Hep B Treatment

Hepatitis B Treatment Information from CDC

City Health Information (CHI): Preventing and Managing Hepatitis B. NYC DOHMH

AASLD PRACTICE GUIDELINES: Chronic Hepatitis B: Update 2009

Hepatitis B Treatment Information from HBV Advocate

Approved treatment For Hepatitis B

5 Oral anti-viral medications currently available:

1.       Lamivudine
2.       Adefovir dipivoxil
3.       Entecavir
4.       Telbivudine
5.       Tenofovir

1.       Lamivudine

  • Brand name: Epivir-HBV
  • Adult dosage :1 tablet (100 mg/day) a day
  • Side Effects: Headache, fatigue, insomnia ,nausea, diarrhea, pancreatitis, abdominal pain, vomiting, neutropenia, transaminases increased, myalgia, neuropathy, musculoskeletal pain, nasal signs and symptoms , cough ,sore throat, infections includes ear, nose, and throat
  • Monitor: liver enzymes (every 3 months during therapy)

2.       Adefovir dipivoxil

  • Brand name: Hepsera
  • Adult Dosage:1 tablet (10 mg) once daily
  • Side Effects: Headache ,Abdominal pain ,diarrhea, Hepatitis exacerbation (up to 25% within 12 weeks of Adefovir discontinuation),weakness, hematuria

3.       Entecavir

  • Brand name: Baraclude
  • Adult Dosage: Nucleoside treatment naive: 0.5 mg once daily; Decompensated liver disease: 1 mg once daily
  • Side Effects: Cardiovascular, Peripheral edema Pyrexia, Ascites, ALT increased
  • Take on an empty stomach
  • Monitor: Liver Function Tests

4.       Telbivudine

  • Brand name:Tyzeka
  • Adult Dosage: : 600 mg once daily
  • Side Effects: Fatigue, neuromuscular & skeletal, headache, dizziness fever, insomnia (This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions)

5.       Tenofovir

  • Brand Name :Viread
  • Adult Dosage: 300 mg once daily
  • Decompensated liver disease: Lifelong treatment is recommended
  • Tenofovir is recommended for first-line treatment of HBV
  • Side Effects: Insomnia ,pain dizziness, depression, fever ,triglycerides increased abdominal pain, nausea, diarrhea, vomiting, neuromuscular & skeletal, creatine kinase increased, weakness

**Resistance can develop to medications if non-compliant**

**Each Patient should speak to their Doctor and see which medication is right for them.**

2 injectable treatments currently available:

  1. Interferon alfa-2b
  2. Peginterferon alfa-2a

Rarely used because of challenging side effects