Telbivudine belongs to a group of medications known as antivirals. It is used to treat people with chronic hepatitis B infection who also have active liver inflammation.

It works by stopping the hepatitis B virus from reproducing. There is no cure for hepatitis B infection - telbivudine decreases the amount of hepatitis B virus in the body and reduces the damage done to the liver by the hepatitis B virus.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The usual recommended dose of telbivudine is 600 mg taken by mouth once daily, with or without food.

Swallow the tablet whole with water. Do not crush, split, or chew it.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor. Do not stop taking this medication without telling your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not take this medication if you:

• are allergic to telbivudine or to any of the ingredients of this medication
• are taking the medication pegylated interferon alfa-2a

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• cough
• diarrhea
• dizziness
• fatigue
• headache
• nausea
• rash
• runny or stuffy nose

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• pain, weakness, or tenderness in your muscles
• signs of liver problems (e.g., yellow eyes or skin, abdominal pain, loss of appetite, pale stools, itchy skin, or dark urine)

Seek immediate medical attention if any of the following occur:

• signs of a serious allergic reaction (e.g., difficulty breathing, hives, or swelling of the face or throat)
• signs of lactic acidosis (e.g., severe tiredness or weakness, unusual muscle pain, trouble breathing, stomach pain with nausea and vomiting, feeling cold - especially in the arms and legs, dizziness or lightheadedness, fast or irregular heartbeat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Kidneys: People with kidney disease may need a different dose of the medication. Be sure you tell your doctor if you have a history of kidney disease. Let your doctor know about all the medications you are taking because some medications can affect the kidneys.

Laboratory tests: Your doctor will order certain laboratory tests to check your response to this medication.

Lactic acidosis: If you experience symptoms of lactic acidosis, contact your doctor immediately. Symptoms of lactic acidosis include severe tiredness or weakness, unusual muscle pain, trouble breathing, stomach pain with nausea and vomiting, feeling cold (especially in the arms and legs), dizziness or lightheadedness, and fast or irregular heartbeat.

Liver problems: This medication can cause liver problems. Your doctor may monitor your liver function while you are taking this medication, especially if you have risk factors for liver problems. If you experience symptoms of liver problems (e.g., abdominal pain, persistent vomiting, feeling unwell, fever, itching, yellowing of the skin and eyes, dark urine), contact your doctor immediately.

Muscle problems: Rarely, telbivudine may lead to a serious muscle problem. Contact your doctor if you experience muscle pain, muscle tenderness, or muscle weakness.

Stopping the medication: If you stop the medication, your hepatitis B infection could get worse. Take the medication exactly as prescribed by your doctor, and do not stop taking the medication without checking with your doctor first.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if telbivudine passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Breast-feeding is not recommended for women taking this medication.

Children: The safety and effectiveness of using this medication have not been established for children under 16 years of age.

Seniors: People over the age of 65 years may have an increased risk of developing side effects due to decreases in kidney function.

There may be an interaction between telbivudine and interferons (e.g., interferon alpha-2b, peginterferon alfa-2a, peginterferon alfa-2b).

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.