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Entecavir
Entecavir is an antiviral medication used to treat chronic hepatitis B virus (HBV) infection. It is typically prescribed for individuals with evidence of active viral replication and liver inflammation, such as elevated liver enzymes (ALT and AST). Entecavir belongs to the class of nucleoside analogs, which work by preventing the virus from multiplying, thereby reducing the amount of hepatitis B virus in the body and slowing the progression of liver damage, such as cirrhosis or liver cancer.
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Frequently Asked Questions
How long will I need to take entecavir?
The duration of treatment with entecavir can vary depending on the patient's response and condition. Some patients may need to take entecavir for several years, and stopping treatment without a doctor’s approval can lead to a flare-up of hepatitis B.
Can I drink alcohol while taking entecavir?
It is best to avoid alcohol while taking entecavir, as alcohol can increase the risk of liver damage, especially in patients with hepatitis B.
What should I do if I miss a dose?
If you miss a dose of entecavir, take it as soon as you remember. If it is close to your next dose, skip the missed dose and continue with your regular schedule. Do not take two doses at once.
Is entecavir safe for pregnant women?
The safety of entecavir in pregnancy has not been well established. If you are pregnant or planning to become pregnant, discuss the risks and benefits with your healthcare provider.
Can I stop taking entecavir once I feel better?
No, it is crucial to continue taking entecavir as prescribed, even if you feel better. Stopping the medication without consulting your doctor can lead to a flare-up of hepatitis B and serious liver damage.
Comprehensive Drug Guide
How Does Entecavir Work?
Entecavir works by inhibiting the reverse transcriptase enzyme of the hepatitis B virus. This enzyme is crucial for the virus to replicate and infect new liver cells. By blocking reverse transcriptase, entecavir reduces the viral load in the body, decreases liver inflammation, and helps prevent further liver damage.
Common Dosages
- Treatment-naïve adults: 0.5 mg once daily
- Lamivudine-refractory patients: 1 mg once daily
- For patients with decompensated liver disease or those previously treated with other antivirals, the dose may also be 1 mg once daily.
Typical Dosing
- For chronic hepatitis B: 0.5 mg once daily for treatment-naïve patients. For patients who have developed resistance to other antivirals (e.g., lamivudine), the typical dose is 1 mg once daily.
- For children aged 2 years and older: The dose is calculated based on body weight.
Typical Dosing
FDA Approved Indications
Treatment of chronic hepatitis B virus (HBV) infection in adults and children aged 2 years and older with evidence of active viral replication and liver damage
Who Shouldn't Take Entecavir?
Known hypersensitivity to entecavir or any components of the formulation
Advice From The Pharmacist
- Take entecavir on an empty stomach, at least 2 hours before or 2 hours after a meal, to ensure optimal absorption.
- It’s important to take entecavir exactly as prescribed to prevent the development of resistance.
- Do not stop taking entecavir without consulting your healthcare provider, as stopping the medication can cause a flare-up of hepatitis B infection, leading to serious liver damage.
- Regular monitoring of liver function and viral load is necessary during treatment to assess the effectiveness of the medication and prevent complications.
Side Effects of Entecavir
Common Side Effects
- Headache
- Fatigue
- Dizziness
- Nausea
- Diarrhea
- Abdominal pain
Uncommon/Severe Side Effects
- Lactic acidosis (buildup of lactic acid in the blood), which can be life-threatening
- Hepatomegaly (enlarged liver)
- Severe liver damage in cases where treatment is stopped abruptly
- Allergic reactions (rash, swelling, difficulty breathing)
Risks and Warnings of Entecavir
- Lactic Acidosis: Entecavir can cause a rare but serious condition called lactic acidosis, where there is a buildup of lactic acid in the blood. Symptoms may include muscle pain, weakness, difficulty breathing, and stomach pain. Seek medical attention if any of these symptoms occur.
- Hepatomegaly and Steatosis: In rare cases, entecavir can cause liver enlargement (hepatomegaly) and a buildup of fat in the liver (steatosis).
- Hepatitis B Flare-Up: Discontinuation of entecavir can lead to a severe flare-up of hepatitis B infection, which may cause serious liver damage. It is important to continue taking the medication unless instructed by your healthcare provider.
- Resistance: Stopping treatment early or missing doses can lead to the development of viral resistance, making the medication less effective.
Interactions with Entecavir
Common Drug Interactions
- Immunosuppressive drugs: Caution is advised when using entecavir with drugs that affect the immune system, as this may increase the risk of infections.
- Other antivirals: Concurrent use of other antiviral medications may require dosage adjustments or careful monitoring for side effects.
Alternatives to Entecavir
- Tenofovir disoproxil fumarate (Viread): Another antiviral used to treat chronic hepatitis B, often chosen for patients who have developed resistance to other medications.
- Lamivudine (Epivir-HBV): An older antiviral used to treat chronic hepatitis B, though resistance may develop with long-term use.
- Adefovir dipivoxil (Hepsera): An antiviral used for chronic hepatitis B, particularly in patients who have failed other treatments.
