What is this medication?
Antihepadnaviral, Antiretroviral, Reverse Transcriptase Inhibitor
Brand Name US: Epivir
Canadian Equivalent: Heptovir
Indicated for treatment of chronic hepatitis B, HIV-1 infection.
Note: Use for chronic hepatitis B infection when the genetic barrier to resistance is not available or appropriate. Lamivudine-HBV has not been evaluated in patients coinfected with HIV, hepatitis C virus, or hepatitis delta virus; with decompensated liver disease; or in liver transplant recipients.
“Alert US Warning
Severe acute exacerbation of hepatitis B have been reported in patients coinfected with hepatitis B virus (HBV) and HIV-1 who discontinued lamivudine or other anti-hepatitis B therapy. Lamivudine tablets and oral solution (used to treat HIV-1 infection) contain a higher dose of lamivudine than lamivudine-HBV tablets and oral solution (used to treat chronic hepatitis B infection). Patients with HIV-1 infection should receive only dosage forms appropriate for treatment of HIV-1.”
How does this medication work?
Lamivudine is a cytosine analog, whose primary mechanism of action is inhibiting HIV reverse transcription via viral DNA chain termination; inhibiting RNA- and DNA dependent polymerase activities of reverse transcriptase.
How should I take this medication?
Usual (Oral): 150mg twice daily or 300mg once daily.
Note: Lamivudine, in combination with abacavir, and either efavirenz, raltegravir, boosted atazanavir, or boosted darunavir, is not recommended in patients with pretreatment HIV RNA ≥100,000 copies/mL.
How to Use: Administered with or without regard to food.
What should I watch for while using this medication?
Before starting Lamivudine, Epivir/Heptovir make sure your physician is aware of any allergies or medications you currently take, and activities you perform. Lamivudine, Epivir/Heptovir has been associated with development of immune reconstitution syndrome, lactic acidosis, pancreatitis, and severe acute exacerbation of hepatitis B (some fatal) in patients with HBV or HIV/HBV coinfection who have discontinued lamivudine. Counseling and HIV testing should be offered to all patients prior to beginning treatment with Lamivudine, Epivir/Heptovir because of the risk of developing lamivudine resistant HIV-1. The emergence of lamivudine resistant HBV variants has also been reported in HIV-1/HBV coinfected patients who have received lamivudine-containing antiretroviral regimens. Lamivudine, Epivir/Heptovir should be used with caution in patients with renal impairment.
What if I miss a dose?
If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.
How should I store this medication?
Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.
What are the possible side effects of using this medication?
Headache, fatigue, malaise, paresthesia, peripheral neuropathy, neuropathy, insomnia, sleep disorder, skin rash, nausea, diarrhea, pancreatitis, sore throat, vomiting, neutropenia, increased serum alanine aminotransferase, infection (ear, nose, and throat), musculoskeletal pain, nasal signs and symptoms, cough, fever, dizziness, chills, depression, increased amylase, increased serum lipase, anorexia, decreased appetite, abdominal pain, abdominal cramps, stomatitis, dyspepsia, increased creatine phosphokinase, myalgia, arthralgia
Note this is not a complete list of side effects, only the most common.
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