Entecavir brands and prices in Pakistan

About Entecavir

Entecavir is an antiviral medicine for long-lasting (chronic) hepatitis B, a virus that attacks the liver. It belongs to a group called nucleoside analogues. It stops the virus from copying itself in the liver, so the amount of virus in the body goes down and the liver can get healthier. It controls the virus but usually does not cure it. WHO recommends entecavir as one of two main medicines for chronic hepatitis B, because it works well, has few side effects and the virus rarely becomes resistant to it. Treatment is started and checked by a hospital liver (hepatology) specialist team, and most people need it for a long time, often for life.

Who should not take it, or should take care

• Do not take it if you are allergic to entecavir or any other ingredient in the tablets.
• Tell your doctor if you have HIV, because entecavir should only be used alongside HIV medicines.
• Tell your doctor if you have kidney problems, as the dose may need changing.
• Tell your doctor if you have had a liver transplant or have other liver disease.
• Tell your doctor if you have been treated for hepatitis B before, especially with lamivudine. Entecavir is not usually used after lamivudine unless a liver specialist agrees.
• Lactic acidosis is more likely in women, in people who are very overweight, and in people who have taken hepatitis B medicines for a long time.
• Pregnancy: tell your liver team if you are pregnant or planning a baby. The UK medicine leaflet says it should not be used in pregnancy unless your doctor decides, and that women who could get pregnant should use effective contraception. NHS liver teams usually advise switching to tenofovir, which has more safety information in pregnancy. Babies of mothers with hepatitis B should get the hepatitis B vaccine soon after birth.
• Breastfeeding: advice differs. The UK medicine leaflet and MedlinePlus say do not breastfeed while taking it. An NHS hospital leaflet (Oxford) says it can be continued while breastfeeding. Ask your liver team.
• The tablets contain lactose. Tell your doctor if you have been told you cannot digest some sugars.

Medicines and drinks that can interact

• Tell your liver team about every medicine you take, including medicines bought without a prescription, vitamins, supplements and herbal products, before you start and before you take anything new.
• HIV medicines: entecavir must only be used in people with HIV if they are also taking HIV treatment.
• Lamivudine or other hepatitis B medicines taken in the past can affect whether entecavir is the right choice and how it is taken.
• Tell any doctor, dentist or pharmacist who treats you that you are taking entecavir, including before surgery or dental work.

Always tell your doctor and pharmacist about every medicine, supplement and herbal product you take.

Using it safely

• Take it exactly as your liver team tells you. Many people can take it with or without food, but some people (for example, after lamivudine has stopped working, or with very advanced liver disease) are told to take it on an empty stomach, away from meals. Follow the advice on your label.
• Do not stop taking it, even if you feel well, unless your liver team tells you to. Stopping can make hepatitis flare up.
• If side effects bother you, do not stop the medicine. Speak to your liver team instead.
• If you forget a dose, check your leaflet or ask your pharmacist what to do. Never take two doses together to make up for a missed one.
• Go to all clinic visits, blood tests and liver scans. They show how well the medicine is working and check for side effects. Checks also continue for some time if treatment is ever stopped.
• Phone or calendar reminders can help you remember your tablets.
• It can make you dizzy, tired or sleepy. If it does, do not drive or use machines.
• In Pakistan, WHO estimates about 3.8 million people live with hepatitis B, and most people with hepatitis do not know they have it. It spreads through unscreened blood, re-used needles and syringes, and unclean tools used for surgery, dental work, piercing, tattoos and shaving, including at barber shops. Ask about testing and vaccination for your family.
• Do not share your medicine. Keep it out of the reach of children, and ask a pharmacist how to get rid of unused tablets rather than putting them in household rubbish or down the drain.

Common questions

Will entecavir cure my hepatitis B?
Usually not. It lowers the amount of virus and helps protect your liver, but the virus normally stays in the body. Only a small number of people clear the virus enough for a specialist to consider stopping treatment.

How long will I need to take it?
Most people need it long-term, and for many it is for life. Only your liver team can decide if it is safe to stop, and they will check your blood closely if they do stop it.

Can I pass hepatitis B to my family while taking entecavir?
The risk goes down but does not go away. Practise safe sex, do not share needles, syringes or razors, and make sure your partner and family are tested and vaccinated against hepatitis B.

Does entecavir treat HIV?
It does not treat HIV. If you have HIV as well as hepatitis B, you need HIV medicines too, otherwise HIV may become harder to treat. Entecavir is a medicine for hepatitis B only.

I want to have a baby. What should I do?
Talk to your liver team before you try, or as soon as you find out you are pregnant. They may switch you to another medicine, usually tenofovir. Tell your midwife you have hepatitis B, so your baby can be vaccinated soon after birth.

Prepared from the sources listed by the MedInfoBase team. General information, not medical advice: it gives no doses. Your doctor or pharmacist decides the medicine and dose for you.