Nephrotoxicity, including acquired Fanconi’s syndrome, caused by adefovir dipivoxil – is there a safe dose?
Article first published online: 30 JUN 2011
© 2011 Blackwell Publishing Ltd
Journal of Clinical Pharmacy and Therapeutics
Volume 37, Issue 2, pages 128–131, April 2012
How to Cite
Law, S.-t., Li, K. K. and Ho, Y. Y. (2012), Nephrotoxicity, including acquired Fanconi’s syndrome, caused by adefovir dipivoxil – is there a safe dose?. Journal of Clinical Pharmacy and Therapeutics, 37: 128–131. doi: 10.1111/j.1365-2710.2011.01278.x
- Issue published online: 6 MAR 2012
- Article first published online: 30 JUN 2011
- Received 15 December 2010, Accepted 12 May 2011
- acquired Fanconi syndrome;
- adefovir dipivoxil therapy;
- chronic hepatitis B infection;
What is known and Objective: Adefovir dipivoxil (ADV) is an oral bioavailable prodrug of adefovir that possesses potent in vitro activity against hepadnaviruses, retroviruses and herpes viruses. ADV is excreted unchanged in the urine through glomerular filtration and tubular secretion and is known to be nephrotoxic at doses of 60 mg daily and above. Thus, the long-term safety of ADV, particularly nephrotoxicity, is a major concern. Our objective is to comment on the nephrotoxcicity of low-dose (10 mg daily) ADV through a case report.
Comment: The clinical features of nephrotoxicity because of ADV are described. A case report of acquired Fanconi’s syndrome in a chronic hepatitis B patient treated with ADV 10 mg daily is used to illustrate several key aspects.
What is new and Conclusion: Adefovir dipivoxil can be nephrotoxic at conventional dosage and therefore, patients treated with long-term ADV should have regular monitoring of renal function, and calcium and phosphate levels.