Potential Drug-Drug Interactions with Adefovir Dipivoxil: Clinical Implications and Management Strategies

Abstract

ABSTRACT: This study meticulously investigates the intricate network of drug interactions, specifically focusing on adefovir dipivoxil, a nucleotide analog employed in treating chronic hepatitis B. The comprehensive analysis explores the influence of various drugs, including Nonsteroidal anti-inflammatory drugs (NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)), histamine H2 receptor antagonists, aminoglycoside antibiotics, and cytochrome P450 enzyme inducers/inhibitors, on the metabolism and elimination of adefovir dipivoxil. The pivotal role of liver enzymes and renal function in the metabolism and excretion of this drug is underscored. The discourse centers on the mechanisms, such as competitive inhibition for renal transporters, enzyme induction/inhibition, and metabolic interference, which can modify the renal elimination of adefovir dipivoxil, potentially leading to toxicity or diminished efficacy. The study highlights that alterations in liver esterase activity and renal function directly impact adefovir dipivoxil exposure. The findings conclude that drugs affecting liver enzymes or renal function significantly influence the metabolism and excretion of adefovir dipivoxil, necessitating vigilant monitoring for potential interactions to optimize the safety and efficacy of adefovir dipivoxil therapy for chronic HBV patients. This review sheds light on critical drug interactions, guiding healthcare professionals to devise safer and more effective treatment regimens for chronic hepatitis B, thereby ensuring improved patient outcomes.