Telbivudine

It is a thymidine analog that can be used in the treatment of HBV. Unlike lamivudine and adefovir, telbivudine is not active against HIV or other viruses. The drug is phosphorylated intracellularly to the triphosphate, which can either compete with endogenous thymidine triphosphate for incorporation into DNA or else be incorporated into viral DNA, where it serves to terminate further elongation of the DNA chain. The drug is administered orally, once a day, with or without food. Telbivudine is eliminated by glomerular fi ltration as the unchanged drug, and no metabolites have been detected. The dose must be adjusted in renal failure. The combination of telbivudine with lamivudine has been no more eff ective than telbivudine alone.