Home Drug Guide Adefovir Dipivoxil

Drug Guide

Generic Name

Adefovir Dipivoxil

Brand Names Hepsera

Classification

Therapeutic: Antiviral (Hepatitis B Virus infection)

Pharmacological: Reverse transcriptase inhibitor (nucleotide analog)

FDA Approved Indications

  • Chronic hepatitis B in adults with active disease

Mechanism of Action

Adefovir inhibits hepatitis B virus DNA polymerase, leading to DNA chain termination and inhibition of viral replication.

Dosage and Administration

Adult: 10 mg once daily, with or without food.

Pediatric: Not approved for pediatric use.

Geriatric: Use with caution, considering renal function.

Renal Impairment: Reduce dosage based on renal function; monitor renal function closely.

Hepatic Impairment: No specific dose adjustment provided, but caution advised.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed in body tissues.

Metabolism: Not extensively metabolized.

Excretion: Primarily excreted unchanged by the kidneys.

Half Life: Approximately 3 to 5 hours.

Contraindications

  • Hypersensitivity to adefovir or any component of the formulation.

Precautions

  • Renal impairment: use with caution, monitor renal function.
  • Lactic acidosis and severe hepatomegaly have been reported with nucleoside analogues.

Adverse Reactions - Common

  • Headache (Common)
  • Nausea (Common)
  • Elevated liver enzymes (Common)

Adverse Reactions - Serious

  • Lactic acidosis (Rare)
  • Severe hepatomegaly with steatosis (Rare)
  • Renal dysfunction including Fanconi syndrome (Rare)

Drug-Drug Interactions

  • Potential nephrotoxic drugs (e.g., aminoglycosides, contrast media)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor renal function (serum creatinine, BUN), liver function tests, and viral load.

Diagnoses:

  • Risk for renal impairment
  • Knowledge deficit related to medication use

Implementation: Administer as prescribed; educate patient, ensure hydration, monitor renal function regularly.

Evaluation: Assess effectiveness by monitoring viral load decrease and liver function tests.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report any signs of kidney problems (e.g., decreased urine output, swelling).
  • Avoid nephrotoxic substances.
  • Attend regular follow-up for blood tests.

Special Considerations

Black Box Warnings:

  • Lactic acidosis and severe hepatomegaly with steatosis.
  • Potential for renal toxicity.

Genetic Factors: None specific.

Lab Test Interference: Possible elevation of serum creatinine.

Overdose Management

Signs/Symptoms: Nausea, dizziness, potentially renal failure.

Treatment: Supportive care; hemodialysis may be considered in severe cases.

Storage and Handling

Storage: Store at room temperature away from moisture and heat.

Stability: Stable under recommended conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.