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Sebivo (Telbivudine)

What Sebivo is and what it is used for

Sebivo belongs to a group of medicines called antiviral medicines, which are used to treat infections caused by viruses.

Sebivo is used to treat adults with chronic hepatitis B.

Hepatitis B is caused by infection with the hepatitis B virus, which multiplies in the liver and causes liver damage. Treatment with Sebivo reduces the amount of hepatitis B virus in the body by blocking its growth, resulting in less liver damage and improved liver function.

Before you take Sebivo

Do not take Sebivo

  • if you are allergic (hypersensitive) to telbivudine or any of the other ingredients of Sebivo (listed in section 6).
  • if you are being treated with pegylated or standard interferon alfa (see “Taking other medicines”). If this applies to you, do not take Sebivo. Talk to your doctor. If you think you may be allergic, ask your doctor for advice.

Take special care with Sebivo

  • if you have or have had any kidney problems. Your doctor may order laboratory tests to check your kidneys are working properly before and during treatment. Depending on the results of these tests your doctor may advise you to change how often you take Sebivo.
  • if you suffer from cirrhosis of the liver (a serious condition which causes liver “scarring”). In this case your doctor will want to monitor you more closely.
  • if you have had a liver transplant.
  • if you are taking any medicines that may cause muscle problems (talk to your doctor or pharmacist if you are unsure).
  • if you are infected with HIV, hepatitis C or D, or are being treated with any antiviral medicines.

If any of these applies to you, tell your doctor before you take Sebivo.

Sebivo can cause persistent unexplained muscle weakness or muscle pain (myopathy). Muscle symptoms may progress and become serious, sometimes leading to muscle breakdown (rhabdomyolysis) which can cause kidney damage.

Uncommonly Sebivo can induce numbness, tingling, pain and/or burning sensations in the arms and/or legs (peripheral neuropathy). If you experience any of these symptoms during your treatment with Sebivo, call your doctor immediately.

Other effects of this type of medicine

Sebivo belongs to a class of medicines (a nucleoside analogue) that can cause an excess of lactic acid in the blood (lactic acidosis) and enlargement of the liver (hepatomegaly) with fatty liver (steatosis). Lactic acidosis is a rare but serious side effect which can occasionally be fatal. Lactic acidosis occurs more often in women, particularly if they are very overweight. Your doctor will monitor you regularly while you are receiving Sebivo. If you experience muscle pain, severe and persistent stomach pain with nausea and vomiting, severe and persistent trouble breathing and tiredness while taking Sebivo, call your doctor immediately.

Some people may get very serious hepatitis symptoms when they stop taking medicines like Sebivo. Your doctor will monitor your health and do regular blood tests to check your liver after you stop treatment with Sebivo. Tell your doctor immediately about any new or unusual symptoms that you notice after stopping treatment (see “If you stop taking Sebivo” in section 3 of this leaflet).

Take care not to infect other people

Sebivo does not reduce the risk of infecting others with hepatitis B virus (HBV) through sexual contact or exposure to contaminated blood or other body fluids. Never share needles. Do not share personal items that could have blood or body fluids on them, such as toothbrushes or razor blades. A vaccine is available to prevent infection with HBV.

Use in children

Sebivo is not recommended for use in children under 16 years of age.

Taking other medicines

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

Your doctor or pharmacist needs to know about other medicines because some medicines could affect your kidneys and because Sebivo mainly leaves the body via the kidneys in the urine.

Do not take Sebivo if you are using pegylated or standard interferon alfa (see “Do not take Sebivo”), because the combination of these medicines may increase your risk of developing peripheral neuropathy (numbness, tingling, and/or burning sensations in the arms and/or legs). Tell your doctor or pharmacist if you are being treated with interferon.

Pregnancy and breast-feeding

Do not use Sebivo during pregnancy unless your doctor recommends it. If you are pregnant or think you may be, tell your doctor before taking Sebivo. Your doctor will discuss with you the potential risks of taking Sebivo during pregnancy.

If you have hepatitis B and become pregnant, talk to your doctor about how you can best protect your baby. It is not known whether Sebivo reduces the risk of passing your hepatitis B virus on to your unborn baby.

Do not breast-feed during treatment with Sebivo. Tell your doctor if you are breast-feeding.

How to take Sebivo

Always take Sebivo exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.

How much Sebivo to take

The usual dose of Sebivo is one 600 mg tablet once a day. Take the tablet at about the same time each day.

The tablet can be taken with or without food. Swallow it whole with some water. Do not chew, split or crush it.

You may need to take Sebivo less frequently if you have kidney problems. Tell your doctor if you have, or have ever had, any kidney problems.

How long to take Sebivo

Do not change your dose or stop taking Sebivo without talking to your doctor. Take Sebivo every day and continue your treatment exactly as prescribed unless your doctor says otherwise. Your doctor will make regular checks to make sure that Sebivo is working. Your hepatitis B symptoms may get worse or become very serious if you stop taking Sebivo.

If you take more Sebivo than you should

If you have taken too much Sebivo, or if someone else accidentally takes your tablets, go to your doctor or hospital for advice straight away. Take the pack of tablets with you and show it to your doctor.

If you forget to take Sebivo

If you forget to take Sebivo, take it as soon as you remember and then take your next dose at its regular time.

However, if it is almost time for your next dose, skip the dose you missed and take the next one at the usual time.

Do not take a double dose to make up for a forgotten tablet. This may increase the chance of you getting unwanted side effects. Ask your doctor or pharmacist if you are not sure what to do.

If you stop taking Sebivo

Stopping treatment with Sebivo may result in a worsening of your hepatitis B infection. Do not stop Sebivo unless your doctor tells you to. While you are taking Sebivo, make sure you do not run out of Sebivo.

Your doctor will monitor your health and do regular blood tests to check your liver after you stop treatment with Sebivo since your hepatitis B infection may get worse or become very serious after stopping treatment. Tell your doctor immediately about any new or unusual symptoms that you notice after stopping treatment.

Possible side effects

Like all medicines, Sebivo can cause side effects, although not everybody gets them. The frequencies are defined as:

very common: attects more than 1 patient in 10
common: affects 1 to 10 patients in 100
uncommon: affects 1 to 10 patients in 1,000
rare: affects 1 to 10 patients in 10,000
very rare: affects less than 1 patient in 10,000
not known: frequency cannot be estimated from the available data.

Some uncommon side effects could be serious:

  • Persistent muscle weakness or muscle pain
  • Numbness, tingling, pain and/or burning sensation in the arms and/or legs If you experience any of these, call your doctor immediately.
  • Sebivo may also cause other side effects:
  • Common side effects
  • Dizziness, headache
  • Cough
  • Diarrhoea, feeling sick (nausea), stomach (abdominal) pain
  • Skin rash
  • Tiredness (fatigue)
  • Blood test results show higher levels of liver enzymes, amylase, lipase or creatine kinase

Uncommon side effects

  • Joint pain
  • Persistent muscle weakness or muscle pain (myopathy/myositis), muscle cramp Back, neck and flank pain
  • Numbness, tingling, pain and/or burning sensation in the arms and/or legs or around the mouth Sciatica (pain in lower back or hip and may radiate into the leg) Taste disturbance Feeling unwell (malaise)
  • Frequency not known
  • Excess of lactic acid in the blood (lactic acidosis) and muscle breakdown (rhabdomyolysis) have been reported.

If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

How to store Sebivo

Keep out of the reach and sight of children.

Do not use Sebivo after the expiry date which is stated on the carton after EXP. The expiry date refers to the last day of that month.

Do not use if the pack is damaged or shows signs of tampering.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

Further information

What Sebivo contains

The active substance is telbivudine. Each tablet contains 600 mg telbivudine.

The other ingredients are: cellulose, microcrystalline; povidone; sodium starch glycolate; silica, colloidal anhydrous; magnesium stearate; hypromellose; titanium dioxide (E171); talc; macrogol.

What Sebivo looks like and contents of the pack

Sebivo film-coated tablets are white to slightly yellowish, oval, film-coated tablets with “LDT” imprinted on one side.

Sebivo film-coated tablets are supplied in packs of 28 or 98 tablets. Not all pack sizes may be marketed in your country.

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