Hepatitis B NRTIs Drug Class

Hepatitis B NRTIs – or Nucleoside Reverse Transcriptase Inhibitors _ are antiviral chemotherapy treatments used to fight Hepatitis B Virus (HBV) infections. These medications help slow the ability of the HBV to multiply in the body by targeting DNA strand elongation of the HBV polymerase (HP). The most popular Hepatitis B NRTIs include Entecavir and Tenofovir, which are both taken by mouth and found to be the most effective with a very slight chance that viruses develop resistance to them. Other commonly used examples of this drug class include Telbivudine and Lamivudine _ also taken by mouth.

Hepatitis B NRTIs Drugs

Below you will find a list of drugs that fall under the class of Hepatitis B NRTIs:

Hepatitis B NRTIs Uses

Since HBV puts the liver at a high risk, NRTIs are used as a treatment option for adults diagnosed with chronic HBV infection _ as well as children who are at a particularly high risk for liver disease.

After an HBV diagnosis, the decision to move forward with HBV treatment is based on the presence of Hepatitis B antigens found in the blood, a high level of HBV DNA in the blood and levels of the liver enzyme alanine aminotransferase (ALT).

Most versions of these drugs are taken in pill form on a daily basis for at least a year until treatment is considered successful. The definition of this success, determined through blood tests, includes indication that the virus is no longer multiplying in the body, liver enzyme levels have returned to normal, and liver damage has improved.

However, HBV does tend to recur once drug treatment is stopped and can often come back in the form of a more severe case of the disease. As a result, certain people may need to take these drugs indefinitely.

Hepatitis B NRTIs Side Effects

Common, urgent side effects of this drug class include trouble breathing and swelling of the lips, tongue, throat or face. 911 should be called immediately if these symptoms are experienced.

Those taking this class of drugs should also contact their healthcare professional if they experience any of the following symptoms:

  • Experience dizziness or racing heart
  • Experience weakness or pain in an extremity
  • Develop hives
  • Have stomach pain
  • Feel unusual and severe muscle pain
  • Notice a yellowing of the skin or whites of the eyes
  • Feel severely sick to the stomach or unusually cold

Other, more common side effects include headache, diarrhea, fever, sore throat and a feeling of unusual tiredness or weakness.

Hepatitis B NRTIs Interactions

Below you will find them most common drugs in the Hepatitis B NRTIs class and their interactions.

Baraclude (Entecavir)

Entecavir has a moderate food interaction, with reduced absorption possible in the presence of food. As such, it should be taken on an empty stomach two hours before or two hours after a meal, unless otherwise directed by your doctor.

Should not be taken by those with Hemodialysis and Renal Dysfunction

Common medications that may interact with Entecavir include:

Viread (Tenofovir)


Disease interactions include

  • Hepatotoxicity
  • Renal Dysfunction

Commonly used major drug interactions include:

Epivir (Lamivudine)

Disease Interaction: High Cholesterol: Patients with high cholesterol should be monitored as interaction with this drug could increase the chances of developing pancreatitis.

Disease interactions include:

  • Pancreatitis
  • Renal Dysfunction

Commonly used major drug interactions include:

Hepsera (Adefovir)

Warning: Some patients have developed severe and sometimes fatal worsening of hepatitis after they stop taking Hepsera

Disease Interactions: Renal Dysfunction

Commonly used major drug interactions include:

Epivir-HBV (Lamivudine)

Warning: Serious and sometimes fatal high blood lactic acid levels and liver problems have occurred with the use of Epivir

  • HBV. This risk might be higher if you are a woman, very overweight or have taken similar medicines for a long period of time.Disease Interaction: High Cholesterol
  • Patients with high cholesterol should be monitored as interaction with this drug could increase the chances of developing pancreatitis.Commonly used major drug interactions include:


  • Arava (Leflunomide)
  • Aubagio (Teriflunomide)
  • Bexarotene
  • Juxtapid (Lomitapide)
  • Kynamro (Mipomersen)
  • Leflunomide
  • Lomitapide
  • Mipomersen
  • Targretin (Bexarotene)
  • Teriflunomide

Tyzeka (Telbivudine)

Disease Interactions:

  • Myopathy
  • Renal Dysfunction
  • Hemodialysis

Commonly used major drug interactions include: