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Fosalvudine tidoxil is an orally bioavailable small molecule nucleoside reverse transcriptase inhibitor (NRTI) prodrug. It was developed by Heidelberg Pharma (formerly Wilex AG) for the treatment of HIV-1 infection. The drug is a lipid conjugate of alovudine (3-deoxy-3-fluorothymidine; FLT), designed to improve the safety profile and reduce the bone marrow and liver toxicity associated with the parent compound. Upon administration, it is metabolized to alovudine triphosphate, which inhibits the viral reverse transcriptase enzyme, thereby preventing HIV replication. Development reached Phase II clinical trials in Germany but was subsequently discontinued.
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