Drug General Information (ID: DDI3US6TJ5)
Drug Name			Telbivudine		Drug Info		Givosiran		Drug Info
Drug Type		Small molecule				Small interfering RNA
Therapeutic Class		Antiviral Agents				Metabolic Agents
Structure

Mechanism of Telbivudine-Givosiran Interaction (Severity Level: Moderate)
Decreased renal excretion due to nephrotoxicity Click to Show/Hide Mechanism Graph
Drug Name		Telbivudine				Givosiran
Mechanism		Primarily eliminated by renal excretion				Nephrotoxicity
Key Mechanism Factor 1
		Factor Name		Nephrotoxicity
		Factor Description		Drug-induced nephrotoxicity is a common and potentially serious complication of medication use. The kidneys are the primary organ for drug excretion, and when they are damaged can lead to decreased drug excretion.
Mechanism Description		Decreased renal excretion of Telbivudine caused by Givosiran mediated nephrotoxicity

Recommended Action
Management		Caution is advised if telbivudine is prescribed in combination with potentially nephrotoxic drugs (e.g., aminoglycosides polypeptide, glycopeptide, and polymyxin antibiotics amphotericin B adefovir cidofovir tenofovir foscarnet cisplatin deferasirox gallium nitrate lithium mesalamine certain immunosuppressants intravenous bisphosphonates intravenous pentamidine high intravenous dosages of methotrexate high dosages and/or chronic use of nonsteroidal anti-inflammatory agents). Renal function should be evaluated prior to and during therapy with telbivudine.

References
1	Product Information. Tyzeka (telbivudine). IDEC Pharmaceuticals Corporation, San Diego, CA.