Starting Treatment for Hepatitis B

Getting Started with Hepsera

There are two types of medication to help fight the hepatitis B virus: oral antiviral medications and interferon (which is generally injected). Oral antiviral medications help stop the hepatitis B virus from multiplying by blocking an enzyme (called “HBV DNA polymerase”) that is necessary for the virus to make copies of itself (“replicate”) inside your body. Interferon helps the body’s immune system fight disease and may slow or stop the growth of the hepatitis B virus. Your doctor will recommend the treatment that he or she believes is right for you. This page will review some considerations when starting the antiviral medication, Hepsera^® (adefovir dipivoxil).

Hepsera is a prescription medication used to treat chronic infection with the hepatitis B virus in adults. Hepsera does not cure chronic hepatitis B, and it does not reduce the risk of spreading hepatitis B to others. The medicine is provided as a 10 mg tablet that you take once a day by mouth. Hepsera can be taken with or without food. Below are some important tips to help ensure that your treatment with Hepsera is as successful as possible:

Do Not Miss a Dose. Always take the recommended dose of Hepsera exactly as prescribed by your doctor.
Plan a Schedule. Try taking Hepsera at the same time each day along with another daily activity, such as brushing your teeth. Build up a routine, so you don't miss a dose.
Remember to Refill. Refill your prescription at least five days before you run out, so you don't miss a dose of Hepsera.
Talk to Your Doctor About Changes. Do not change your dose of Hepsera or stop taking Hepsera without talking to your doctor first. Your hepatitis may get worse if you change your dose or stop.
Don't Double Up. Never double up on Hepsera if you miss a dose.
Missing a Dose. If you forget to take Hepsera, take it as soon as you remember that day. Do not take more than one dose of Hepsera in a day. Do not take two doses at the same time. Call your doctor or pharmacist if you are not sure what to do.
Length of Treatment. It is unknown how long you should take Hepsera. You and your doctor will need to decide when it is best for you to stop treatment with Hepsera.
Taking Other Medications. Before taking Hepsera or any time during treatment, talk to your doctor about any medicines, prescription or non-prescription, and supplements (including herbal), that you are taking or plan to take.

Next: Tracking your treatment progress >>

Important Safety Information

1. Some people who stop taking Hepsera get a very serious hepatitis. This usually happens within 12 weeks after stopping. You will need to have regular blood tests to check for liver function and hepatitis B virus levels if you stop taking Hepsera.

2. Hepsera may cause a severe kidney problem called nephrotoxicity. It usually happens in people that already have a kidney problem, but it can happen to anyone that uses Hepsera. You will need to have regular blood tests to check for kidney function while you are taking Hepsera.

3. Some people who have taken medicines like Hepsera that are called nucleoside or nucleotide analogs have developed a serious condition called lactic acidosis (buildup of an acid in the blood). Lactic acidosis is a medical emergency and must be treated in the hospital. Call your doctor right away if you get any of the following signs of lactic acidosis:

You feel very weak or tired.
You have unusual (not normal) muscle pain.
You have trouble breathing.
You have stomach pain with nausea and vomiting.
You feel cold, especially in your arms and legs.
You feel dizzy or lightheaded.
You have a fast or irregular heartbeat.

Some people who have taken medicines like Hepsera have developed serious liver problems called hepatotoxicity, with liver enlargement (hepatomegaly) and fat in the liver (steatosis). Call your doctor right away if you get any of the following signs of liver problems:

Your skin or the white part of your eyes turns yellow (jaundice).
Your urine turns dark.
Your bowel movements (stools) turn light in color.
You don't feel like eating food for several days or longer.
You feel sick to your stomach (nausea).
You have lower stomach pain.

You may be more likely to get lactic acidosis or serious liver problems if you are very overweight (obese) or have been taking nucleoside analog medicines [Combivir^® (zidovudine plus lamivudine), Emtriva^® (emtricitabine), Epivir^®, Epivir-HBV^® (lamivudine), Hivid^® (zalcitabine), Retrovir^® (zidovudine), Trizivir^® (zidovudine plus lamivudine plus abacavir), Videx^® (didanosine), Viread^® (tenofovir disoproxil fumarate), Zerit^® (stavudine) and Ziagen^® (abacavir)] for a long time.

4. If you get or have HIV that isn't being treated with medicines, Hepsera may increase the chances your HIV infection cannot be helped with usual HIV medicines. This can happen if you get or have HIV and don't know it, or if your HIV is not being treated while you are taking Hepsera. You should get an HIV test before you start taking Hepsera and any time after that when there's a chance you were exposed to HIV.

Patients should be aware of Important Safety Information about Hepsera and may read additional product information for patients, including the box titled "Warnings." It is important that you discuss your treatment options and any questions that you may have with your healthcare provider.

Make sure loved ones get tested for hepatitis B. If they test negative, protect them with the vaccine.