lamivudine, Epivir; Epivir HBV
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
GENERIC NAME: lamivudine
BRAND NAME: Epivir, Epivir HBV
DRUG CLASS AND MECHANISM: Lamivudine is an oral medication that is used for the treatment of infections with the human immunodeficiency (HIV) and hepatitis B viruses. It is in a class of drugs called reverse transcriptase inhibitors which also includes zalcitabine (Hivid), zidovudine (Retrovir), didanosine (Videx), emtricitabine (Emtriva), and stavudine (Zerit). During infection with HIV, the HIV virus multiplies within the body's cells. The viruses then are released from the cells and spread throughout the body where they infect other cells. In this manner, HIV infection spreads to new, uninfected cells that the body is continually producing, and HIV infection is perpetuated. When producing new viruses, the HIV virus must manufacture new DNA for each virus. Reverse transcriptase is the virus' enzyme that forms this new DNA. Lamivudine first is converted within the body to its active form, lamivudine triphosphate. This active form is similar to a chemical, deoxycytidine triphosphate, that is used by reverse transcriptase to make new DNA. The reverse transcriptase uses lamivudine triphosphate instead of deoxycytidine triphosphate, and the lamivudine triphosphate interferes with the reverse transcriptase. Lamivudine does not kill existing HIV virus, and it is not a cure for HIV. Lamivudine was approved by the FDA in 1995.
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 100, 150, and 300 mg; oral solution: 5, 10 mg/ml
STORAGE: Tablets and solution should be stored at room temperature, 15 C to 30 C (59 F to 86 F).
DOSING: For the treatment of HIV infection the recommended dose for adults is 150 mg twice daily or 300 mg once daily for those weighing 50 kg or more and 4 mg/kg twice daily (not to exceed 150 mg twice daily) if less than 50 kg.
Neonates are treated with 2 mg/kg twice daily.
Children (1 month to 16 years old) should be treated with 4 mg/kg twice daily up to a maximum dose of 300 mg daily. Children (<16 years old) weighing less than 50 kg should receive 4 mg/kg twice daily up to a maximum dose of 300 mg daily. Children (>16 years old) weighing 50 kg or more should receive 150 mg twice daily or 300 mg daily.
Adults with hepatitis B are treated with 100 mg daily.
Children >2 years old are treated with 3 mg/kg daily up to a maximum dose of 100 mg.
For post-exposure prevention of HIV infection, 150 mg twice daily of lamivudine is administered in conjunction with 600 mg daily of zidovudine (Retrovir) for 28 days.
Lamivudine may be administered without regard to meals.
PREGNANCY: Use of lamivudine during pregnancy has not been adequately evaluated.
NURSING MOTHERS: It is not known whether lamivudine is secreted in breast milk. HIV infected mothers should not breast feed because of the potential risk of transmitting HIV to an infant that is not infected.
SIDE EFFECTS: The most severe side effects of lamivudine are pancreatitis, liver failure and metabolic disturbance (lactic acidosis). Lamivudine also causes a decrease in blood cells, muscle pain and weakness, and nerve damage in the extremities (peripheral neuropathy). Symptoms of peripheral neuropathy are tingling, numbness and pain in the feet or hands. Other side effects are fever, abdominal pain, weight loss, nausea, vomiting, diarrhea, hair loss, and difficulty sleeping.
Reference: FDA Prescribing Information
Last Editorial Review: 9/6/2012
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