Entecavir-- switching to a different brand

Today I went to the pharmacy to get entecavir, but I was told that my usual entecavir (sandoz) is out of stock (yes, It is true. I checked TGA shortage database). However, they have the alternative entecavir (apotex) available for me to collect. The pharmacist seems sure that the two are exactly the same, but I am just being pedantic and would like to double check here. Now I have a few questions:

  1. Is it safe to change the brand (from sandoz to apotex)? — I guess I have no other option, but just to double check.
  2. google tells me that there is a list of meds containing entecavir. Are they the same in terms of treating hepb? Safe to switch to any of them if I have to (and available in pharmacies)?
  3. It starts to worry me that the supply of the meds could be an issue, and it could be out of stock. Is it possible that all the entecavir meds are out of stock and I couldn’t get anything from the pharmacy? I hope I’m worrying too much, but I did hear sad stories about dulaglutide shortage in Australia for type 2 diabetes patients. Please tell me I worry too much. I guess I have to change meds if it really happens?
  4. I had a quick check on entecavir (apotex) here, and it says “On November 28, 2022 Entecavir (Apotex) was not listed on the Australian Register of Therapeutic Goods (ARTG)” . What does it mean? I did find it is listed in TGA Is it not registered? Is it still safe to take?
  5. If I have to stay at a different country for a relatively long time and have to get meds there, is it safe to continue entecavir from their local sponsor (their local brand)?
    Sorry for so many questions. Any response or comments would be appreciated! Thanks!

Hi @abcde ,

These are great questions! Maybe something most of us might not have even thought enough to ask, but would be really good to know for the future. I am guessing that each country or even regions of a country may have different pharmacy policies. Not being an expert, I would also guess that any brand of Entecavir or generic is ok to switch to, unless you have some specific condition or allergy to any possible fillers or coatings? I am interested to see what the experts say.

-Paul

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Hi @abcde,

Indeed good questions. I would go with your pharmacist on this, the active ingredients in each would be the same (see here for previous discussions on the matter: https://www.hepbcommunity.org/t/rx-vs-generic-is-one-better-than-the-another/2895; Generic Medication).

I am not sure about med supplies, but the TGA seems to have measures in place for these potential events (https://www.tga.gov.au/safety/shortages/accessing-medicines-during-shortage). Given so many generics companies produces entecavir (as you linked to), it seems unlikely that they’ll all be affected at the same time for an extended period.

I have stayed in Germany for many years, and used the generic form of tenofovir there. It wasn’t really a problem.

Thomas

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Thanks @ThomasTu @PuallyHBV for your reply !

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Hi abcde

I had the same issue, I used the same brand for a year and due to shortages I had to switch to entecavir apotex. I haven’t had any issues at all, my viral loads are still undetected with this drug and no side effects.

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I wish I could use generic entecavir, but it gave me a rising heartbeat, dizziness, headache, fatigue, and nausea. I could not take it. So I stuck with the name brand. It costs much more than generic. Luckily, I have health insurance, and I only pay $100 every three months. I have been taking entecavir (Baraclude) for more than 12 years with no issues. My ALT maintains between 17-13, with undetectable DNA. I do blood tests and ultrasounds every six months.

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Thanks @Elton and @jce1234 for sharing your stories! So glad to hear that the medication is working for both of you and your viral load is undetectable!

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