Telbivudine

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Telbivudine_structure.svg

Telbivudine is an antiviral drug used in the treatment of hepatitis B. It is a synthetic thymidine nucleoside analogue with potent and selective activity against the hepatitis B virus (HBV). Telbivudine is marketed under the brand name Tyzeka in the United States and Sebivo in other countries.

Mechanism of Action[edit]

Telbivudine works by inhibiting the DNA polymerase of the hepatitis B virus, which is essential for viral replication. By incorporating itself into the viral DNA, telbivudine causes premature chain termination, thereby preventing the virus from multiplying and spreading.

Pharmacokinetics[edit]

Telbivudine is administered orally and is well absorbed from the gastrointestinal tract. It reaches peak plasma concentrations within 1 to 4 hours after ingestion. The drug is primarily excreted unchanged in the urine, with a half-life of approximately 15 hours.

Clinical Use[edit]

Telbivudine is indicated for the treatment of chronic hepatitis B in patients with evidence of active viral replication and either evidence of persistent elevations in serum alanine aminotransferase (ALT) or histologically active disease. It is particularly effective in patients who are nucleoside analogue-naive.

Side Effects[edit]

Common side effects of telbivudine include:

Resistance[edit]

Resistance to telbivudine can develop, particularly with long-term use. The most common mutation associated with resistance is the M204I mutation in the HBV polymerase gene. Cross-resistance with other nucleoside analogues, such as lamivudine and entecavir, can also occur.

Contraindications[edit]

Telbivudine is contraindicated in patients with a known hypersensitivity to the drug or any of its components. Caution is advised in patients with renal impairment, as dose adjustments may be necessary.

Pregnancy and Lactation[edit]

Telbivudine is classified as a pregnancy category B drug. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether telbivudine is excreted in human milk; therefore, caution should be exercised when administered to nursing mothers.

See Also[edit]

References[edit]


External Links[edit]

Telbivudine

Telbivudine


Trade names Tyzeka, Sebivo


Chemical nomenclature
IUPAC name 1-[(2S,4R,5S)-4-Hydroxy-5-(hydroxymethyl)oxolan-2-yl]-5-methylpyrimidine-2,4-dione



Routes Oral
Pregnancy category B



Half-life 15 hours
Excretion Renal
Legal status Rx-only
Identifiers
CAS Number 3424-98-4
PubChem 457898
DrugBank DB01265
ChemSpider 403168
UNII 3O2K1G66ZY
KEGG D06067
ChEMBL 1201187
Chemical data


Chemical formula C10H14N2O5


SMILES CC1=CN(C(=O)NC1=O)C2CC(C(O2)CO)O
InChI 1S/C10H14N2O5/c1-5-2-12(10(16)11-9(5)15)8-3-6(14)7(4-13)17-8/h2,6-8,13-14H,3-4H2,1H3,(H,11,15,16)/t6-,7+,8+/m0/s1
InChIKey HNVIMBABAJGQLR-RRKCRQDMSA-N


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