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telbivudine (Tyzeka)

Indications: - hepatitis B Contraindications: Caution: patients > 65 years of age Pregnancy category: B Dosage: - 600 mg PO QD (taper, do NOT abruptly discontinue) Tabs: 600 mg Storage: - store in orginal container - oral solution must be used within two months once original container is opened [4] Pharmacokinetics: - primarily cleared by renal excretion Dosage adjustment in renal failure: Creatinine clearance dosage > 50 mL/min 600 mg QD 30-49 mL/min 600 mg every other day < 30 mL/min 600 mg every 3 days ESRD 600 mg every 4 days dialysis administer 600 mg after dialysis Monitor: - serum ALT periodically & for several months after discontinuation [3] Adverse effects: 1) myalgia, myopathy may occurs weeks to months after starting therapy 2) fatigue, malaise, pyrexia, arthralgia, abdominal pain, diarrhea, gastritis, cough, headache 3) laboratory abnormalities - elevated serum creatine kinase, increased ALT, increased serum lipase, increased serum amylase, increased total bilirubin, neutropenia, thrombocytopenia 5) fatal lactic acidosis may be complication Drug interactions: 1) coadministration of telbivudine with drugs that alter renal function may alter plasma levels of telbivudine 2) coadministration of other drugs associated with myopathy - corticosteroids, chloroquine, hydroxychloroquine, statins, fibrates, penicillamine, zidovudine, cyclsporine Mechanism of action: 1) thymine nucleoside analogue 2) blocks hepatitis B DNA polymerase Notes: cost $500/month

Interactions

drug interactions

General

antiviral agent

Database Correlations

PUBCHEM cid=159269

References

  1. Prescriber's Letter 13(12): 2006 New Drug: Tyzeka (Telbivudine) Detail-Document#: 221204 (subscription needed) http://www.prescribersletter.com
  2. Novartis Pharmaceuticals Corporation http://www.novarits.com
  3. Prescriber's Letter 17(7): 2010 Recommended Lab Monitoring for Common Medications Liver Function Test Scheduling Detail-Document#: 260704 (subscription needed) http://www.prescribersletter.com
  4. Prescriber's Letter 21(6): 2014 Oral Meds to Keep in Original Containers Detail-Document#: 300622 (subscription needed) http://www.prescribersletter.com