Tab%25252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520voihep

# Tab%25252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520voihep ## Overview This medication is a nucleoside analog used in the treatment of chronic hepatitis B virus (HBV) infection. ## Primary Indications * Chronic Hepatitis B virus (HBV) infection in adults and pediatric patients. ## Adult Dosing The recommended dose is 300 mg orally once daily. ## Pediatric Dosing * Children aged 12 years and older who weigh at least 35 kg: 300 mg orally once daily. * Dosing for children younger than 12 years or those weighing less than 35 kg is not established and should be based on local protocol or expert consultation. ## Dose Adjustments * **Renal Impairment:** Dose adjustment is required based on creatinine clearance (CrCl). * CrCl 30-49 mL/min: 300 mg every other day. * CrCl 10-29 mL/min: 300 mg twice weekly (e.g., Monday and Thursday). * CrCl < 10 mL/min or on hemodialysis/continuous ambulatory peritoneal dialysis: 300 mg once weekly. * **Hepatic Impairment:** No dose adjustment is generally needed. However, caution is advised in patients with decompensated cirrhosis. ## Contraindications * Hypersensitivity to the active ingredient or any component of the formulation. * Co-infection with HBV and HCV in patients with decompensated liver disease. ## Adverse Effects Common adverse effects include headache, dizziness, nausea, diarrhea, fatigue, abdominal pain, and rash. Serious adverse effects may include lactic acidosis, severe hepatomegaly with steatosis, and nucleoside analog resistance. ## Key Drug Interactions * **Didanosine:** Co-administration may increase the risk of pancreatitis and peripheral neuropathy. Avoid concurrent use. * **Ribavirin:** Co-administration may increase the risk of anemia. * **Other nephrotoxic drugs:** Use with caution as it may increase the risk of renal toxicity. ## Monitoring * Liver function tests (ALT, AST, bilirubin, albumin) regularly. * Renal function (serum creatinine, CrCl) at baseline and periodically. * HBV DNA levels to assess viral suppression. * Lactic acid levels if symptoms of lactic acidosis arise. ## Clinical Pearls * Treatment should be guided by a healthcare professional experienced in managing chronic HBV. * Patients should be advised that this medication does not cure HBV and can still transmit the virus. * Discontinuation of therapy may lead to exacerbations of hepatitis B. Consider monitoring for flares after treatment cessation. *** *This information is intended for healthcare professionals and should not replace a thorough review of the current prescribing information and relevant clinical literature.*