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Hepatitis D virus entry inhibitor

Bulevirtide

Brand names: Hepcludex

Bulevirtide is a subcutaneous entry inhibitor used for the treatment of chronic hepatitis delta (hepatitis D) infection with compensated liver disease.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It binds and blocks the sodium taurocholate co-transporting polypeptide (NTCP) receptor on hepatocytes, preventing entry of hepatitis B and hepatitis delta virus into liver cells.

Prescribing in practice

  • Because NTCP is also a bile-acid transporter, bulevirtide causes a dose-related rise in serum bile-acid levels, so it should not be combined with other NTCP-inhibiting medicines.
  • It should be initiated and supervised by a physician experienced in managing chronic viral hepatitis.
  • Concurrent hepatitis B should be assessed and managed, and the drug is not recommended in decompensated cirrhosis.

Monitoring

Monitor hepatitis delta RNA and liver biochemistry for response, and review the expected rise in bile-acid concentrations.

Counselling the patient

  • This medicine is given as a daily injection under the skin and you will be taught the technique.
  • Itching can occur because of changes in bile salts in the blood.
  • Keep attending for blood tests so the team can check how well the treatment is working.

Evidence & guidelines

Antiviral and biochemical responses in chronic hepatitis delta were shown in the MYR301 phase 3 study.

Reference: NICE TA evaluation; EASL HDV guidelines; SmPC; Confirm identity and dosing against the manufacturer SPC (eMC) and NICE. Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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