Medicine Information

Cavir

Name: Cavir
Brand: Cavir
Rating: 4.5 (117 reviews)

Tablet1 mgAntiviral (Hepatitis B)ATC: J05AF10

Generic Name

Entecavir

Manufacturer

Generic Pharma Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
cavir 1 mg tablet	৳ 90.27	৳ 902.70

Description

Overview of the medicine

Cavir 1 mg Tablet contains Entecavir, an antiviral medication used to treat chronic hepatitis B virus (HBV) infection. It works by reducing the amount of HBV in the body, which helps to improve liver function and reduce the risk of serious liver problems like cirrhosis and liver cancer.

Uses & Indications

Treatment of chronic hepatitis B virus (HBV) infection in adults and pediatric patients ≥2 years of age with evidence of active viral replication and persistent elevations in serum aminotransferases (ALT or AST) or histologically active disease.

Treatment of chronic hepatitis B in adults with compensated liver disease with evidence of viral replication, and in adults with decompensated liver disease.

Dosage

Adults

0.5 mg or 1 mg once daily, depending on prior nucleoside analogue therapy and liver status. For nucleoside-naïve patients with compensated liver disease: 0.5 mg once daily. For patients refractory to lamivudine or with decompensated liver disease: 1 mg once daily.

Elderly

No specific dose adjustment required based on age; consider renal function.

Renal_impairment

Dose adjustment required based on creatinine clearance: CrCl 30-50 mL/min: 0.5 mg every 48 hours or 0.25 mg once daily; CrCl 10-29 mL/min: 0.5 mg every 72 hours or 0.15 mg once daily; CrCl <10 mL/min (hemodialysis or CAPD): 0.5 mg every 7 days or 0.05 mg once daily (administer after dialysis).

How to Take

Oral. Take on an empty stomach (at least 2 hours after a meal and 2 hours before the next meal) once daily. Food can decrease absorption.

Mechanism of Action

Entecavir is a guanosine nucleoside analog with activity against HBV polymerase. It is phosphorylated to the active triphosphate form, which competes with the natural substrate deoxyguanosine triphosphate for incorporation into HBV DNA, effectively inhibiting HBV polymerase activity, including base priming, reverse transcription of the negative strand from the pregenomic messenger RNA, and synthesis of the positive strand HBV DNA.

Pharmacokinetics

Onset

Reduction in HBV DNA levels observed within weeks.

Excretion

Primarily excreted renally (62-73% of a single dose in urine as unchanged drug).

Half life

Elimination half-life is approximately 128-149 hours (intracellular triphosphate) or 5-9 hours (plasma).

Absorption

Rapidly absorbed after oral administration, peak plasma concentrations typically occur within 0.5 to 1.5 hours.

Metabolism

Not a substrate, inhibitor, or inducer of cytochrome P450 enzymes. Primarily cleared by the kidneys.

Side Effects

Contraindications

Hypersensitivity to entecavir or any component of the formulation.

Drug Interactions

Drugs that reduce renal function or compete for active tubular secretion

May increase entecavir concentrations. Co-administration with drugs like lamivudine, adefovir dipivoxil, or tenofovir disoproxil fumarate did not result in significant drug interactions.

Storage

Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.

Overdose

Limited experience with overdose. Monitor for signs of toxicity and provide supportive care. Hemodialysis removes approximately 13% of the dose over 4 hours.

Pregnancy & Lactation

Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. It is unknown if entecavir is excreted in human milk; caution is advised during breastfeeding. Discuss risks with a healthcare provider.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets per box30 tablets per box

Shelf Life

Typically 2-3 years from manufacturing date.

Availability

Pharmacies, hospitals, specialized clinics

Approval Status

FDA approved (original drug: Baraclude)

Patent Status

Generic versions available (original patent expired)

WHO Essential Medicine

Yes

Clinical Trials

Numerous clinical trials have established the efficacy and safety of entecavir in patients with chronic HBV infection, including those with compensated and decompensated liver disease, and in treatment-naïve and lamivudine-refractory patients.

Lab Monitoring

Liver function tests (ALT, AST, bilirubin)
Renal function tests (creatinine, eGFR)
HBV DNA levels
HBeAg/anti-HBe status
HBsAg/anti-HBs status
CBC (Complete Blood Count)

Doctor Notes

Emphasize adherence to therapy to avoid viral resistance and exacerbation of hepatitis.
Regularly assess renal function, especially in elderly or co-morbid patients.
Advise patients about the potential for lactic acidosis and to report symptoms like unusual muscle pain, difficulty breathing, or abdominal pain.

Patient Guidelines

Take exactly as prescribed by your doctor.
Do not stop taking the medicine without consulting your doctor, as this may lead to severe worsening of hepatitis B.
Take on an empty stomach to ensure proper absorption.
Report any unusual symptoms or side effects immediately.

Missed Dose Advice

If a dose is missed, take it as soon as remembered, unless it is almost time for the next dose. Do not take a double dose to make up for a missed one.