Author: Zhongshan West District Hospital Chief Pharmacist Du Guifang
Drug classification: Anti-infection/antiretroviral drugs
What diseases can this drug be used for?
☆ Entecavir tablets are suitable for the treatment of chronic hepatitis B in patients with active viral replication, continuous increase in serum alanine aminotransferase (ALT) or histological showing active lesions (including patients with compensatory and decompensated liver disease).
☆ Also suitable for the treatment of nucleoside-treated pediatric patients with nucleoside-treated liver disease of chronic HBV infection from 2 to 18 years old (expression of active viral replication and continuous elevation of serum ALT levels or histological evidence of moderate to severe inflammation and/or fibrosis ).
How to use this medicine?
☆ This product should be taken under the guidance of an experienced doctor and do not take medicine at will.
☆ Entecavir tablets should be taken orally on an empty stomach (at least 2 hours before or after a meal).
☆ Adult:
① Oral entecavir tablets, once a day, 0.5 mg each time (0.5 mg per tablet, one tablet).
② Patients who have had viremia during lamivudine treatment or have lamivudine drug resistance mutations are once a day, 1 mg each time (0.5 mg per tablet, 2 tablets).
③ Patients with decompensated cirrhosis, 1 mg once a day.
④ In patients with renal insufficiency, the apparent oral clearance rate of this product decreases with the decrease of creatinine clearance. Therefore, patients with a creatinine clearance of 50 ml/min [including those treated with hemodialysis or persistent non-clinical peritoneal dialysis (CAPD)] should adjust the dosage under the guidance of a doctor.
☆ Children:
① Used in patients with nucleoside treatment for chronic HBV infection with compensatory liver disease for 2 years to 18 years old [the serum ALT increase should last at least 6 months before treatment in patients with HBeAg-negative pediatric patients].
② The treatment of pediatric patients should carefully consider the needs of individual patients and refer to the current children's treatment guidelines. It must be performed under the guidance of a doctor and under the supervision of an adult.
③ Children with body weight greater than or equal to 32.6kg: the daily dose is 0.5 mg, with or without food administration. Patients weighing less than 32.6kg should use oral solutions.
What are the precautions when applying this medicine?
☆ Please consult your doctor before taking the medicine and do not use it at will.
☆ Some hepatitis B patients have worsened after discontinuing the use of entecavir. Therefore, liver function monitoring is usually required for several months after stopping the drug, and treatment needs to be restarted if necessary.
☆ After taking entecavir, severe liver side effects and excessive lactate in the blood may occur. Women, obese or long-term medication patients are at higher risk.
☆ Taking entecavir may make AIDS treatment more difficult. Therefore, a doctor may arrange for you to undergo HIV testing before taking the medication.
☆ If you have renal insufficiency, or are undergoing hemodialysis or peritoneal dialysis treatment, please inform your doctor in advance. The doctor will adjust the dosage and dosage intervals according to your condition. Patients undergoing hemodialysis may need to take the medication after dialysis .
What are the common side effects of this medicine?
☆ Common side effects: elevated ALT, headache, fatigue, dizziness, nausea, abdominal pain, abdominal discomfort, upper abdominal pain, liver discomfort, myalgia, insomnia, and rubella , etc.
☆ The common adverse reactions in patients treated with lamivudine include: headache, fatigue, dizziness, etc.
If you have the following situations, please pay attention to the medication
☆ Those who are allergic to entecavir or any ingredient in the preparation are prohibited.
☆ There are reports that the patient had severe and acute exacerbation after cessing the antiviral treatment of hepatitis B (including entecavir).For patients who have stopped hepatitis B antiviral treatment, liver function should be closely monitored for at least a few months. If necessary, antiviral treatment needs to be restarted.
☆ Limited clinical experience suggests that if entecavir is used in patients with chronic hepatitis B and HIV infection and has not been treated with anti-HIV, resistance to HIV nucleoside reverse transcriptase inhibitors may occur. Therefore, it is not recommended to use entecavir in patients with HBV combined with HIV who have not received high-efficiency antiretroviral therapy (HAART). HIV antibodies should be tested in all patients before starting entecavir treatment.
☆ Entecavir tablets cannot reduce the risk of HBV transmitted through sexual contact or contamination of blood sources. Therefore, appropriate protective measures are still required to interfere with the spread of the disease when taking the medicine. At the same time, it is not clear whether this product will affect the mother-to-child transmission of HBV. Therefore, appropriate measures should be taken to prevent newborns from getting infected with HBV.
☆ Since entecavir tablets may cause headaches and dizziness, staff engaged in precision operations (such as drivers, drivers, precision machine tool operators, etc.) should pay attention to the effects of adverse reactions when taking medication.
Can special groups take this product?
☆ Pregnant women: The impact of entecavir on pregnant women is not sufficient. Entecavir tablets can only be used when sufficient trade-offs are made on the fetus’ potential risks and interests.
☆ In the experiment, entecavir can be secreted from rat milk, but it is still unclear whether there is secretion in human milk, so breastfeeding for mothers who take entecavir tablets is not recommended.
☆ Children: The safety and effectiveness data of entecavir tablets used in children under 16 years of age have not yet been established.
☆ Elderly: Elderly patients may experience renal loss. Be cautious when choosing a dose and pay attention to monitoring renal function.
☆ People with liver function impairment: Patients with liver insufficiency do not need to adjust the dosage.
☆ Renal function impairment: Patients with creatinine clearance rate of 50ml/min should adjust the dosage.
How to get this medicine?
☆ This product is a prescription drug and requires a doctor to prescribe it to a hospital pharmacy or a pharmacy qualified to sell prescription drugs to obtain it.
How to save this medicine?
☆ Sealed and stored in a dry place below 30°C. At the same time, please keep this product in a place that children cannot reach.
Reviewer: Guangdong Pharmacy Society, Zhongshan West District Hospital, Deputy Director Pharmacist Han Qunying
or above are original works of volunteers of the "Drug Safety Cooperation Alliance". If reprinted, please indicate the author and source!
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