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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
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.


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.


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


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


• Hypersensitivity to drug or its components


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.


• 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


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.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved


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.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.


Epivir, 3TC AIDS An anti-HIV nucleoside analogue with activity against HBV Adverse effects Headache, nausea, ↓ WBCs, rare alopecia. See AIDS, HIV.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.


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.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
Specifically, he would like begin clinical trials of lamivudine for various age-associated conditions such as frailty, Alzheimer's disease and arthritis.
(18) Cells were treated with lamivudine, adefovir, and NCC at various concentrations (62.5,125, 250, 500, and 1000 [micro]M).
Prior to treatment, the median HAI in 23 patients in the lamivudine group was 5 (4-6), and the median post-treatment HAI was 3 (2-5).
Most patients were on at least one antiretroviral drug active against HBV: lamivudine in 1 092 cases (90.1%) and tenofovir in 110 (9.1%).
Common clinical adverse effects were seen in more proportions in Tenofovir, Lamivudine and Efavirenz regimen considering the fact that there are only 13 patients getting that regimen; 23.7% of patients under Tenofovir, Lamivudine and Efavirenz regimen had fatigue compared to 6.4% in Tenofovir, Lamivudine and Nevirapine regimen (p value=0.02<0.05); 30.7% of patients under Tenofovir, Lamivudine and Efavirenz regimen had headache compared to 5.94% in other regimen (p value=0.0019<0.05); 30.7% of patients under Tenofovir, Lamivudine and Efavirenz regimen had nausea compared to 16% in Tenofovir, Lamivudine and Nevirapine regimen (p value=0.0003<0.05).
The activity of lamivudine against EBOV infection was evaluated in a cell-based ELISA with 1995 isolate EBOV H.
Lamivudine which is a nucleoside analog has been used in treatment of chronic HBV for many years.
This retrospective study included 53 patients with chronic hepatitis B who were on lamivudine treatment since June 2005 at the Department of Gastroenterology, Hamad Medical Corporation.
In this issue, Kumar et al (2) performed a randomized pilot study to compare lamivudine and adefovir in terms of the HBV kinetics.
Lamivudine is associated with the development of the highest rate of resistance.
The newer drug achieved better therapeutic and histologic responses than lamivudine did in some subsets of patients, and had greater antiviral efficacy overall, said Dr.