telbivudine telbivudine telbivudine is an antiviral drug used in the treatment of hepatitis b infection. it is marketed by swiss pharmaceutical company novartis under the trade names sebivo (european union) and tyzeka (united states). clinical trials have shown it to be significantly more effective than lamivudine or adefovir, and less likely to cause resistance. however, hbv signature resistance mutation m204i (a change from methionine to isoleucine at position 204 in the reverse transcriptase domain of the hepatitis b polymerase) or l180m+m204v have been associated with telbivudine resistance. telbivudineclinical datatrade namestyzeka, sebivoother names1-(2-deoxy-β-l-ribofuranosyl)-5-methyluracilβ-l-2-deoxythymidineβ-l-thymidine (ldt)1--5-methyl-1h-pyrimidine-2,4-dioneahfs/drugs.commonographmedlineplusa607045license data eu ema: by inn us dailymed: telbivudine pregnancycategory au: b1 routes ofadministrationby mouthatc codej05af11 (who) legal statuslegal status au: s4 (prescription only) uk: pom (prescription only) us: ℞-only eu: rx-only pharmacokinetic dataprotein bindinglow (3.3% in vitro)metabolismnilelimination half-life40 to 49 hours (terminal phase)excretionkidneyidentifiers iupac name 1-(2-deoxy-β-l-erythro-pentofuranosyl)-5-methylpyrimidine-2,4(1h,3h)-dione cas number3424-98-4 ypubchem cid159269drugbankdb01265 ychemspider140081 yunii2oc4hkd3sfchemblchembl374731 ncomptox dashboard (epa)dtxsid30187813 echa infocard100.125.511 chemical and physical dataformulac10h14n2o5molar mass242.231 g·mol−13d model (jsmol)interactive image smiles cc1cn(2c(o)(co)o2)c(=o)c1=o inchi inchi=1s/c10h14n2o5/c1-5-3-12(10(16)11-9(5)15)8-2-6(14)7(4-13)17-8/h3,6-8,13-14h,2,4h2,1h3,(h,11,15,16)/t6-,7+,8+/m1/s1 ykey:iqfyykkmvgjfeh-csmhccousa-n y ny (what is this?) (verify) telbivudine is a synthetic thymidine β-l-nucleoside analogue; it is the l-isomer of thymidine. telbivudine impairs hepatitis b virus (hbv) dna replication by leading to chain termination. it differs from the natural nucleotide only with respect to the location of the sugar and base moieties, taking on an levorotatory configuration versus a dextrorotatory configuration as do the natural deoxynucleosides. it is taken orally in a dose of 600 mg once daily with or without food. telbivudine has no in vitro activity against hiv-1, and in a case-series of three hiv-hbv co-infected patients, telbivudine did not produce sustained hiv-1 virologic suppression or induce any resistance mutations in hiv-1. in 2016, novartis posted a discontinuation notice for tyzeka.