Drug safety evaluation of adefovir in HBV infection

Mauro Viganò, Pietro Lampertico, Massimo Colombo

Research output: Contribution to journalArticlepeer-review


Several nucleos(t)ide analogs (NUC) are available for the management of patients with chronic hepatitis B (CHB). In most patients, NUC need to be administered on a long-term basis, thus increasing the risk of adverse effects. Adefovir dipivoxil (ADV), the first nucloeotide analog developed to treat CHB, may indeed cause nephrotoxicity. Areas covered: The pharmacokinetic mechanism of action, potential mechanism of renal damage and long-term safety profile of ADV in CHB patients have been reported. The current monitoring modalities, together with dosage adjustments, treatment of patients with ADV-related kidney impairment and the therapeutic algorithm in place at the authors' Liver Center are also summarized. Although, in short-term clinical trials, a daily dose of 10 mg of ADV was safe owing to a low rate of negligible nephrotoxic effects, the same dose may be associated with a usually reversible, proximal renal tubular toxicity as reflected by hypophosphatemia and elevated creatinine levels. Occasionally, Fanconi syndrome occurred in ADV-treated patients. Expert opinion: Renal function at baseline and during treatment should be carefully assessed in all patients receiving ADV to adjust the dose according to creatinine clearance, aimed to prevent or minimize nephrotoxicity.

Original languageEnglish
Pages (from-to)809-818
Number of pages10
JournalExpert Opinion on Drug Safety
Issue number5
Publication statusPublished - Sep 2011


  • adefovir dipivoxil
  • chronic hepatitis B
  • creatinine
  • creatinine clearance
  • hepatitis B virus
  • kidney
  • nucleotide analog
  • renal impairment
  • safety

ASJC Scopus subject areas

  • Pharmacology (medical)


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