Drugs excreted by or which affect affect renal tubular excretion 

Other nephrotoxic drugs eg. cyclosporine, tacrolimus, aminoglycosides, NSAIDs

Treatment of chronic Hepatitis B  in adults with compensated liver disease

GI upset, asthenia, headache, abdominal pain, raised serum creatinine levels,

Renal insufficiency, renal failure

Pruritus, lactic acidosis, severe hepatomegaly,

Post treatment excaberation of hepatitis, pancreatitis,

Hypophosphatomia, nephrotoxicity ( prolonged use )

Monitor patients every 3 months for hepatitis B biochemical , virological, and serological markers to determine tratment duration

Renal impairmen- t Monitor renal function prior to initiation of therapy, then every 3 months.

Cirrhosis, monitor closely for hepatic decompensation

Monitor patients for several months after stopping therapy for acute excaberationof hepatitis particularly obese women with hepatomegaly, hepatitis or other factors for liver disease,

Risk of lactic acidosis, sometimes fatal.

Co-infection with hepatitis C or D or HIV.

Elderly

Pregnancy, labour delivery

Indication-

Treatment of chronic Hepatitis B in adults with compensated liver disease

Dosage-

Take with or without food

1 tablet daily Use in combination with lamivudine to reduce risk of redsistence

Not recommended for patients below 18 years

Take with or without food

Observe caution if required to be used during or labour and delivery