Lamivudine

Lamivudine is a prescription medication used to treat human immunodeficiency virus (HIV) infection. Lamivudine is also used to treat chronic hepatitis B virus infection. Lamivudine belongs to a group of drugs called nucleoside reverse transcriptase inhibitors (NRTI), which block a process HIV and hepatitis B viruses need to reproduce.

This medication comes in tablet and oral liquid forms and is taken once or twice a day, depending on the condition being treated. 

Lamivudine can be taken with or without food.

Some of the common side effects of lamivudine include ear, nose or throat infections, diarrhea, headache, ill feeling, and fatigue. 

Lamivudine is a prescription medicine used to treat human immunodeficiency virus (HIV) infection and chronic hepatitis B infection virus infection in adults and children. 

Lamivudine is not cure for HIV infection or hepatitis B infection virus infection. 

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information. 

Lamivudine may be found in some form under the following brand names:

• Epivir

• Epivir HBV

Serious side effects can occur with lamivudine use. See "Lamivudine Precautions" section.

Commonly reported side effects include:

• headache
• ear, nose or throat infections
• sore throat
• malaise (general ill feeling) and fatigue
• nausea
• diarrhea
• cough
• fever
• chills
• muscle and joint pain

This is not a complete list of lamivudine side effects. Ask your doctor or pharmacist for more information.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• interferon medications
• zalcitabine (Hivid)
• emtricitabine
• trimethoprim/sulfamethoxazole (Bactrim, Septra), an antibiotic

Ask your doctor if you are unsure if you are taking any of these medications.

This is not a complete list of lamivudine drug interactions. Ask your doctor or pharmacist for more information.

Some severe side effects have been reported with lamivudine use including the following:

Lactic Acidosis/Severe Hepatomegaly With Steatosis. Lamivudine can cause serious damage to the liver and a condition called lactic acidosis. If you experience any of the following symptoms, call your doctor immediately: 

Pancreatitis. Lamivudine can cause life-threatening inflammation of the pancreas (pancreatitis). Tell your doctor immediately if you have any signs of pancreatitis, such as:

• fast heart rate 
• short, quick breaths
• nausea and vomiting
• fever
• swollen, tender abdomen (stomach area)

Fat Redistribution. Lamivudine can change the distribution of fat on your body. You may gain fat in areas such as in the abdomen or at the back of the neck (a "buffalo hump"), and may lose weight in other areas.

Worsening of hepatitis (inflammation of the liver) when treatment with lamivudine is stopped. Your doctor will monitor you and your labs for at least several months after you stop taking lamivudine. 

Do not take lamivudine if you:

• are allergic to lamivudine or to any of its ingredients
• are taking other medications containing lamivudine
• are taking emtricitabine

There is a risk of HIV-1 Resistance if this medication is used in patients with unrecognized or untreated HIV-1 infection. Epivir HBV (lamivudine) contains a lower dose of the active ingredient, lamivudine. If there is a co-infection (HIV and HBV), then the higher dose should be prescribed and taken. 

Information About Therapy With Lamivudine: Lamivudine is not a cure for HIV infection and patients may continue to experience illnesses associated with HIV-1 infection, including opportunistic infections. Patients should remain under the care of a physician when using lamivudine. Patients should be advised that the use of lamivudine has not been shown to reduce the risk of transmission of HIV-1 to others through sexual contact or blood contamination.

Lamivudine does not stop you from spreading HIV and/or hepatitis B virus (HBV) to others by sex, sharing needles, or being exposed to your blood. Avoid doing things that can spread HIV and/or HBV infection to others.

• Do not share or re-use needles or other injection equipment.
• Do not share personal items that can have blood or body fluids on them, like toothbrushes and razor blades.
• Do not have any kind of sex without protection. Always practice safer sex by using a latex or polyurethane condom to lower the chance of sexual contact with semen, vaginal secretions, or blood. 

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of lamivudine there are no specific foods that you must exclude from your diet when receiving lamivudine.

Before receiving lamivudine, tell your doctor if you:

• are allergic to lamivudine or any of the other ingredients of lamivudine
• have ever had liver disease such as liver failure, cirrhosis, or hepatitis
• are seriously overweight (especially if you’re a woman)
• are diabetic (Epivir HBV contains sucrose)
• use insulin
• have kidney disease
• have had pancreatitis (inflammation of the pancreas) in the past, particularly children

Tell your doctor if you are pregnant or breastfeeding.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category C. It is not known if lamivudine will harm your unborn baby. There are no adequate and well-controlled trials of lamivudine in pregnant women.

Tell your doctor if you are breastfeeding or plan to breastfeed. It is very important that you speak with your doctor about the best way to feed your baby.

For mothers being treated for hepatitis B infection:

Lamivudine has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from lamivudine, a choice should be made whether to stop nursing or to stop use of this medication. The importance of the drug to the mother should be considered.

For mothers being treated for HIV:

If your baby does not already have HIV, there is a chance that it can be transmitted through breastfeeding. The Centers for Disease Control and Prevention recommends that women with HIV do not breastfeed.

Lamivudine comes as a tablet and liquid to take by mouth, usually once daily or every 12 hours (twice a day) and depends on what condition you are being treated for. Lamivudine can be taken with or without food.

Take lamivudine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Continue to take lamivudine even if you feel well. Do not stop taking lamivudine without talking to your doctor.

If you miss a dose, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your kidney function
• your weight
• your height
• your age
• your gender

Adults, for the treatment of HIV:

• The recommended dose of Epivir (lamivudine) in HIV infected adults and adolescents over 16 years of age is 300 mg daily, taken by mouth, as either 150 mg twice daily or 300 mg once daily.
• The dose may be decreased if you have kidney problems. 

Children, for the treatment of HIV:

• The recommended dose of Epivir (lamivudine) oral solution in HIV infected children 3 months to 16 years of age is based on the child's weight. The recommendation is 4 mg/kg twice daily or 8 mg/kg once daily (up to a maximum of 300 mg daily), taken by mouth, in combination with other antiretroviral agents.
• Children weighing at least 14 kg, can be given Epivir (lamivudine) tablets.

Adults, for the treatment of chronic hepatitis B:

• The recommended oral dose of Epivir HBV (lamivudine) for treatment of chronic hepatitis B in adults is 100 mg once daily.
• The dose may be reduced if you have kidney problems. 

If you take too much lamivudine, call your local Poison Control Center or seek emergency medical attention right away.

• Store lamivudine tablets at room temperature between 15° to 30°C (59° to 86°F).
• Lamivudine oral solution does not require refrigeration, but should be stored tightly closed in a cool place.
• Keep this and all medicines out of the reach of children.

WARNING: RISK OF LACTIC ACIDOSIS, EXACERBATIONS OF HEPATITIS B IN CO-INFECTED PATIENTS UPON DISCONTINUATION OF LAMIVUDINE , DIFFERENT FORMULATIONS OF LAMIVUDINE:

Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues alone or in combination, including lamivudine and other antiretrovirals. Suspend treatment if clinical or laboratory findings suggestive of lactic acidosis or pronounced hepatotoxicity occur.

Severe acute exacerbations of hepatitis B have been reported in patients who are co-infected with hepatitis B virus (HBV) and human immunodeficiency virus (HIV-1) and have discontinued lamivudine. Hepatic function should be monitored closely with both clinical and laboratory follow-up for at least several months in patients who discontinue lamivudine and are co-infected with HIV-1 and HBV. If appropriate, initiation of anti-hepatitis B therapy may be warranted.

Epivir, which is used to treat HIV-1 infection, contains a higher dose of the active ingredient (lamivudine) than Epivir HBV which is used to treat chronic HBV infection. Patients with HIV-1 infection should receive only dosage forms appropriate for treatment of HIV-1.