the liver or liver cancer. Adefovir may not prevent the spread of hepatitis B to other people.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I discuss with my healthcare provider before taking adefovir?

You should not take adefovir if you are allergic to it.

Do not take adefovir if you also take Atripla, Complera, Stribild, Truvada, or Viread.

Some people taking adefovir develop a serious condition called lactic acidosis. This may be more likely in women, in people who are overweight or have liver disease, and in people who have taken HIV/AIDS medication for a long time. Talk with your doctor about your risk.

Tell your doctor if you have been exposed to HIV, or if you have untreated HIV or AIDS. Taking medicines to treat chronic hepatitis B can cause HIV infection to become resistant to the standard HIV and AIDS medications. You may need to be tested for HIV before you start taking adefovir.

To make sure adefovir is safe for you, tell your doctor if you have:

  • kidney disease; or

  • liver disease.

FDA pregnancy category C. It is not known whether adefovir will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Your name may need to be listed on an antiviral pregnancy registry when you start using this medication.

It is not known whether adefovir passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

What should I avoid while taking adefovir?

Taking this medication will not prevent you from passing hepatitis B to other people. Do not have unprotected sex or share razors or toothbrushes. Talk with your doctor about safe ways to prevent transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

How is this medicine (Adefovir) best taken?

Use this medicine as ordered by your doctor. Read all information given to you. Follow all instructions closely.

  • Take with or without food.
  • To gain the most benefit, do not miss doses.
  • Keep taking adefovir as you have been told by your doctor or other health care provider, even if you feel well.

What do I do if I miss a dose?

  • Take a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.
  • Do not take more than 1 dose of this medicine in the same day.

If OVERDOSE is suspected

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Dosing Geriatric

Refer to adult dosing.

Dosing Renal Impairment

Adult recommendations only (no dosage adjustment recommendations available for patients <18 years with renal impairment):

CrCl ≥50 mL/minute: No dosage adjustment necessary

CrCl 30-49 mL/minute: 10 mg every 48 hours

CrCl 10-29 mL/minute: 10 mg every 72 hours

Hemodialysis: Dialyzable (~35%): 10 mg every 7 days (following dialysis)

Drug Interactions

Cabozantinib: MRP2 Inhibitors may increase the serum concentration of Cabozantinib. Monitor therapy

Orlistat: May decrease the serum concentration of Antiretroviral Agents. Monitor therapy

Tenofovir Products: Adefovir may diminish the therapeutic effect of Tenofovir Products. Adefovir may increase the serum concentration of Tenofovir Products. Tenofovir Products may increase the serum concentration of Adefovir. Avoid combination

Pregnancy Risk Factor C Pregnancy Considerations

Adverse events have been observed in animal reproduction studies.

Health care providers are encouraged to enroll women exposed to adefovir during pregnancy in the Hepsera pregnancy registry (800-258-4263).

Liver Dose Adjustments

No adjustment recommended.

Dialysis

Adults:
Hemodialysis: 10 mg orally every 7 days following a dialysis session
Peritoneal dialysis: Data not available

Adolescents: Data not available

Adefovir Pregnancy Warnings

A pregnancy registry has been established to monitor fetal outcomes of pregnant women exposed to adefovir. Healthcare providers are encouraged to register patients by calling 1-800-258-4263 (USA).

Adefovir dipivoxil has been assigned to pregnancy category C by the FDA. Animal studies have failed to reveal evidence of embryotoxicity or teratogenicity. There are no controlled data in human pregnancy. Adefovir dipivoxil is only recommended for use during pregnancy when benefit outweighs risk. There are no data concerning adefovir's effect on mother-to-infant hepatitis B virus transmission. Appropriate infant immunization is recommended to prevent neonatal acquisition of the virus.

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