Telbivudine

What is Telbivudine

Telbivudine is a synthetic thymidine nucleoside analogue with activity against hepatitis B virus (HBV).

Telbivudine is not a cure for HBV, but the drug may lower viral load and prevent infection of new hepatocytes.

When compared to lamivudine 100 mg/day for 1 year in patients with HBeAg-positive chronic HBV, patients receiving telbivudine 400 or 600 mg/day had a greater virologic and biochemical response; patients experienced a greater mean reduction in HBV DNA levels, (6.01 vs. 4.57 log10 copies/ml reduction for telbivudine vs. lamivudine, respectively, p < 0.05), greater HBV DNA clearance (61% vs. 32% for telbivudine vs. lamivudine, respectively p < 0.05), and a higher number achieving normalization of ALT concentrations (86% vs 63% for telbivudine vs. lamivudine, respectively, p < 0.05). In this same trial, a combination of telbivudine and lamivudine was also evaluated, but combination therapy conferred no additional benefit over telbivudine monotherapy.

Brand Name

Tyzeka

Indications

  • hepatitis B infection
  • hepatitis B virus

Side Effects

  1. abdominal pain
  2. antimicrobial resistance
  3. arthralgia
  4. back pain
  5. chest pain (unspecified)
  6. cough
  7. diarrhea
  8. dizziness
  9. dyspepsia
  10. elevated hepatic enzymes
  11. fatigue
  12. fever
  13. flank pain
  14. headache
  15. hepatitis B exacerbation
  16. hepatomegaly
  17. hepatotoxicity
  18. hyperamylasemia
  19. hyperbilirubinemia
  20. hypoesthesia
  21. insomnia
  22. lactic acidosis
  23. muscle cramps
  24. musculoskeletal pain
  25. myalgia
  26. myopathy
  27. nausea
  28. neutropenia
  29. paresthesias
  30. peripheral neuropathy
  31. pruritus
  32. rash
  33. rhabdomyolysis
  34. steatosis
  35. thrombocytopenia
  36. vomiting
  37. weakness

Monitoring Parameters

  • hepatitis B serology
  • LFTs

Contraindications

  • antimicrobial resistance
  • Black patients
  • breast-feeding
  • children
  • dialysis
  • geriatric
  • hepatitis B and HIV coinfection
  • hepatitis B exacerbation
  • hepatotoxicity or lactic acidosis
  • Hispanic patients
  • human immunodeficiency virus (HIV) infection
  • human immunodeficiency virus (HIV) infection resistance
  • infants
  • liver transplant
  • myopathy
  • neonates
  • pancreatitis
  • pregnancy
  • renal disease
  • renal failure
  • renal impairment
  • rhabdomyolysis

Interactions

  • Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
  • Acyclovir
  • Adefovir
  • Amikacin
  • Amlodipine; Celecoxib
  • Amphotericin B
  • Amphotericin B cholesteryl sulfate complex (ABCD)
  • Amphotericin B lipid complex (ABLC)
  • Amphotericin B liposomal (LAmB)
  • Angiotensin-converting enzyme inhibitors
  • Celecoxib
  • Chloroquine
  • Cidofovir
  • Cisplatin
  • Corticosteroids
  • Cyclosporine
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diflunisal
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Echinacea
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Esomeprazole; Naproxen
  • Etodolac
  • Famotidine; Ibuprofen
  • Fenoprofen
  • Fibric acid derivatives
  • Fluconazole
  • Flurbiprofen
  • food
  • Foscarnet
  • Ganciclovir
  • HMG-CoA reductase inhibitors
  • Hydrocodone; Ibuprofen
  • Hydroxychloroquine
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Indomethacin
  • Interferon Alfa-2a
  • Interferon Alfa-2b
  • Interferon Alfa-2b; Ribavirin
  • Interferon Alfa-n3
  • Interferon Alfacon-1
  • Interferon Beta-1a
  • Interferon Beta-1b
  • Interferon Gamma-1b
  • Interferons
  • Itraconazole
  • Ketoconazole
  • Ketoprofen
  • Ketorolac
  • Lamivudine, 3TC; Zidovudine, ZDV
  • Lansoprazole; Naproxen
  • Lovastatin; Niacin
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meloxicam
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Niacin, Niacinamide
  • Niacin; Simvastatin
  • Non-Ionic Contrast Media
  • Nonsteroidal antiinflammatory drugs
  • Orlistat
  • Oxaprozin
  • Pamidronate
  • Peginterferon Alfa-2a
  • Peginterferon Alfa-2b
  • Peginterferon beta-1a
  • Penicillamine
  • Piroxicam
  • Ribavirin
  • Rofecoxib
  • Sulindac
  • Tacrolimus
  • Tolmetin
  • Valacyclovir
  • Valdecoxib
  • Valganciclovir
  • Vancomycin
  • Voriconazole
  • Zidovudine, ZDV
  • Zoledronic Acid
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