telbivudine at a glance
Medicine class
Nucleoside analogue antiviral
Main role
Suppressing chronic hepatitis B virus in selected adults with compensated liver disease
Administration
Oral film-coated tablet; take with or without food and swallow whole
Specialist oversight
Treatment should be initiated by a clinician experienced in chronic hepatitis B
Availability
The selected product is listed as discontinued
What is telbivudine used for?
The selected product is discontinued. Its indication was:
Treatment of chronic hepatitis B in adults with compensated liver disease, viral replication, persistently raised ALT, and evidence of active liver inflammation or fibrosis.
Use was to be considered only when an alternative antiviral with a higher barrier to resistance was unavailable or unsuitable.
How does telbivudine work?
Inside cells, telbivudine is converted to an active triphosphate form. This competes with a natural DNA building block at hepatitis B viral polymerase and stops viral DNA chains from forming, reducing viral replication.
How to take telbivudine
Follow the specialist’s instructions and do not stop treatment without clinical advice, because hepatitis can worsen after withdrawal.
Take the tablet by mouth with or without food.
Swallow the tablet whole; do not chew, split or crush it.
Tell the specialist about swallowing difficulties or impaired kidney function, as these affect formulation and prescribing decisions.
telbivudine side effects
Common or expected effects
- Headache or dizziness
- Fatigue
- Nausea, abdominal pain or diarrhoea
- Cough
- Rash
- Raised muscle, liver, pancreatic or digestive-enzyme blood-test results
Get urgent medical advice
- Persistent unexplained muscle pain, tenderness or weakness, which may indicate myopathy or rhabdomyolysis
- Numbness, tingling or reduced sensation suggesting peripheral neuropathy
- Lactic acidosis, sometimes associated with serious muscle, liver, pancreatic or kidney problems
- Severe worsening of hepatitis, particularly after treatment is stopped
telbivudine in pregnancy
The SmPC reports limited first-trimester information and more extensive later-pregnancy experience without an identified fetal or neonatal toxicity signal. Telbivudine should be used only when the expected maternal benefit outweighs potential fetal risk. Hepatitis B during pregnancy requires specialist care to assess maternal treatment and measures protecting the baby from infection.
telbivudine while breastfeeding
Hepatitis B itself does not automatically prevent breastfeeding, but the selected SmPC says not to breastfeed while taking telbivudine because transfer into human milk is unknown. Discuss treatment and feeding options with the hepatitis and maternity teams.
telbivudine interactions
Tell the prescriber and pharmacist about all medicines. Important examples include:
Standard or pegylated interferon alfa
This combination is contraindicated because it substantially increases the risk of peripheral neuropathy.
Medicines affecting kidney function, including aminoglycosides, loop diuretics, platinum compounds, vancomycin and amphotericin B
They may alter telbivudine or co-administered medicine concentrations, requiring caution and monitoring.
Common questions about telbivudine
Answers are fully visible for fast scanning and source review.
What is telbivudine used for?
It was licensed for selected adults with chronic hepatitis B, active viral replication and compensated liver disease.
Is telbivudine still available?
The selected product is listed as discontinued. A specialist or pharmacist should confirm current availability and treatment arrangements.
Does telbivudine cure chronic hepatitis B?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.