Home Drug Guide Telbivudine

Drug Guide

Generic Name

Telbivudine

Brand Names Tyzeka

Classification

Therapeutic: Antiviral Agent

Pharmacological: Nucleoside Reverse Transcriptase Inhibitor (NRTI)

FDA Approved Indications

  • Chronic hepatitis B virus (HBV) infection in adults

Mechanism of Action

Telbivudine is a thymidine nucleoside analog that inhibits HBV DNA replication by incorporating into viral DNA and causing chain termination, thereby reducing viral replication.

Dosage and Administration

Adult: 600 mg orally once daily, with or without food

Pediatric: Not approved for pediatric use

Geriatric: Uses should be cautious; adjust for renal impairment

Renal Impairment: Dose adjustment recommended based on renal function; see prescribing information

Hepatic Impairment: No specific adjustment, but monitor response

Pharmacokinetics

Absorption: Rapidly absorbed with peak plasma concentrations within 1 hour

Distribution: Limited data, presumed to distribute into body fluids

Metabolism: Not extensively metabolized

Excretion: Excreted primarily by the kidneys

Half Life: Approximately 15 hours

Contraindications

  • Known hypersensitivity to telbivudine or any component of the formulation

Precautions

  • Lactic acidosis and severe hepatomegaly with steatosis have been reported with nucleoside analogs
  • Renal impairment requires dose adjustment
  • Monitor renal function regularly
  • Potential for resistance development

Adverse Reactions - Common

  • Fatigue (Common)
  • Headache (Common)
  • Hepatitis B flare upon discontinuation (Common)

Adverse Reactions - Serious

  • Lactic acidosis (Rare)
  • Proximal muscle weakness (Rare)
  • Serious renal impairment (Rare)

Drug-Drug Interactions

  • Caution when used with other nucleoside analogs or nephrotoxic drugs

Drug-Food Interactions

  • No significant food interactions reported

Drug-Herb Interactions

  • Limited data; consult with healthcare provider before use with herbal supplements

Nursing Implications

Assessment: Monitor renal function, liver function, and for signs of lactic acidosis

Diagnoses:

  • Risk for decreased renal perfusion
  • Risk for lactic acidosis

Implementation: Administer as prescribed, ensure adherence, monitor labs

Evaluation: Assess viral load, liver function, and adverse effects regularly

Patient/Family Teaching

  • Take medication exactly as prescribed, at the same time daily
  • Report symptoms of muscle weakness, unusual fatigue, or signs of lactic acidosis
  • Maintain regular follow-up appointments for lab monitoring
  • Use contraception if applicable, as efficacy in pregnancy not fully established

Special Considerations

Black Box Warnings:

  • Lactic acidosis and severe hepatomegaly with steatosis

Genetic Factors: No specific genetic factors identified

Lab Test Interference: May affect tests for hepatitis B viral load

Overdose Management

Signs/Symptoms: Nausea, vomiting, severe hepatic or renal impairment

Treatment: Supportive care, hemodialysis may be considered due to renal elimination

Storage and Handling

Storage: Store at room temperature 20°C to 25°C (68°F to 77°F); protect from moisture

Stability: Stable under recommended storage conditions; discard after expiration

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.