What is HEPSERA?

HEPSERA

(adefovir dipivoxil) Tablets

PATIENT INFORMATION

HEPSERA® (hep-SER-rah)

Generic Name: (adefovir dipivoxil) tablets

Read this information carefully before you start taking HEPSERA. Read
and check for new information each time you get more HEPSERA. This information
does not take the place of talking with your doctor about your medical
condition or your treatment.

What is the most important information I should know about HEPSERA?

1. Some people who take HEPSERA get a worse or very serious hepatitis
   when they stop taking it. This usually happens within 12 weeks after
   stopping. You will need to have regular blood tests to check for liver
   function and hepatitis B virus levels if you stop taking HEPSERA.
   
   
   
   


2. HEPSERA may cause a severe kidney problem called nephrotoxicity.
   It usually happens in people that already have a kidney problem,but
   it can happen to anyone that uses HEPSERA. You will need to have regular
   blood tests to check for kidney function while you are taking HEPSERA.
   
   
   
   


3. If you get or have HIV that isn’t being treated with medicines,HEPSERA
   may increase the chances your HIV infection cannot be helped with usual
   HIV medicines. This can happen if you get or have HIV and don’t
   know it,or if your HIV is not being treated while you are taking HEPSERA.
   You should get an HIV test before you start taking HEPSERA and anytime
   after that when there’s a chance you were exposed to HIV.
   
   
   
   


4. Some people who have taken nucleoside analog medicines, like HEPSERA,
   have developed a serious condition called lactic acidosis (build
   up of an acid in the blood). Lactic acidosis is a medical emergency
   and must be treated in the hospital. Call your doctor right away
   if you get any of the following signs of lactic acidosis:

• You feel very weak or tired.


• You have unusual (not normal) muscle pain.


• You have trouble breathing.


• You have stomach pain with nausea and vomiting.


• You feel cold, especially in your arms and legs.


• You feel dizzy or lightheaded.


• You have a fast or irregular heartbeat.

Some people who have taken medicines like HEPSERA have developed
serious liver problems called hepatotoxicity,with liver enlargement
(hepatomegaly) and fat in the liver (steatosis). Call your doctor
right away if you get any of the following signs of liver problems:

• Your skin or the white part of your eyes turns yellow (jaundice).


• Your urine turns dark.


• Your bowel movements (stools) turn light in color.


• You don’t feel like eating food for several days or longer.


• You feel sick to your stomach (nausea).


• You have lower stomach pain.

You may be more likely to get lactic acidosis or serious liver problems
if you are very overweight (obese) or have been taking nucleoside analog
medicines [Combivir (zidovudine plus lamivudine), Epivir-HIV, Epivir-HBV
(lamivudine), Hivid (zalcitabine), Retrovir (zidovudine), Trizivir (zidovudine
plus lamivudine plus abacavir), Videx (didanosine), Viread (tenofovir
disoproxil fumarate), Zerit (stavudine), Ziagen (abacavir)], like HEPSERA,
for a long time.

What is HEPSERA?

HEPSERA is a medicine used to treat adults with continuing (chronic)
infections with active hepatitis B virus. HEPSERA has not been studied
in adults over the age of 65 or in children.

• HEPSERA will not cure your chronic hepatitis B.


• HEPSERA may help lower the amount of hepatitis B virus in your body.


• HEPSERA may lower the ability of the virus to multiply and infect
  new liver cells.


• We do not know if HEPSERA will reduce your chances of getting liver
  cancer or liver damage (cirrhosis) from chronic hepatitis B.


• We do not know how long HEPSERA may help your hepatitis. Sometimes
  viruses change in your body and medicines no longer work. This is called
  drug resistance.


• HEPSERA does not stop you from spreading hepatitis B to others by
  sex or sharing needles. So practice safe sex and needle use.

Who should not take HEPSERA?

• Do not take HEPSERA if you are allergic to any of the ingredients in
HEPSERA. The active ingredient in HEPSERA is adefovir dipivoxil. See the
end of this leaflet for a complete list of all the ingredients in HEPSERA.

Tell your doctor if:

• You are pregnant. We do not know if HEPSERA can harm your unborn
  child. You and your doctor will need to decide if HEPSERA is right for
  you. If you take HEPSERA and you are pregnant, talk to your doctor about
  how you can be on the HEPSERA pregnancy registry.


• You are breast-feeding. We do not know if HEPSERA can pass
  through your milk and if it can harm your baby. You will need to choose
  either to breast-feed or take HEPSERA, but not both.


• You have kidney problems now or had them before. Your dose
  and schedule of HEPSERA may be reduced. Blood tests will need to be
  done regularly to see how your kidneys are working.

Tell your doctor about all the medicines you take, including prescription
and non-prescription medicines, vitamins, and herbal supplements. Some
medicines may affect how HEPSERA works, especially medicines that affect
how your kidneys work. HEPSERA can affect how your other medicines
work. Your dose of HEPSERA and the other medicines may be changed. Do
not take any other medicines while you are taking HEPSERA, unless your
doctor has told you it is okay.

How should I take HEPSERA?

• Your doctor will tell you how much HEPSERA to take.


• Your doctor will tell you when and how often to take HEPSERA.


• Take HEPSERA the same time each day that your doctor tells you. If
  you forget to take HEPSERA, take it as soon as you remember that day.
  Do not take more than 1 dose of HEPSERA in a day. Do not take
  2 doses at the same time. Call your doctor or pharmacist if you are
  not sure what to do.


• Do not change your dose of HEPSERA or stop HEPSERA without
  talking to your doctor. Your hepatitis may get worse if you change doses
  or stop.


• You may take HEPSERA with or without food.


• When your HEPSERA supply gets low,call your doctor or pharmacy for
  a refill. Do not run out of HEPSERA.


• If you take too much HEPSERA, call your local poison control center
  or emergency room right away.

Some patients get worse or very serious hepatitis B symptoms when they
stop taking HEPSERA (See, "What is the most important information
I should know about HEPSERA?"). We don’t know how long you should
use HEPSERA. You and your doctor will need to decide when it is best for
you to stop taking HEPSERA. After you stop taking HEPSERA, your doctor
will still need to check your health and take blood tests to check your
liver for a few months.

What should I avoid while taking HEPSERA?

Avoid doing things that can spread hepatitis B since HEPSERA doesn’t
stop you from passing the infection to others.

• Do not share needles or other injection equipment.


• Do not share personal items that can have blood or body fluids on
  them, like toothbrushes or razor blades.


• Do not have any kind of sex without protection. Practice "safe
  sex" using condoms and dental dams.

What are the possible side effects of HEPSERA?

HEPSERA can cause the following serious side effects: (See, "What
is the most important information I should know about HEPSERA?")

1. a worse or very serious hepatitis if you stop taking it


2. a severe kidney problem called nephrotoxicity


3. increase your chance of developing a form of HIV that cannot be
   treated with usual HIV medicines


4. lactic acidosis and liver problems

The most common side effects of HEPSERA are weakness, headache, stomach
pain and nausea. The most common side effects in patients with liver transplants
and chronic hepatitis B are weakness, headache, stomach pain, and itching.
Some patients with liver transplants also had changes in the way their
kidneys worked.

These are not all of the possible side effects of HEPSERA. For more information,
ask your doctor or pharmacist.

General information about the safe and effective use of HEPSERA:

Medicines are sometimes prescribed for conditions not mentioned in patient
information leaflets. Do not use HEPSERA for a condition for which it
was not prescribed. Do not give HEPSERA to other people, even if they
have the same symptoms that you have.

This leaflet summarizes the most important information about HEPSERA.
If you would like more information, talk with your doctor. You can ask
your doctor or pharmacist for information about HEPSERA that is written
for health professionals.

HEPSERA tablets should be stored at room temperature and should be stored
in their original container.

What are the Ingredients of HEPSERA?

Active Ingredient: Adefovir dipivoxil

Inactive Ingredients: croscarmellose sodium, lactose monohydrate,
magnesium stearate, pregelatinized starch and talc.

June 2003

©2002,2003 Gilead Sciences, Inc.