Entecavir
Clinical data | |
---|---|
Pronunciation | /ɛnˈtɛkəvɪər/ en-TEK-ə-veer |
Trade names | Baraclude, others |
Other names | BMS-200475-01 |
AHFS/Drugs.com | Monograph |
MedlinePlus | a605028 |
License data | |
Pregnancy category |
|
Routes of administration | By mouth |
ATC code | |
Legal status | |
Legal status | |
Pharmacokinetic data | |
Bioavailability | n/a (≥70)[3] |
Protein binding | 13% (in vitro) |
Metabolism | negligible/nil |
Elimination half-life | 128–149 hours |
Excretion | Kidney 62–73% |
Identifiers | |
| |
JSmol) | |
Melting point | 220 °C (428 °F) value applies to entecavir monohydrate and is a minimum value[4] |
| |
| |
(what is this?) (verify) |
Entecavir (ETV), sold under the brand name Baraclude, is an
Common side effects include headache, nausea,
Entecavir was approved for medical use in 2005.[5] It is on the World Health Organization's List of Essential Medicines.[7] Available as a generic medication in the United States.
Medical uses
Entecavir is mainly used to treat chronic hepatitis B infection in adults and children two years and older with active viral replication and evidence of active disease with elevations in liver enzymes.[3] It is also used to prevent HBV reinfection after liver transplant[8] and to treat HIV patients infected with HBV. Entecavir is weakly active against HIV, but is not recommended for use in HIV-HBV co-infected patients without a fully suppressive anti-HIV regimen[9] as it may select for resistance to lamivudine and emtricitabine in HIV.[10]
The efficacy of entecavir has been studied in several randomized, double-blind, multicentre trials. Entecavir by mouth is effective and generally well tolerated treatment.[11]
Pregnancy and breastfeeding
No adequate and well-controlled studies exist in pregnant women.[1]
Side effects
The majority of people who use entecavir have little to no side effects.[12] The most common side effects include headache, fatigue, dizziness, and nausea.[3] Less common effects include trouble sleeping and gastrointestinal symptoms such as sour stomach, diarrhea, and vomiting.[13]
Serious side effects from entecavir include lactic acidosis, liver problems, liver enlargement, and fat in the liver.[3]
Laboratory tests may show an increase in alanine transaminase (ALT), hematuria, glycosuria, and an increase in lipase.[3] Periodic monitoring of hepatic function and hematology are recommended.[3]
Mechanism of action
Entecavir is a
Entecavir reduces the amount of HBV in the blood by reducing its ability to multiply and infect new cells.[15]
Administration
Entecavir is taken by mouth as a tablet or solution. Doses are based on a person's weight.[3] The solution is recommended for children more than 2 years old who weigh up to 30 kg. Entecavir is recommended on an empty stomach at least 2 hours before or after a meal, generally at the same time every day. It is not used in children less than 2 years old. Dose adjustments are also recommended for people with decreased kidney function.[3]
History
- 1992: SQ-34676 at Squibb as part of anti-herpes virus program[16]
- 1997: BMS 200475 developed at BMS pharmaceutical research institute as antiviral nucleoside analogue à Activity demonstrated against HBV, HSV-1, HCMV, VZV in cell lines & no or little activity against HIV or influenza[17]
- Superior activity observed against HBV pushed research towards BMS 200475, its base analogues and its enantiomer against HBV in HepG2.2.15 cell line[17]
- Comparison to other NAs, proven more selective potent inhibitor of HBV by virtue of being Guanine NA[18]
- 1998: Inhibition of hepadnaviral polymerases was demonstrated in vitro in comparison to a number of NAs-TP[19]
- Metabolic studies showed more efficient phosphorylation to triphosphate active form[20]
- 3-year treatment of woodchuck model of CHB à sustained antiviral efficacy and prolonged life spans without detectable emergence of resistance[21]
- Efficacy # LVD resistant HBV replication in vitro[22]
- Superior activity compared to LVD in vivo for both HBeAg+ & HBeAg− patients[23][24]
- Efficacy in LVD refractory CHB patients[25]
- Entecavir was approved by the U.S. Food and Drug Administration (FDA) in March 2005.[26]
Patent information
On August 26, 2014,
References
- ^ a b c "Entecavir (Baraclude) Use During Pregnancy". Drugs.com. 3 December 2019. Retrieved 24 January 2021.
- FDA. Retrieved 22 Oct 2023.
- ^ a b c d e f g h i "Baraclude- entecavir tablet, film coated Baraclude- entecavir solution". DailyMed. Retrieved 24 January 2021.
- ISBN 978-0-911910-00-1.
- ^ a b c d e f g h "Entecavir". The American Society of Health-System Pharmacists. Archived from the original on 20 December 2016. Retrieved 28 November 2016.
- ISBN 9781597455657.
- hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
- PMID 21762659.
- ^ "Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents" (PDF). Panel on Antiretroviral Guidelines for Adults and Adolescents. Archived (PDF) from the original on 1 November 2016. Retrieved 15 March 2015.
- PMID 17582071.
- S2CID 115493805. Archived from the originalon 2011-10-08. Retrieved 2010-03-29.
- ^ "Entecavir: Indications, Side Effects, Warnings - Drugs.com". www.drugs.com. Archived from the original on 2016-11-07. Retrieved 2016-11-10.
- ^ "Entecavir Side Effects in Detail - Drugs.com". www.drugs.com. Archived from the original on 2016-11-10. Retrieved 2016-11-10.
- S2CID 13149070.
- ^ "Entecavir: Indications, Side Effects, Warnings - Drugs.com". www.drugs.com. Archived from the original on 2016-11-07. Retrieved 2016-11-07.
- .
- ^ .
- PMID 9210663.
- PMID 9835515.
- PMID 9869593.
- PMID 11679911.
- PMID 12121928.
- PMID 16525137.
- PMID 16525138.
- PMID 16762627.
- ^ "Drug Approval Package: Baraclude (Entecavir) NDA #021797 & 021798". U.S. Food and Drug Administration (FDA). 28 December 2011. Retrieved 24 January 2021.
- ^ "Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations". U.S. Food and Drug Administration (FDA). Archived from the original on 4 March 2016. Retrieved 2015-08-29.
- ^ "Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations". U.S. Food and Drug Administration (FDA). Archived from the original on 15 November 2016. Retrieved 14 November 2016.
{{cite web}}
: CS1 maint: unfit URL (link) - ^ "Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations". U.S. Food and Drug Administration (FDA). Search results from the "OB_Rx" table for query on "202122.". Archived from the original on 22 December 2015. Retrieved 2015-08-29.
- ^ "Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations". U.S. Food and Drug Administration (FDA). Search results from the "OB_Rx" table for query on "205740.". Archived from the original on 4 March 2016. Retrieved 2015-08-29.
- ^ "Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations". U.S. Food and Drug Administration (FDA). Search results from the "OB_Rx" table for query on "206217.". Archived from the original on 4 March 2016. Retrieved 2015-08-29.
External links
- "Entecavir". Drug Information Portal. U.S. National Library of Medicine.