There are two main types of anti-hepatitis B virus drugs: long-acting interferons and nucleoside (acid) analogs, the former requiring subcutaneous injections, while the latter can be taken orally, so it is usually felt that nucleoside (acid) analogs are easy to take and safe. In general, there is nothing wrong with this view. The overall safety and tolerability of oral antivirals are indeed good, but there are still adverse reactions, even rare and rare serious ones, in clinical applications. Considering that oral antivirals usually need to be taken for a long time, or even for life, a single-minded emphasis on the good safety of oral antivirals can easily paralyze people and create problems. The main side effects to watch out for that can occur with long-term treatment with nucleoside (acid) analogs are: such as renal insufficiency (mainly seen with adefovir treatment), hypophosphatasia (mainly seen with adefovir, tenofovir treatment), myositis (mainly seen with tipifedin treatment), rhabdomyolysis (mainly seen with tipifedin), and lactic acidosis (seen with lamivudine, entecavir, and tipifedin). The 2015 edition of the American College of Hepatology guidelines for chronic hepatitis B also devotes a special section to the relationship between oral antivirals and bone and kidney disease, which shows that the side effects of these drugs have become a major concern. In order to prevent and control the side effects of oral antivirals, on the one hand, care should be taken to minimize the risk by carefully and thoughtfully communicating the relevant medical history with the physician before starting treatment. For example, if a pre-existing problem of decreased kidney function is detected, the doctor will be more careful with the medication or adjust the dose in a targeted manner. On the other hand, follow-up monitoring of oral antivirals must be strengthened, even if the disease is relatively stable, and regular follow-up visits must be made, not only for prescribing medication but also for regular checkups. Specifically, patients taking telbivudine should be monitored for CK every 3-6 months; patients taking tenofovir or adefovir should be monitored for creatinine and blood phosphorus every 3-6 months. If monitoring reveals a significant increase in blood creatinine, creatine phosphokinase or lactate dehydrogenase during treatment, with corresponding clinical manifestations, such as general deterioration, obvious myalgia, muscle weakness and other symptoms, patients should be closely observed, and the doctor will give therapeutic intervention accordingly if adverse reactions occur, and if necessary, the original drug should be discontinued and replaced by other drugs in a timely manner. In conclusion, although the overall safety of oral antiviral drugs is good, the safety of long-term application remains to be observed, and should not be careless in treatment, and should be actively monitored, early detection and treatment.