About
Entecavir is an oral antiviral agent belonging to the class of guanosine nucleoside analogues, specifically designed for the treatment of chronic hepatitis B virus (HBV) infection. It acts as a potent inhibitor of HBV reverse transcriptase, an enzyme crucial for the virus's replication cycle. Entecavir is phosphorylated intracellularly to its active triphosphate form, which then competes with the natural substrate, deoxyguanosine triphosphate, for incorporation into the viral DNA. This competition leads to the inhibition of all three functions of the HBV polymerase: base priming, reverse transcription of the negative strand from the pregenomic messenger RNA, and synthesis of the positive strand of HBV DNA.
Its high specificity and potent antiviral activity make it a cornerstone in managing chronic HBV, reducing viral load, and improving liver histology. Entecavir is effective in both nucleoside-naive and lamivudine-refractory patients, demonstrating sustained viral suppression and a low rate of resistance development over long-term treatment. It is crucial for preventing disease progression, including cirrhosis and hepatocellular carcinoma, in individuals with chronic HBV infection.
Uses
- Treatment of chronic hepatitis B virus (HBV) infection.
- Used in adults with compensated or decompensated liver disease.
- Effective in patients with lamivudine-refractory HBV.
- Reduces the risk of HBV-related complications like cirrhosis and hepatocellular carcinoma.
Directions For Use
Take orally once daily on an empty stomach (at least 2 hours after a meal and 2 hours before the next meal).
Benefits
- Highly potent against HBV.
- Low rate of resistance development.
- Improves liver histology and reduces inflammation.
- Significantly lowers HBV DNA levels.
- Reduces the risk of liver disease progression.
- Well-tolerated by most patients.
Side Effects
- Headache
- Fatigue
- Dizziness
- Nausea
- Diarrhea
- Dyspepsia
- Insomnia
- Increased liver enzymes
- Abdominal pain
- Rash
- Lactic acidosis (rare)
- Severe hepatomegaly with steatosis (rare)
Safety Measures
- Alcohol - Avoid or limit alcohol consumption as it can worsen liver disease, which is the primary condition Entecavir treats.
- Pregnancy - Consult a doctor. Use only if the potential benefit justifies the potential risk to the fetus. Limited human data exist, but animal studies show no major teratogenicity.
- Breastfeeding - Consult a doctor. It is unknown if Entecavir is excreted in human milk. A decision should be made whether to discontinue nursing or the drug, considering the importance of the drug to the mother.
- Liver - Use with caution in patients with decompensated liver disease. Close monitoring of liver function is crucial, and dose adjustment may be needed.
- Kidney - Dose adjustment is required for patients with renal impairment. Regular monitoring of renal function is essential.
- Lung - No specific contraindications or major concerns related to lung conditions are typically associated with Entecavir.
Disclaimer
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