Creatinine clearance (mL/min)* | Recommended oral dose |
Entecavir¶ (nucleoside) | |
NA treatment naïve | |
≥50 | 0.5 mg daily |
30 to 49 | 0.25 mg daily or 0.5 mg every 48 hours |
10 to 29 | 0.15 mg daily or 0.5 mg every 72 hours |
<10 or hemodialysisΔ or continuous ambulatory peritoneal dialysis | 0.05 mg daily or 0.5 mg every 7 days |
Lamivudine refractory/resistant | |
≥50 | 1 mg daily |
30 to 49 | 0.5 mg daily or 1 mg every 48 hours |
10 to 29 | 0.3 mg daily or 1 mg every 72 hours |
<10 or hemodialysisΔ or continuous ambulatory peritoneal dialysis | 0.1 mg daily or 1 mg every 7 days |
Tenofovir disoproxil fumarate (TDF, nucleotide) | |
≥50 | 300 mg daily |
30 to 49 | 300 mg every 48 hours |
10 to 29 | 300 mg every 72 to 96 hours |
<10 with hemodialysisΔ | 300 mg once a week or after a total of approximately 12 hours of dialysis |
<10 without hemodialysis | Insufficient data; no recommendation◊ |
Continuous ambulatory peritoneal dialysis | Insufficient data; no recommendation◊ |
Tenofovir alafenamide (TAF, nucleotide) | |
≥15 | 25 mg daily |
<15 with hemodialysis | 25 mg on hemodialysis days; dose after dialysis |
<15 without hemodialysis | Insufficient data; no recommendation◊ |
Lamivudine (3TC, nucleoside) | |
≥50 | 100 mg daily |
30 to 49 | 100 mg first dose, then 50 mg daily |
15 to 29 | 100 mg first dose, then 25 mg daily |
5 to 14 | 35 mg first dose, then 15 mg daily |
<5 or hemodialysisΔ or continuous ambulatory peritoneal dialysis | 35 mg first dose, then 10 mg daily |
Adefovir dipivoxil (nucleotide) | |
≥50 | 10 mg daily |
30 to 49 | 10 mg every 48 hours |
10 to 29 | 10 mg every 72 hours |
<10 (not receiving hemodialysis) | Insufficient data; no recommendation◊ |
Hemodialysis | 10 mg every seven days following dialysis |
Continuous ambulatory peritoneal dialysis | Insufficient data; no recommendation◊ |
Telbivudine (LdT, nucleoside)§ | |
≥50 | 600 mg daily |
30 to 49 | 600 hours mg every 48 hours |
10 to 29 (not receiving hemodialysis) | 600 mg every 72 hours |
Hemodialysis | 600 mg every 96 hours following dialysisΔ |
Continuous ambulatory peritoneal dialysis | Insufficient data; no recommendation◊ |
NA: nucleoside or nucleotide analogue.
* Can be estimated by using the Cockroft-Gault equation. Separate calculators for creatinine clearance using conventional and SI units are available in UpToDate.
¶ For doses <0.5 mg, entecavir oral solution is recommended.
Δ Administer after intermittent hemodialysis.
◊ Data establishing the safety, efficacy, and optimal dosing in end-stage kidney disease (with or without dialysis) are not available.
§ Discontinued in the United States; may be available in other countries.Do you want to add Medilib to your home screen?