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Entecavir is a medicine used to treat hepatitis B virus infection in certain cases. This active ingredient has the trade name Hepariv. So what is Hepariv and how should it be used?
1. What are the uses of Hepariv?
Hepariv is manufactured by Medicore Laboratories Pvt., Ltd (India), the main ingredient is the active ingredient Entecavir 0.5mg. Hepariv is produced in the form of film-coated tablets for oral use and is packaged in a box of 1 blister x 6 tablets. The active ingredient Entecavir in Hepariv is a Nucleoside guanosine analogue with antiviral activity against HBV. After absorption Entecavir is phosphorylated to the active form, Entecavir triphosphate with an intracellular half-life of up to 15 hours. Due to its competitive effect with the natural substrate Deoxyguanosine triphosphate, functionally Entecavir triphosphate inhibits all 3 activities of HBV polymerase (hepatitis B virus reverse transcriptase):
Provide base; Negative strand reverse transcriptase from pre-gene messenger mRNA; Synthesis of positive sequence of HBV DNA virus.
2. Indications and contraindications of Hepariv
Hepariv is indicated for the treatment of chronic hepatitis B in adults with compensated cirrhosis and evidence of viral replication activity, persistently elevated liver enzymes and histological manifestations. studies, including Lamivudin-resistant cases.However, patients with a history of allergy or hypersensitivity to Entecavir or any of its ingredients should not use Hepariv, because of contraindications.
3. Dosage, how to use Hepariv
Hepariv is to be taken on an empty stomach, at least 2 hours after eating and 2 hours before the next meal.
Recommended dose of Hepariv for adults and adolescents ≥ 16 years old with chronic hepatitis B virus infection and not yet treated with Nucleoside drugs: 1 Hepariv tablet (0.5mg Entecavir) orally once a day.
Recommended dose of Hepariv for adults and adolescents ≥ 16 years of age with a history of hepatitis B virus infection in the blood during Lamivudine use or with lamivudine resistance mutations: 2 Hepariv tablets (equivalent to 1mg Entecavir) ), drink 1 time/day.
Dosage of Hepariv for patients with renal failure adjusted according to creatinine clearance:
ClCr ≥ 50 ml/min: 1 tablet of Hepariv x 1 time/day, if resistance to Lamivudine increases to 2 tablets of Hepariv x 1 time/day ; ClCr: 30-50 ml/min: 1⁄2 tablets of Hepariv x 1 time/day, if resistant to Lamivudine, double 1 tablet of Hepariv x 1 time/day; ClCr: 10-30 ml/min: 1⁄3 Hepariv tablets (approximately 0.15mg Entecavir) x 1 time/day, if Lamivudine resistant, double 0.3 mg x 1 time/day; ClCr < 10ml/min: 0.05mg x 1 time/day, double if the patient is resistant to Lamivudin (0.1 mg x 1 time/day); Patients should take Hepariv after hemodialysis or continuous outpatient peritoneal dialysis (CAPD). Note: Patients with impaired liver function do not need to adjust the dose of Hepariv.
4. Side effects of Hepariv
The most common adverse effects of treatment with Hepariv are headache, fatigue, dizziness and nausea. Other adverse effects of Hepariv include diarrhea, dyspepsia, insomnia, and vomiting.
Increased levels of liver enzymes may occur with Hepariv and there have been reports of worsening of hepatitis following discontinuation of treatment with Entecavir.
Lactic acidosis, often associated with hepatomegaly and severe fatty liver, has been associated with monotherapy with nucleoside analogues (eg, Hepariv) or antiretroviral agents.
5. Hepariv drug interactions
Entecavir is eliminated primarily by the kidneys, therefore the co-administration of Hepariv with drugs that may impair renal function or compete for active tubular secretion may increase serum concentrations of Entecavir or other drugs. shared drugs.
Concomitant treatment of Hepariv with Lamivudine, Adefovir dipivoxil or Tenofovir disoproxil fumarate did not result in significant drug interactions.
6. Attention when using Hepariv
Lactic acidosis and hepatomegaly associated with severe steatosis, including fatal cases, have been reported with the use of Nucleoside analogues alone (e.g. Hepariv) or in combination with other agents. antiretroviral drugs. Exacerbation of acute hepatitis B has been reported in patients who have discontinued anti-hepatitis B therapy, including Hepariv. Therefore, patients should continue to be closely monitored for both clinical and laboratory liver function for at least several months after discontinuing hepatitis B antiviral therapy. appropriate anti-hepatitis B therapy. Dosage adjustment of Hepariv is recommended for patients with creatinine clearance less than 50 ml/min, including those undergoing hemodialysis or continuous outpatient peritoneal dialysis (CAPD). The safety and efficacy of Hepariv in post-liver transplantation patients have not been established. If treatment with Hepariv is necessary for a liver transplant patient who has or is taking an immunosuppressant that can affect renal function, such as Cyclosporin or Tacrolimus, the patient should be carefully monitored for function both. before and during treatment with Hepariv . Pregnancy: There are no adequate and well-controlled studies with the use of Hepariv in pregnant women. Reproduction studies in animals cannot accurately predict response in humans, so Hepariv should be used during pregnancy only if clearly needed and under careful assessment of the risks. and potential benefits. There are no studies in pregnant women and no data on the effect of Hepariv on mother-to-child transmission of hepatitis B virus. Therefore, patients should be given appropriate interventions to prevent neonatal infection with hepatitis B virus. It is not known whether Entecavir is excreted in breast milk, so physicians should instruct mothers not to breast-feeding while being treated with Hepariv. Hepariv is a medicine used to treat hepatitis B virus infection in certain cases. To ensure the effectiveness of treatment and avoid unwanted side effects, patients need to strictly follow the instructions of the doctor, professional pharmacist.
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