Entecavir has a large population of hepatitis B patients in mainland China, conservatively estimated to be one million, and it is known as the first-line antiviral drug for hepatitis B together with TAF and tenofovir.
Entecavir has the advantages common to first-line drugs, such as ease of use, strong efficacy, low drug resistance rate, and few side effects, but also has its unique advantages: the most prominent is the safe dose, which is only 0.5 mg per tablet, the dose of TAF is 50 times that of it, and the dose of tenofovir is 600 times that of it.
The treatment principle of entecavir is: after oral administration, it is phosphorylated into a more active triphosphate, which is combined with the catalyst of hepatitis B virus DNA - polymerase (or polyzyme), and the polymerase loses its effect, and the development of hepatitis B replication virus is greatly inhibited in the absence of catalysts, and the speed of entecavir inhibition of hepatitis B virus is faster than the rate of mutation of hepatitis B virus, so that the purpose of inhibiting the virus is achieved.
Since the current nucleoside drugs cannot kill the hepatitis B virus mother, it is a long-term process to determine the oral drug for antiviral therapy, and entecavir is no exception, which should be regarded as the most obvious shortcoming.
Entecavir has accumulated rich application data and experience in the process of 17 years of use in the mainland, doctors are more recommended, patients are more trusted, as long as they insist on taking it, they will achieve tangible results, but due to the large group of patients, various behaviors are dazzling, because of improper use, resulting in poor drug efficacy, or drug resistance. Sort it out, and there are about 10 behaviors:
1. Don't read the manual, go by feeling. This is the most reason, entecavir is required to be taken on an empty stomach, and taken at least 2 hours before and after meals, otherwise it will affect the efficacy of the drug, and it is 1 tablet a day, and it is effective to take it for a fixed period of time, and if you miss 1 dose, the efficacy is only about 25%.
2. The dosage is insufficient. In addition to the factor of insufficient creatinine clearance, most patients have 1 tablet per day, and some patients can't trust domestic generic drugs, using imported entecavir, and their own economic conditions are average, because the pills are more expensive, they take one pill and divide it into 2 days, which is not an exception.
3. Incoherent medication. Entecavir, like other first-line drugs, insists on long-term to be effective, not the existence of being able to take it, some patients want to take a tablet, but don't take it if they can't think of it, which leads to recurrence of the disease and drug resistance.
4. Be your own doctor. After using it for a period of time, the physical examination found that the indicators were getting better, and I felt much better than before, and after a few more weeks, I stopped entecavir without consulting the doctor, which is dangerous, especially for older patients.
5. Change dressings at will. There are two common situations: one is the same drug from different manufacturers, and the other is to switch to other drugs. The first case is okay, the second case should be cautious, it is best to follow the doctor's advice, and try not to change it if the response is good.
6. Failure to carefully select drugs based on their own conditions. Although it is also a first-line drug, the drug effect is stronger than entecavir, but it is not suitable for patients with impaired renal function and elderly patients.
7. There are many and miscellaneous medications. Generally speaking, entecavir antiviral treatment is sufficient, some patients are anxious, and at the same time take a variety of liver protection drugs, and some have greater side effects on the liver and kidney, which affects the follow-up treatment and does the wrong thing with good intentions.
8. Pedal two boats. If the effect is obvious, I don't know who plays the role, if the effect does not meet expectations, or even worse, it is suspected that it is the problem of entecavir, the key is to delay the treatment and waste money.
9. Neglect regular physical examinations. Regular physical examination is a necessary step to evaluate the antiviral treatment of entecavir, check liver function, B ultrasound, and if necessary, add HBV DNA, creatinine, alpha-fetoprotein, etc., some patients do not have strict self-management, which affects the follow-up treatment.
10. Confusion treatment. In some patients, who are normal carriers of the hepatitis B virus, or who are abnormally elevated aminotransferases due to non-hepatitis B factors, they are biased to listen to and believe in it, and treatment is complicated by entecavir or other drugs.
Summary: Treatment is a collaborative process of doctors, patients, medicines, and the environment, and it is more important for hepatitis B patients to self-manage and self-demand. Entecavir is a good drug, and it should be used to give it the effect it should have.