Identification
Name Telbivudine
Accession Number DB01265
Type small molecule
Description Telbivudine is a synthetic thymidine nucleoside analog with specific activity against the hepatitis B virus. Telbivudine is orally administered, with good tolerance, lack of toxicity and no dose-limiting side effects.
Structure
Categories (*)
Molecular Weight 242.2286
Groups approved
Monoisotopic Weight 242.090271568
Pharmacology
Indication For the treatment of chronic hepatitis B in adult and adolescent patients >=16 years of age with evidence of viral replication and either evidence of persistent elevations in serum aminotransferases (ALT or AST) or histologically active disease.
Mechanism of action Telbivudine 5'-triphosphate inhibits HBV DNA polymerase (reverse transcriptase) by competing with the natural substrate, thymidine 5'-triphosphate. This leads to the chain termination of DNA synthesis, thereby inhibiting viral replication. Incorporation of telbivudine 5'-triphosphate into viral DNA also causes DNA chain termination, resulting in inhibition of HBV replication. Telbivudine inhibits anticompliment or second-strand DNA.
Absorption Absorbed following oral administration. Telbivudine absorption and exposure were unaffected when a single 600-mg dose was administered with a high-fat (~55 g), high-calorie (~950 kcal) meal.
Protein binding In vitro binding of telbivudine to human plasma proteins is low (3.3%).
Biotransformation No metabolites of telbivudine were detected following administration of [14C]-telbivudine in humans. Telbivudine is not a substrate, or inhibitor of the cytochrome P450 (CYP450) enzyme system.
Route of elimination Telbivudine is eliminated primarily by urinary excretion of unchanged drug.
Toxicity There is no information on intentional overdose of telbivudine, but one subject experienced an unintentional and asymptomatic overdose. Healthy subjects who received telbivudine doses up to 1800 mg/day for 4 days had no increase in or unexpected adverse events. A maximum tolerated dose for telbivudine has not been determined.
Affected organisms
  • Hepatitis B virus
Interactions
Drug Interactions
Drug Mechanism of interaction
Peginterferon alfa-2a Co-administration of Peginterferon alpha-2a and Telbivudine may increase the risk of serious peripheral neuropathy.
Food Interactions
  • Take without regard to meals.
P protein [Includes: DNA-directed DNA polymerase
Name P protein [Includes: DNA-directed DNA polymerase
Gene Name P
Pharmacological action yes
Actions Not Available
References
  • Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. - Pubmed
  • Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. - Pubmed
  • Lui YY, Chan HL: Treatment of chronic hepatitis B: focus on telbivudine. Expert Rev Anti Infect Ther. 2009 Apr;7(3):259-68. - Pubmed
  • Nash K: Telbivudine in the treatment of chronic hepatitis B. Adv Ther. 2009 Feb;26(2):155-69. Epub 2009 Feb 18. - Pubmed
  • Lui YY, Chan HL: A review of telbivudine for the management of chronic hepatitis B virus infection. Expert Opin Drug Metab Toxicol. 2008 Oct;4(10):1351-61. - Pubmed
  • Amarapurkar DN: Telbivudine: a new treatment for chronic hepatitis B. World J Gastroenterol. 2007 Dec 14;13(46):6150-5. - Pubmed
  • Keam SJ: Telbivudine. Drugs. 2007;67(13):1917-29. - Pubmed
  • Ruiz-Sancho A, Sheldon J, Soriano V: Telbivudine: a new option for the treatment of chronic hepatitis B. Expert Opin Biol Ther. 2007 May;7(5):751-61. - Pubmed
  • Han SH: Telbivudine: a new nucleoside analogue for the treatment of chronic hepatitis B. Expert Opin Investig Drugs. 2005 Apr;14(4):511-9. - Pubmed
  • Jones R, Nelson M: Novel anti-hepatitis B agents: A focus on telbivudine. Int J Clin Pract. 2006 Oct;60(10):1295-9. - Pubmed
DTHybrid score 0.9888
DNA
Name DNA
Gene Name Not Available
Pharmacological action yes
Actions Not Available
References
  • Nash K: Telbivudine in the treatment of chronic hepatitis B. Adv Ther. 2009 Feb;26(2):155-69. Epub 2009 Feb 18. - Pubmed
  • Gaeta GB, Stornaiuolo G: Therapy of chronic hepatitis B: focus on telbivudine. Dig Liver Dis. 2007 Nov;39 Suppl 3:S372-8. - Pubmed
  • Ruiz-Sancho A, Sheldon J, Soriano V: Telbivudine: a new option for the treatment of chronic hepatitis B. Expert Opin Biol Ther. 2007 May;7(5):751-61. - Pubmed
DTHybrid score Not Available