Drug General Information (ID: DDIJ6NSDR3)
Drug Name			Peginterferon alfa-2a		Drug Info		Telbivudine		Drug Info
Drug Type		Interferons				Small molecule
Therapeutic Class		Antineoplastics				Antiviral Agents

Mechanism of Peginterferon alfa-2a-Telbivudine Interaction (Severity Level: Major)
Increased risk of peripheral neuropathy Click to Show/Hide Mechanism Graph
Drug Name		Peginterferon alfa-2a				Telbivudine
Mechanism		Peripheral neuropathy				Peripheral neuropathy
Key Mechanism Factor 1
		Factor Name		Peripheral neuropathy
		Factor Description		Peripheral neuropathy is a disorder of the peripheral nerves that can cause sensory and motor symptoms, and even paralysis in severe cases. Signs and symptoms of peripheral neuropathy may include: gradual numbness, tingling or prickling in the feet or hands that can spread up the legs and arms; sharp, stinging, pricking or burning sensations; extreme sensitivity to touch; pain during activities that should not cause pain; lack of coordination and falls; muscle weakness; and paralysis if the motor nerves are affected.
Mechanism Description		Increased risk of peripheral neuropathy by the combination of Peginterferon alfa-2a and Telbivudine

Recommended Action
Management		The safety and efficacy of telbivudine in combination with alfa interferons for the treatment of chronic hepatitis B have not been demonstrated, thus concomitant use should generally be avoided. Coadministration of telbivudine with pegylated interferon alfa-2a is specifically contraindicated by the manufacturer. Patients treated with these agents should be advised to report any numbness, tingling, and/or burning sensations in the arms and/or legs, with or without gait disturbance. Telbivudine therapy should be interrupted if peripheral neuropathy is suspected, and discontinued if confirmed.

References
1	Product Information. PEG-Intron (peginterferon alfa-2b) Schering Corporation, Kenilworth, NJ.
2	Product Information. Pegasys (peginterferon alfa-2a). Roche Laboratories, Nutley, NJ.
3	Product Information. Tyzeka (telbivudine). IDEC Pharmaceuticals Corporation, San Diego, CA.