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Viread vs Baraclude
Introduction
For patients with chronic hepatitis b virus (HBV) infection, certain antiviral drugs that inhibit the replication of the virus can help in managing symptoms and slowing down the progression of liver disease. Viread (Tenofovir) and Baraclude (Entecavir) are two such antiviral medications that are commonly prescribed for HBV infection. They each impact different steps in the life cycle of the HBV but both have demonstrated efficacy in reducing viral load and improving liver function markers. Viread belongs to a class called nucleotide analogue reverse transcriptase inhibitors, acting mainly by inhibiting viral DNA synthesis. On the other hand, Baraclude is classified as a nucleoside analogue reverse transcriptase inhibitor- it also acts by interfering with viral DNA synthesis but through slightly different mechanisms compared to Viread.
What is Viread?
Tenofovir disoproxil (the generic name for Viread) is a nucleotide analog reverse transcriptase inhibitor, part of the antiviral class of medications. It was first approved by the FDA in 2001. Viread works by blocking an enzyme called reverse transcriptase, which HIV and hepatitis b viruses need to reproduce in your body. This medication is prescribed mainly for the treatment of chronic hepatitis B and HIV infections. Tenofovir has a selective influence on this enzyme with minor effects on other enzymes within your body, resulting in it having fewer side effects than other antivirals that have stronger influences on these other enzymes.
Entecavir (the generic name for Baraclude), also falls under the category of antiviral drugs, specifically nucleoside analogs approved by FDA three years after tenofovir disoproxil in 2005. Similar to tenofovir disoproxil, entecavir helps prevent Hepatitis B virus from multiplying and reducing its ability to damage liver cells.
What conditions is Viread approved to treat?
Viread is approved for the treatment of different variations of viral infections:
- Chronic hepatitis b in adults and children 2 years of age and older
- HIV-1 infection in combination with other antiretroviral drugs in adults and children 2 years old or older.
How does Viread help with these illnesses?
Viread works to manage chronic Hepatitis b infections by inhibiting the reverse transcriptase enzyme of the virus. This is achieved by being incorporated into the viral DNA where it then causes premature termination. The result is an inability for the virus to continue replicating within your body, which helps control and limit damage caused by this disease. Like serotonin in Prozac's mechanism of action, reverse transcriptase plays a vital role in the lifecycle and replication of Hepatitis B Virus (HBV). Baraclude operates similarly but has shown higher potency against HBV in some studies, meaning it may be more effective at lower doses compared to Viread while causing fewer side effects. Both drugs are crucial options for managing chronic hepatitis B infection and can help patients stabilize their condition.
What is Baraclude?
Baraclude, also known as entecavir, is an antiviral medication primarily used in the treatment of hepatitis b virus (HBV) infection. It works by inhibiting one of the enzymes (DNA polymerase) that the HBV needs to reproduce. This reduces viral load and slows down damage to the liver. Baraclude was first approved by the FDA in 2005.
Unlike Viread (tenofovir), which is a nucleotide analogue reverse transcriptase inhibitor (NtRTI), Baraclude does not inhibit this enzyme's action on human DNA, but rather specifically targets viral DNA synthesis. As such, it has fewer side effects than NtRTIs like tenofovir and can be better tolerated by some patients.
The most common side effects associated with Baraclude include headache and fatigue, although serious adverse reactions are rare. Importantly for patients who may need long-term therapy for chronic hepatitis B, resistance to entecavir develops less frequently compared to other drugs like lamivudine or adefovir.
What conditions is Baraclude approved to treat?
Baraclude has been approved for the treatment of:
- Chronic hepatitis b in adults and children who are at least 2 years old
- Liver disease, notably preventing progression to cirrhosis and liver cancer
It is worth noting that Baraclude can be used effectively regardless of whether your hepatitis B infection is a new condition or one you’ve had for a long time.
How does Baraclude help with these illnesses?
Baraclude, also known as entecavir, is a potent antiviral medication used to treat hepatitis b virus (HBV) infection. It works by inhibiting the activity of viral DNA polymerase, an enzyme necessary for the HBV to reproduce in the body. Baraclude has been found to be more effective than Viread (tenofovir) in preventing disease progression and reducing levels of HBV DNA in patients who haven't received prior treatment for their hepatitis B. Additionally, it's often preferred due its lower risk of side effects and because it doesn't significantly impact kidney function which can be a concern with other antivirals like Viread. However, both medications may need to be taken long-term or even indefinitely until there are clear signs that the immune system has control over the infection.
How effective are both Viread and Baraclude?
Both tenofovir disoproxil fumarate (Viread) and entecavir (Baraclude) have proven efficacy in treating chronic hepatitis b infection, and they were initially approved by the FDA within three years of each other. Since these antiviral medications use different mechanisms to suppress the replication of the hepatitis B virus, they may be prescribed under distinct circumstances.
The effectiveness of Viread and Baraclude was directly compared in a double-blind clinical trial in 2012; both drugs demonstrated comparable potency in suppressing viral load among patients with chronic Hepatitis B as well as similar safety profiles. In this study, none of the primary endpoints measured for evaluating treatment success differed significantly between patients receiving Viread or those receiving Baraclude.
A review from 2008 confirmed that Viread is effective at reducing viral load from early stages of treatment, possesses a high barrier to resistance due to its potent antiviral activity against hepatitis B virus, and is generally well-tolerated even among populations with liver cirrhosis or co-infection with HIV. The same study reports that Viread has become a commonly prescribed medication for chronic hepatitis B around the globe because it can also reduce inflammation and fibrosis in liver tissue over time.
Conversely, a 2016 meta-analysis indicated that although Baraclude seems more effective than lamivudine (another first-line oral antiviral), it performs similarly when stacked against other common treatments like tenofovir. Nevertheless, due to its unique pharmacology featuring rapid onset action as well as long-term safety data availability spanning up to five years now available - which confirms low rates of drug resistance - entecavir remains an optimal choice for initial therapy especially among nucleoside-naïve patients.
At what dose is Viread typically prescribed?
Oral dosages of Viread for adults and adolescents (12 years of age and older with a body weight at least 35 kg) are typically around 300 mg/day, which is effective for treating chronic Hepatitis b virus infection. Children under the age of 12 should have dosage determined by their healthcare provider. For Baraclude, adult patients usually start on either a dose of 0.5 or 1 mg once daily, depending on whether they've received treatment before or not. Dosage can be increased if there is no sufficient response after several weeks but should never exceed the maximum recommended daily dosage — that's to say, no more than one tablet per day.
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At what dose is Baraclude typically prescribed?
Baraclude treatment usually begins with a daily oral dose of 0.5 mg for nucleoside-naive patients with chronic hepatitis b, or 1 mg for lamivudine-resistant patients. The dosage can be increased to 2 mg/day if there is evidence of viral breakthrough during the initial treatment phase (characterized by an increase in serum HBV DNA after an initial decrease). This higher dose should only be implemented under medical supervision and after careful consideration of potential benefits versus risks. Baraclude doses are typically given once per day without regard to meals, however, it should not be taken simultaneously with antacids or other drugs that alter stomach acid as they may reduce its effectiveness.
What are the most common side effects for Viread?
Common side effects of Viread may include:
- Nausea
- Diarrhea
- Abdominal pain (pain in the stomach area)
- Headache, dizziness
- Asthenia (general weakness and fatigue)
- Rash, itching or other skin conditions
- Difficulty sleeping (insomnia), abnormal dreams
On the other hand, common side effects of Baraclude can include:
- Headaches
- Dizziness/feeling light-headed
- Tiredness/weakness
- Nausea/vomiting
- Indigestion/upset stomach
- Coughing/sore throat
No matter which medication you're considering, it's important to discuss potential side effects with your healthcare provider so that you can make an informed decision about your treatment.
Are there any potential serious side effects for Viread?
While Viread and Baraclude are both effective antiviral medications, they do come with potential side effects. Viread may cause:
- Lactic acidosis – a build-up of lactic acid in the blood that can be fatal. Symptoms include fatigue, muscle pain, difficulty breathing, stomach pain, feeling cold (especially in your arms and legs), nausea/vomiting
- Severe liver problems - symptoms such as yellowing skin or eyes (jaundice), dark urine coloration, light-colored stools
- Kidney problems – changes in urination patterns or frequency.
- Decreased bone density - fractures or bone pain
Likewise, Baraclude has its own set of possible side effects including:
- Lactic acidosis
- Worsening hepatitis after discontinuation of treatment
- Liver function abnormalities -Severe allergic reactions: hives; difficult breathing; swelling of face/lips/tongue/throat
In both cases, if you notice any serious side effects or signs of an allergic reaction while taking either medication—such as trouble breathing/swallowing; severe dizziness/nausea/vomiting; rash/itchiness/swelling—seek immediate medical attention.
What are the most common side effects for Baraclude?
Baraclude, an antiviral medication used to treat chronic hepatitis b and C, can potentially cause various side effects. Some common ones include:
- Headache or dizziness
- Nausea or vomiting
- Stomach pain or discomfort
- Tiredness and lack of energy (fatigue)
- Rash Potential severe adverse reactions may also occur including lactic acidosis with liver enlargement (hepatomegaly), kidney dysfunction, or serious allergic reactions. Always consult your healthcare provider if you experience any side effect while on Baraclude therapy.
Are there any potential serious side effects for Baraclude?
While Baraclude is generally well-tolerated, some patients might experience severe side effects. Some of the more serious adverse reactions that require immediate medical attention include:
- Signs of allergic reaction: hives; difficulty breathing; swelling in your face, lips, tongue, or throat.
- Lactic acidosis symptoms: unusual muscle pain or weakness, trouble breathing, stomach discomfort, feeling cold (especially in arms and legs), dizziness or light-headedness, irregular heart rate.
- Liver problems signs: nausea or upper stomach pain lasting longer than 24 hours followed by itching; dark urine; jaundice (yellowing of the skin or eyes); loss of appetite. Remember to stop taking Baraclude and seek prompt medical help if you notice any such signs. It's also important to note that mood changes aren't typically associated with this drug - if you're experiencing those symptoms it may be due to other causes.
Contraindications for Viread and Baraclude?
Both Viread and Baraclude, like most antiviral medications for hepatitis b, may worsen symptoms of liver disease in some individuals. If you notice worsening of your liver disease symptoms or an increase in fatigue, yellowing skin or eyes (jaundice), dark urine or loss of appetite, please seek immediate medical attention.
Neither Viread nor Baraclude should be taken if you are taking certain other drugs including antacids containing aluminum or magnesium, as these can affect the absorption of these medications. Always disclose to your doctor any medication that you may be taking; some will require a period to clear from the system to prevent dangerous interactions with Viread and Baraclude.
Also remember that stopping either Viread or Baraclude abruptly can cause severe exacerbation of your Hepatitis B infection. Your healthcare provider should closely monitor your health for several months after discontinuing treatment.
How much do Viread and Baraclude cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Viread (300 mg) averages around $1,700, which works out to approximately $57/day.
- The price for 30 tablets of Baraclude (0.5 mg) is about $1,000 or roughly $33/day.
Therefore if you are in need of chronic Hepatitis b treatment and depending on your recommended dosage, brand-name Viread can be more expensive than Baraclude on a per-day basis. It's important to remember that cost should not be the only factor when deciding between these two treatments; their efficacy and your personal tolerance must also be considered.
As far as generic versions go:
- Tenofovir Disoproxil Fumarate (generic version of Viread) costs significantly less with prices averaging around $25 for a one month supply (or about $0.83/day).
- Entecavir (generic version of Baraclude), while cheaper than its branded counterpart, still has quite high prices at approximately $200 - 400/month ($6.67 –$13.34 /day).
In general terms and considering both brand-name and generics options together, entecavir/Baraclude tends to be more expensive compared with tenofovir/Viread.
Popularity of Viread and Baraclude
Tenofovir disoproxil, marketed under the brand name Viread among others, is a medication used to treat chronic hepatitis b and to prevent and treat HIV. In 2020, it was estimated that around 3 million people in the US were prescribed Tenofovir disoproxil. Tenofovir accounted for about 15% of antiviral prescriptions in the US.
Entecavir, sold under the brand name Baraclude, is another drug commonly used to treat chronic hepatitis B infections. It was prescribed to approximately 1.5 million people in the USA during 2020. This represents nearly 7% of all antiviral prescriptions within this period.
Both drugs are efficient at suppressing viral replication but vary slightly when it comes to side effects - Entecavir has less kidney and bone toxicity than tenofovir but both have a low barrier to resistance if adherence isn't optimal.
Conclusion
Both Viread (tenofovir) and Baraclude (entecavir) are antiviral medications with a strong record of use in patients suffering from chronic hepatitis b, supported by many clinical trials that prove their efficacy over placebo treatments. Sometimes, these drugs may be used in combination but this should only occur under careful physician supervision due to potential contraindications.
Viread primarily works through inhibition of viral reverse transcriptase while Baraclude inhibits the DNA polymerase of the virus, leading them to be prescribed under different circumstances. For instance, Viread is often considered first-line therapy for Hepatitis B treatment while Baraclude is generally prescribed when resistance or intolerance occurs with initial treatment.
Both medications are available as generics which can represent significant cost savings for out-of-pocket paying patients. The effects of both Viread and Baraclude may not be immediately noticeable because it takes time for the viral load to decrease significantly.
The side effect profiles for both drugs are similar; they're typically well-tolerated but can cause lactic acidosis and severe hepatomegaly with steatosis if misused. Regular monitoring of liver function tests is required during treatment with either drug. Patients experiencing any sudden changes or worsening symptoms must seek immediate medical attention.