lamivudine, Epivir; Epivir HBV (cont.)

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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).

PRESCRIBED FOR: Lamivudine is used for the treatment of HIV infection and hepatitis B infection. It also is used off-label for prevention of HIV among individuals accidentally exposed to HIV.

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.

DRUG INTERACTIONS: Trimethoprim/sulfamethoxazole (Bactrim) increases the concentration of lamivudine in the body. Zalcitabine (Hivid) and lamivudine may interfere with the activity of each other.

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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