Adefovir Disease Interactions

Adefovir is primarily eliminated by the kidney via glomerular filtration and active tubular secretion. Renal impairment, including acute renal failure and Fanconi syndrome, has been reported with adefovir use. Close monitoring of renal function and lengthening the dosing interval are recommended for patients with creatinine clearance less than 50 mL/min. Creatinine clearance should be calculated in all patients before starting adefovir treatment and during treatment when clinically appropriate. Routine monitoring of serum creatinine and phosphorus is recommended for patients at risk of or with a history of renal dysfunction. Safety and effectiveness have not been evaluated in patients with renal insufficiency using dose adjustments; therefore, the benefit of adefovir treatment should be weighed against the risk of renal toxicity. Adefovir should be avoided in patients who are currently using or have recently used nephrotoxic drugs.