Updated: January 25, 2026
What Is Adefovir? Uses, Dosage, and What You Need to Know in 2026
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Peter Daggett
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Overview
What is adefovir dipivoxil (Hepsera)? Learn what it treats, how it works, its dosage and forms, who can take it, and important warnings in this 2026 guide.
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Adefovir dipivoxil — sold under the brand name Hepsera — is an antiviral medication used to treat chronic hepatitis B virus (HBV) infection. It belongs to a class of drugs called nucleotide analog reverse transcriptase inhibitors (NtRTIs). This guide covers everything patients and caregivers need to know about adefovir in 2026.
What Is Adefovir Used For?
Adefovir is FDA-approved to treat chronic hepatitis B in adults and adolescents aged 12 and older who have evidence of active viral replication and liver inflammation or damage. It is specifically indicated for patients with:
Compensated chronic hepatitis B with evidence of active HBV DNA replication
Lamivudine-resistant hepatitis B with either compensated or decompensated liver disease (used in combination with lamivudine)
Pre- and post-liver transplant patients with lamivudine-resistant HBV
Adefovir is NOT a cure for hepatitis B. It suppresses the virus to reduce liver damage and lower the risk of cirrhosis, liver failure, and liver cancer over time. It does not eliminate the virus from the body.
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Brand and Generic Names
Brand name: Hepsera (Gilead Sciences)
Generic name: Adefovir dipivoxil (manufactured by Apotex, Sigmapharm, and others)
Drug class: Nucleotide analog reverse transcriptase inhibitor (NtRTI)
FDA approval: 2002 (Hepsera); generics available after ~2010
Adefovir Dosage and How to Take It
Standard dose: 10 mg orally once daily, with or without food
Form: White tablet, round, 10 mg
With or without food: Food does not affect how well it works — take it at the same time each day to maintain consistent blood levels
Renal impairment adjustments: CrCl 20-49 mL/min: 10 mg every 48 hours; CrCl 10-19 mL/min: 10 mg every 72 hours; hemodialysis: 10 mg every 7 days
Take adefovir at the same time every day. Do not skip doses or stop without your doctor's guidance. Missing doses can allow the virus to replicate and increase resistance risk.
Who Should Not Take Adefovir?
Adefovir is contraindicated (not to be used) in:
Patients with a known hypersensitivity to adefovir or any component of the tablet
Patients currently taking tenofovir disoproxil fumarate (TDF/Viread) or tenofovir alafenamide (TAF/Vemlidy) — these should not be used concurrently with adefovir
Use with caution in patients with pre-existing kidney disease, those taking other nephrotoxic medications, and HIV-positive patients who are not on antiretroviral therapy.
Important Storage Instructions
Store adefovir tablets at room temperature: 68-77°F (20-25°C). Keep in the original container with the desiccant. Keep out of reach of children. Do not use if the seal over the bottle opening is broken or missing.
Is Adefovir the Right Medication for You?
In 2026, current hepatitis B treatment guidelines recommend entecavir, tenofovir DF (TDF), or tenofovir alafenamide (TAF) as first-line agents due to superior potency and/or safety profiles. Adefovir is still appropriate for certain patients — particularly those with lamivudine resistance, those who have failed other agents, or those with specific circumstances that favor its use. Discuss with your hepatologist or gastroenterologist which option is best for your situation.
If you have been prescribed adefovir and are having trouble finding it at your pharmacy, medfinder can locate a pharmacy with it in stock. Read next: How Does Adefovir Work? Mechanism of Action Explained
Frequently Asked Questions
Adefovir dipivoxil (Hepsera) is FDA-approved to treat chronic hepatitis B virus (HBV) infection in adults and adolescents aged 12 and older with evidence of active viral replication. It is particularly useful for patients with lamivudine-resistant HBV. It is not a cure — it suppresses the virus to prevent liver damage.
The standard dose is one 10 mg tablet taken orally once daily. It can be taken with or without food. It should be taken at the same time each day to maintain consistent blood levels. Dose adjustments are required for patients with impaired kidney function.
Hepsera is the brand name for adefovir dipivoxil, made by Gilead Sciences. Generic adefovir dipivoxil is the same drug made by other manufacturers (such as Apotex and Sigmapharm). Generics are therapeutically equivalent to Hepsera, typically less expensive, and covered by Medicare Part D. Hepsera brand is not covered by Medicare.
Adefovir is FDA-approved for adolescents aged 12 and older. Its safety and efficacy in this age group were studied in a clinical trial. For children under 12, the efficacy of adefovir was not significantly better than placebo in clinical studies, so it is not recommended for that age group.
Yes, but less commonly than in previous years. Current hepatitis B treatment guidelines favor entecavir, tenofovir DF, and tenofovir alafenamide as first-line agents due to superior potency and safety. Adefovir remains useful in specific situations — particularly for patients with lamivudine-resistant HBV or contraindications to first-line agents.
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