title: Myotoxicity of telbivudine in pre-existing muscle damage.
abstract: OBJECTIVE
  It is unknown if telbivudine causes muscle damage only in patients with pre-existing muscle pathology.
  
  
  METHODS
  A 27 yo male of African origin received telbivudine for hepatitis B during 3 months. Three weeks after initiation of the drug he developed myalgia, and tiredness. Creatine-kinase increased from 278 U/l (n, <170 U/l) at baseline to 3243 U/l. Shortly after discontinuation of telbivudine muscle symptoms and hyper-CK-emia disappeared. The findings suggest that pre-existing muscle damage favored the myotoxic effect of telbivudine.
  
  
  CONCLUSIONS
  Telbivudine appears to cause accelerated muscle toxicity if given to patients who already have muscle damage. Patients under telbivudine should be closely monitored for muscular side effects and those with pre-existing muscle damage should not receive the drug.
authors.affiliation: Department of Neurology, Krankenanstalt Rudolfstiftung, Vienna, Austria. fifigs1@yahoo.de
authors.forename: Josef
authors.initials: J
authors.lastname: Finsterer
authors.forename: Leyla
authors.initials: L
authors.lastname: Ay
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003402:Creatine Kinase / Q000097:blood; D006509:Hepatitis B / Q000188:drug therapy; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000473:pathology; D009135:Muscular Diseases / Q000139:chemically induced* / Q000473:pathology; D009705:Nucleosides / Q000008:administration & dosage / Q000009:adverse effects*; D011744:Pyrimidinones / Q000008:administration & dosage / Q000009:adverse effects*; D000077712:Telbivudine; D013936:Thymidine / Q000031:analogs & derivatives
chemical_list: D000998:Antiviral Agents; D009705:Nucleosides; D011744:Pyrimidinones; D000077712:Telbivudine; D003402:Creatine Kinase; D013936:Thymidine