Entecavir
- Atc Codes:J05AF10
- CAS Codes:209216-23-9#142217-69-4
- PHARMGKB ID:209216-23-9#142217-69-4
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Substrate of
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Baraclude; Belgium: Baraclude; Cyprus: Baraclude; Denmark: Baraclude; Estonia: Baraclude; Finland: Baraclude; France: Baraclude; Germany: Baraclude; Greece: Baraclude; Hungary: Baraclude; Ireland: Baraclude; Italy: Baraclude; Latvia: Baraclude; Lithuania: Baraclude; Netherlands: Baraclude; Poland: Baraclude; Portugal: Baraclude; Romania: Baraclude; Slovakia: Baraclude; Spain: Baraclude; Sweden: Baraclude; UK: Baraclude.
North America
Canada: Baraclude; USA: Baraclude.
Latin America
Argentina: Baraclude.
Asia
Japan: Baraclude.
Drug combinations
Chemistry
Entecavir: C~12~H~15~N~5~O~3~ H~2~O. Mw: 295.29. (1) 6H-Purin-6-one, 2-amino-1,9-dihydro-9-[(1S,3R,4S)-4-hydroxy-3-(hydroxymethyl)-2-methylenecyclopentyl]-monohydrate; (2) 9-[(1S,3R,4S)-4-Hydroxy-3-(hydroxymethyl)-2-methylenecyclopentyl]guanine monohydrate. CAS-209216-23-9; CAS-142217-69-4 (anhydrous)(1999).
Pharmacologic Category
Antivirals; Nucleosides and Nucleotides. Nucleoside Reverse Transcriptase Inhibitor. Antiretroviral Agent. (ATC-Code: J05AF10).
Mechanism of action
A synthetic purine nucleoside analog derived from guanine, entecavir is an active antiviral agent against human hepatitis B virus (HBV). The drug undergoes phosphorylation by cellular enzymes to form its active metabolite, entecavir triphosphate. By competing with the natural substrate deoxyguanosine triphosphate, entecavir triphosphate inhibits activities of HBV DNA polymerase (reverse transcriptase).
Therapeutic use
Used for the management of chronic HBV infection in adults with evidence of active HBV replication and either persistent elevations in serum transaminase (ALT or AST) concentrations or histologic evidence of active liver disease.
Pregnancy and lactiation implications
There are no studies in pregnant women and no data regarding the effect of entecavir on vertical transmission of HBV. Infants born to HBV-infected women should receive the usual recommended combined regimen of hepatitis B virus vaccine and hepatitis B immune globulin. Women should not breast-feed infants while receiving the drug.
Unlabeled use
Contraindications
Hypersensitivity to entecavir or any component of the formulation.
Warnings and precautions
Severe, acute exacerbation of hepatitis B may occur upon discontinuation. Exacerbations of hepatitis also reported during entecavir treatment of HBV. Use of entecavir for treatment of chronic HBV infection in unrecognized or untreated HIV infection may result in emergence of HIV isolates with resistance to nucleoside reverse transcriptase inhibitors (NRTIs). Due to the possible risk of emergence of NRTI-resistant HIV, entecavir should not be used for the treatment of HBV in HIV-infected patients not receiving antiretroviral therapy. Entecavir not systematically evaluated for treatment of HIV infection; such use not recommended. Lactic acidosis and severe hepatomegaly with steatosis reported with nucleoside analogs, including fatal cases (use with caution in risk factors for liver disease). Use with caution in renal impairment or patients receiving concomitant therapy which may reduce renal function. Use with caution in the elderly. Cross-resistance may develop in patients failing previous therapy with lamivudine.