lamivudine

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lamivudine

 [lah-miv´u-dēn]
a nucleoside analogue that inhibits reverse transcriptase and is used as an antiviral agent in treatment of hepatitis B infection and, in combination with zidovudine, in treatment of HIV infection and AIDS. Administered orally

lamivudine

Epivir, Epivir-HBV, 3TC (CA), Heptovir (CA), Zeffix (UK)

Pharmacologic class: Nucleoside reverse transcriptase inhibitor

Therapeutic class: Antiretroviral

Pregnancy risk category C

FDA Box Warning

• Lactic acidosis and severe hepatomegaly with steatosis (including fatal cases) have occurred when drug was used alone or in combination with other nucleoside analogues.

• Epivir tablets and oral solution (used to treat human immunodeficiency virus [HIV] infection) contain higher dose of active ingredient (lamivudine) than Epivir-HBV tablets and oral solution (used to treat chronic hepatitis B). Patients with HIV should receive only dosing forms appropriate for HIV treatment.

• After Epivir discontinuation, severe acute hepatitis B exacerbations have occurred in patients co-infected with hepatitis B virus (HBV) and HIV. Monitor hepatic function closely for at least several months in these patients. If appropriate, begin anti-hepatitis B therapy.

Action

Inhibits HIV reverse transcription by viral DNA chain termination. Impedes RNA- and DNA-dependent DNA polymerase activities.

Availability

Oral solution: 5 mg/ml and 10 mg/ml in 240-ml bottles

Tablets: 100 mg, 150 mg, 300 mg

Indications and dosages

HIV infection (given with other antiretrovirals)

Adults and children older than age 16: 150 mg P.O. b.i.d. or 300 mg P.O. daily

Children ages 3 months to 16 years: 4 mg/kg P.O. b.i.d. to a maximum of 150 mg P.O. b.i.d.

Chronic HBV

Adults: 100 mg (Epivir-HBV) P.O. once daily

Children ages 2 to 17: 3 mg/kg (Epivir-HBV) P.O. once daily, to a maximum of 100 mg P.O. daily

Dosage adjustment

• Renal impairment

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:
• impaired renal function, history of hepatic disease, obesity, granulocyte count below 1,000/mm3
• long-term therapy
• elderly patients
• women (especially if pregnant)
• children.

Administration

• Give with or without food.

Be aware that Epivir contains 150 mg lamivudine and Epivir-HBV contains 100 mg lamivudine. Strengths are not interchangeable.

Know that when given to patients with unrecognized or untreated HIV, Epivir-HBV is likely to cause rapid emergence of HIV resistance.

Adverse reactions

CNS: fatigue, headache, insomnia, malaise, asthenia, depression, dizziness, paresthesia, peripheral neuropathy, seizures

GI: nausea, vomiting, diarrhea, anorexia, abdominal discomfort, dyspepsia, splenomegaly, pancreatitis

Hematologic: anemia, neutropenia

Hepatic: hepatomegaly with steatosis

Metabolic: hyperglycemia, lactic acidosis

Musculoskeletal: muscle, joint, or bone pain; muscle weakness; myalgia; rhabdomyolysis

Respiratory: cough, abnormal breath sounds, wheezing

Skin: alopecia, rash, urticaria, erythema multiforme, Stevens-Johnson syndrome

Other: lymphadenopathy, body fat redistribution, hypersensitivity reactions including anaphylaxis; immune reconstitution syndrome

Interactions

Drug-drug.Co-trimoxazole: increased lamivudine blood level

Zalcitabine: interference with effects of both drugs

Drug-diagnostic tests.Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, creatine kinase, liver function tests: increased levels

Hemoglobin, hematocrit, neutrophils: decreased levels

Patient monitoring

• Check vital signs regularly.
• Monitor CBC and platelet count frequently. Watch for evidence of bone marrow toxicity.
• Monitor blood glucose level and kidney and liver function test results.
• Assess neurologic and mental status. Report signs or symptoms of depression.
• Closely monitor obese patients, women, and patients with a history of hepatic disease; they're at increased risk for lactic acidosis and severe hepatomegaly with steatosis.
• Monitor HIV patients for co-infection with HBV (which may recur when drug is withdrawn).

Monitor patients for signs and symptoms of immune reconstitution syndrome.

Patient teaching

• Tell patient he may take with or without food.
• Advise patient to minimize GI upset by eating small, frequent servings of healthy food and drinking plenty of fluids.
• Tell HIV patient that drug doesn't cure virus or prevent its transmission and that opportunistic infections may occur. Advise him to take appropriate precautions during sex.
• Teach patient how to recognize and immediately report signs and symptoms of immune reconstitution syndrome.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• Caution HIV patient not to breastfeed, because of risk of passing infection to infant.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

lamivudine

/la·miv·u·dine/ (lah-miv´u-dēn) a nucleoside analogue that inhibits reverse transcriptase, used as an antiviral agent in the treatment of chronic hepatitis B and, in combination with zidovudine, the treatment of HIV infection and AIDS.

lamivudine

(lə-mīv′yo͞o-dēn′)
n.
An antiviral drug, C8H11N3O3S, that is a nucleoside reverse transcriptase inhibitor and is used in the treatment of chronic hepatitis B and, in combination with other drugs, in the treatment of HIV infection.

lamivudine (3TC)

[lämiv′udēn]
a nucleoside analog that inhibits reverse transcriptase and is used as an antiviral agent in treatment of hepatitis B infection and, in combination with zidovudine, in treatment of HIV infection and AIDS. Administered orally.
indications The Epivir brand name form of this drug is used to treat HIV infection in combination with zidovudine. The Epivir-HBV brand name form is used to treat hepatitis B.
contraindication Known hypersensitivity to this drug prohibits its use.
adverse effects Life-threatening effects are neutropenia, anemia, thrombocytopenia, and pediatric pancreatitis. Other adverse effects are anorexia, cramps, dyspepsia, taste change, hearing loss, and photophobia. Common side effects are fever, headache, malaise, dizziness, insomnia, depression, fatigue, chills, nausea, vomiting, diarrhea, cough, rash, myalgia, arthralgia, and musculoskeletal pain.

lamivudine®

Epivir, 3TC AIDS An anti-HIV nucleoside analogue with activity against HBV Adverse effects Headache, nausea, ↓ WBCs, rare alopecia. See AIDS, HIV.

lamivudine

A reverse transcriptase inhibitor drug used to treat infections with retroviruses, such as HIV. The drug has also been used to treat hepatitis. The drug is on the WHO official list. A brand name is Epivir.

lamivudine (3TC),

n brand name: Epivir;
drug class: antiviral, nucleoside analog;
action: inhibition of HIV reverse transcriptase; also inhibits RNA- and DNA-dependent DNA polymerase;
use: in combination with zidovudine for the treatment of HIV infection.
References in periodicals archive ?
To order this report: Therapy Industry : Generics in the Antivirals Market to 2018 - Launch of Generic Combivir and Patent Expiry of Sustiva, Kaletra and Epivir-HBV will Drive Volume Growth
Human immunodeficiency virus (HIV) counseling and testing should be offered to all patients before beginning EPIVIR-HBV and periodically during treatment, because EPIVIR-HBV Tablets and Oral Solution contain a lower dose of the same active ingredient (lamivudine) as EPIVIR Tablets and Oral Solution used to treat HIV infection.
To read the complete Prescribing Information for EPIVIR-HBV, please visit our Web site at http://www.
The site contains easy to read hepatitis B educational materials in English and several Asian languages, links to national events for healthcare providers, selected research on EPIVIR-HBV, and links to other hepatitis B education sites.
Patients taking EPIVIR-HBV should be monitored by a physician.