Is entecavir (Baraclude) better than tenofovir?

Both entecavir (Baraclude) and [tenofovir (Viread)](https://www.goodrx.com/tenofovir/what-is) are [first-choice medications](https://journals.lww.com/hep/Fulltext/2018/04000/Update_on_prevention,_diagnosis,_and_treatment_of.34.aspx) for treating hepatitis B. Studies suggest that the two medications work [equally well](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6872143/) to control the virus. They also both have generally tolerable side effects and a [low risk of resistance](https://journals.lww.com/hep/Fulltext/2018/04000/Update_on_prevention,_diagnosis,_and_treatment_of.34.aspx#:~:text=higher%20potency%20and-,high%20resistance%20barrier,-%2C%20prophylactic%20first%E2%80%90line) (when the virus no longer responds to treatment). Speak with your provider if you have questions about how these two medications [compare](https://www.goodrx.com/compare/viread-vs-baraclude) and which medication might be right for you.

Can I take entecavir (Baraclude) with tenofovir?

If your HBV is [difficult to treat](https://journals.lww.com/hep/Fulltext/2018/04000/Update_on_prevention,_diagnosis,_and_treatment_of.34.aspx#:~:text=adding%20emtricitabine.231-,Table%208,-%2D%20Antiviral%20Options), it's possible that your provider might ask you to take entecavir (Baraclude) along with [tenofovir (Viread)](https://www.goodrx.com/tenofovir/what-is). Make sure to get your [blood tests](https://www.cdc.gov/hepatitis/hbv/interpretationOfHepBSerologicResults.htm) done so your provider can track how well entecavir (Baraclude) is working against the virus and see if you need a change to your treatment plan.

Can I drink alcohol when I'm taking entecavir (Baraclude)?

We don't know if alcohol directly interacts with entecavir (Baraclude). However, it's best to [avoid alcohol](https://www.goodrx.com/drugs/safety/medications-to-not-mix-with-alcohol) if you have hepatitis B to protect your liver.

entecavir

Generic Baraclude

Used for Hepatitis B

Basics Side effects Pros & cons Pharmacist tips FAQs Warnings Dosage Interactions Cost Alternatives Latest news Images References Prices Medicare

Entecavir (Baraclude) is a first-choice antiviral medication used for the treatment of hepatitis B. Some side effects of the medication can include headache and fatigue. Entecavir (Baraclude) is available as a tablet and a liquid solution that are typically taken once daily. While both forms of the medication have a brand name, only the tablet has a generic version available as well.

Reviewed by:

Hope Chang, PharmD, AAHIVP

Allison Gourley, PharmD

Last reviewed on May 3, 2023

Basics Side effects Pros & cons Pharmacist tips FAQs Warnings Dosage Interactions Cost Alternatives Latest news Images References Prices Medicare

What is Entecavir (Baraclude)?

What is Entecavir (Baraclude) used for?

Hepatitis B virus (HBV)

How Entecavir (Baraclude) works

Entecavir (Baraclude) is a type of antiviral medication called a nucleoside reverse transcriptase inhibitor (NRTI). It inserts itself into the hepatitis B virus's DNA. This prevents the virus from making copies of itself.

Drug facts

Common BrandsBaraclude

Drug ClassAntiviral

Controlled Substance ClassificationNot a controlled medication

Generic StatusLower-cost generic available

AvailabilityPrescription only

Side effects of Entecavir (Baraclude)

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Headache
Fatigue
Dizziness
Nausea
Higher liver lab results

Less Common Side Effects

Indigestion
Diarrhea
Trouble sleeping

Entecavir (Baraclude) serious side effects

Contact your healthcare provider immediately if you experience any of the following.

Lactic acidosis: extreme tiredness, sudden weakness, fast and shallow breathing, loss of appetite, nausea, vomiting
Liver problems: stomach pain, tiredness

Source: DailyMed

The following Entecavir (Baraclude) side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

Abdominal or stomach discomfort

cough

decreased appetite

diarrhea

difficulty with swallowing

dizziness

fast heartbeat

fast, shallow breathing

general feeling of discomfort

hives, itching, or rash

muscle pain or cramping

nausea

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

right upper abdominal or stomach pain and fullness

sleepiness

tightness in the chest

unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Acid or sour stomach

belching

headache

heartburn

indigestion

stomach discomfort, upset, or pain

Rare

Trouble sleeping

Unusual drowsiness

Incidence not known

Hair loss

thinning of the hair

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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Avg retail price

$835.93(Save 98.04%)

GoodRx discount

$16.40

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Pros and cons of Entecavir (Baraclude)

Pros

First-choice medication for hepatitis B
Generally mild side effects
Not known to have a risk of kidney damage like other hepatitis B medications (e.g., tenofovir (Viread))
Can use in children as young as 2 years old
Available as a liquid solution for young children and people who have a hard time swallowing tablets

Cons

Not a cure for hepatitis B
Must take on an empty stomach (at least 2 hours after a meal and 2 hours before your next meal)
Requires dose adjustments for people with kidney problems
Not the best option for people who’ve taken lamivudine (Epivir HBV) in the past because of possible viral resistance
Not a first-choice option for people with both hepatitis B and HIV

Pharmacist tips for Entecavir (Baraclude)

Take entecavir (Baraclude) once a day on an empty stomach at least 2 hours after a meal and 2 hours before your next meal. Food can affect how well this medication works, so taking it on an empty stomach is important for treating your hepatitis B virus.
For the liquid solution: Use the dosing spoon that comes with the medication, and follow the directions to measure the dose accurately. Rinse the spoon after each use, and let it air dry. Don't mix the medication with water or any other liquids. The liquid can be used up until the expiration date on the bottle.
Keep your regularly scheduled clinic and lab appointments. This will help your provider make sure that entecavir (Baraclude) is working well against the virus and check for side effects.
Store the entecavir (Baraclude) tablets and liquid solution at room temperature. Make sure to close the bottle tightly after each use to protect the medication from moisture. Keep the bottle in the outer carton to protect it from light.

Common questions about Entecavir (Baraclude)

No, there are currently no antiviral treatment options available that can cure hepatitis B. However, proper treatment can help control the virus in the body and lower the risk of serious liver damage. It's important that you continue to take entecavir (Baraclude) as prescribed. Stopping the medication too soon or missing doses can make the hepatitis B virus come back and possibly be harder to treat.

You should continue to take entecavir (Baraclude) as long as your provider instructs you to. We don't exactly know what the ideal amount of time you should take the medication for your HBV infection is. But studies show that many people have taken entecavir (Baraclude) for several years without problems. Remember to get your blood tests done on time when your provider orders them. These blood tests help your provider see how well entecavir (Baraclude) is working to stop the hepatitis B virus from growing and to check your liver. Discuss with your provider about how long you'll need to take entecavir (Baraclude).

You can take entecavir (Baraclude) at any time of the day. But make sure to take it at around the same time every day. You'll need to take entecavir (Baraclude) on an empty stomach. So, try to choose a time of day that's usually between meal times (at least 2 hours after a meal and 2 hours before your next meal). Speak with your provider or pharmacist if you're having trouble finding a good time for you to take entecavir (Baraclude) during the day.

Both entecavir (Baraclude) and tenofovir (Viread) are first-choice medications for treating hepatitis B. Studies suggest that the two medications work equally well to control the virus. They also both have generally tolerable side effects and a low risk of resistance (when the virus no longer responds to treatment). Speak with your provider if you have questions about how these two medications compare and which medication might be right for you.

If your HBV is difficult to treat, it's possible that your provider might ask you to take entecavir (Baraclude) along with tenofovir (Viread). Make sure to get your blood tests done so your provider can track how well entecavir (Baraclude) is working against the virus and see if you need a change to your treatment plan.

Yes, the two forms of entecavir (Baraclude) are interchangeable. This means that if someone is taking the liquid solution and gets switched to the tablets, their dose will remain the same. This also applies if someone is switching from the tablets to the liquid solution. Both forms of the medication need to be taken on an empty stomach.

We don't know if alcohol directly interacts with entecavir (Baraclude). However, it's best to avoid alcohol if you have hepatitis B to protect your liver.

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Risks and warnings for Entecavir (Baraclude)

Entecavir (Baraclude) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Worsening of hepatitis B after stopping treatment

Risk factors: Hepatitis B virus | Stopping entecavir (Baraclude)

Black Box Warning Don't stop taking entecavir (Baraclude) unless instructed by your healthcare provider. Your hepatitis B could come back and get worse if you stop your treatment. If you have severe liver damage, your liver health could get worse as well. If you're instructed to stop entecavir (Baraclude), make sure you get your blood tests done regularly, especially during the first few months after stopping. This is how your provider will check your liver health and HBV infection.

Hepatitis B and HIV co-infection

Risk factors: HIV infection

Black Box Warning Your provider will test you for HIV before you start entecavir (Baraclude) and periodically while you're taking the medication. Having undiagnosed or untreated HIV while taking HBV treatment can potentially cause HIV drug resistance and make the HIV infection harder to treat. For this reason, entecavir (Baraclude) isn't recommended for people who have both HBV and untreated HIV. We currently don't know if entecavir (Baraclude) can be used to treat HIV. If you happen to have hepatitis B and HIV, your provider will recommend a medication regimen that works well to treat both infections.

Lactic acidosis and liver problems

Risk factors: Obesity | Women | History of liver problems

Black Box Warning Although rare, NRTIs, including entecavir (Baraclude), can cause life-threatening problems like lactic acidosis (too much lactic acid in the blood) and fatty liver disease. Most cases of these problems have happened in women. Risk factors can also include obesity, long-term NRTI use, and poor liver health. Symptoms of lactic acidosis include extreme tiredness, sudden weakness, and fast and shallow breathing, while symptoms of fatty liver disease can include stomach pain. Stop taking entecavir (Baraclude) and go to the emergency room right away if this happens.

Entecavir (Baraclude) dosage

The average cost for 30 tablets of 0.5mg of Entecavir (Baraclude) is $16.40 with a free GoodRx coupon. This is 98.04% off the average retail price of $835.93.

Tablet

Dosage	Quantity	Price as low as	Price per unit
0.5mg	30 tablets	$16.40	$0.55
1mg	90 tablets	$41.25	$0.46

Typical dosage for Entecavir (Baraclude)

People 16 years and older: The typical dose is 0.5 mg or 1 mg by mouth once a day on an empty stomach. The dose depends on your liver health and your hepatitis B infection.
Children 2 years and older weighing at least 22 pounds: The dose is based on your child's weight. The maximum dose is 1 mg by mouth per day. Children weighing less than 66 pounds should use the entecavir (Baraclude) oral solution instead of the tablet.

Your dose might differ if you have kidney problems (either by taking a lower strength or by taking the medication less often).

Interactions between Entecavir (Baraclude) and other drugs

Entecavir (Baraclude) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Entecavir (Baraclude). Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

How much does Entecavir (Baraclude) cost?

To access savings, use a GoodRx coupon and pay just a fraction of the retail price.

Baraclude (brand)

GoodRx lowest price

$16.40

(save 99.64%)

Entecavir (Baraclude) (generic)

GoodRx lowest price

$16.40

(save 99.42%)

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What are alternatives to Entecavir (Baraclude)?

There are a number of medications that your doctor can prescribe in place of Entecavir (Baraclude). Compare a few possible alternatives below.

Entecavir (Baraclude)

Used for:

Hepatitis B virus (HBV)

$16.40Lowest GoodRx priceView prices

Tenofovir disoproxil fumarate (Viread)

Used for:

Treatment of HIV infection - people ages 2 years and older
Treatment of chronic (long-term) hepatitis B - Brand Viread for people ages 2 years and older; generic for people ages 12 years and older

$42.16Lowest GoodRx priceView prices

Adefovir (Hepsera)

Used for:

Hepatitis B virus (HBV)

$765.30Lowest GoodRx priceView prices

News about Entecavir (Baraclude)

Hepatitis B In AAPI Communities: Risks, Barriers, and Resources

Asian Americans/Pacific Islanders are uniquely at risk of developing hepatitis B and liver cancer. In fact, this is the biggest health disparity affecting this community. Learn more about hepatitis B and how it poses a specific risk to AAPI individuals with GoodRx.

Here’s How to Save As Much As $2000 on Your Prescriptions With GoodRx

Picture this: You go to the pharmacy to pick up a generic medication (the affordable version of a brand drug that your doctor swore would be affordable), only to be quoted over $1,000 for a 30-day supply.

Entecavir (Baraclude) images

This medicine is White, Oval Tablet Imprinted With "An" And "446".White Oval 446 And An - Entecavir 0.5mg Tablet

This medicine is White, Triangle Tablet Imprinted With "Cl" And "426".White Triangle 426 And Cl - Entecavir 0.5mg Tablet

This medicine is White, Triangle Tablet Imprinted With "A" And "88".White Triangle A And 88 - Entecavir 0.5mg Tablet

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References

Best studies we found

Aurobindo Pharma Limited. (2022). ENTECAVIR tablet [package insert]. DailyMed.

Centers for Disease Control and Prevention. (2023). Interpretation of hepatitis B serologic test results.

Chen, M., et al. (2019). Comparative efficacy of tenofovir and entecavir in nucleos(t)ide analogue-naive chronic hepatitis B: A systematic review and meta-analysis. PLoS One.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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