Drug Database: Lamivudine

What is lamivudine?What is lamivudine?

What is lamivudine?

Lamivudine (brand name: Epivir) is a prescription medicine approved by the U.S. Food and Drug Administration (FDA) for the treatment of HIV in adults and children. Lamivudine is always used in combination with other HIV medicines.

For more information on the use of lamivudine in people with HIV, please refer to the Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV and the Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection.

Lamivudine may also be used as part of an antiretroviral therapy (ART) regimen to prevent mother-to-child transmission (perinatal transmission) of HIV. When used to prevent perinatal transmission of HIV, lamivudine may be given to infants after birth. For more information, please refer to the Recommendations for the Use of Antiretroviral Drugs During Pregnancy and Interventions to Reduce Perinatal HIV Transmission in the United States.

To learn more about preventing the transmission of HIV from a mother to her infant after birth, please read the HIVinfo fact sheet on Preventing Perinatal Transmission of HIV After Birth.

HIV medicines cannot cure HIV, but using HIV medicines as directed by a health care provider helps people with HIV live longer, healthier lives. HIV medicines also reduce the risk of HIV transmission. If you are using HIV medicines, do not cut down on, skip, or stop using them unless your health care provider tells you to. For more information about using your HIV medicines as prescribed and ways to overcome barriers to medication adherence, please read the HIVinfo fact sheet on HIV Treatment Adherence.

Lamivudine is also effective against hepatitis B virus infection (HBV) and may be included as part of an antiretroviral therapy (ART) regimen to treat both HIV and HBV in people with HIV/HBV coinfection. In addition to lamivudine, the ART regimen should include another drug that is active against both HIV and HBV. For more information on the HBV-related use of lamivudine, please refer to the HBV section of the Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents With HIV and the Guidelines for the Prevention and Treatment of Opportunistic Infections in Children With and Exposed to HIV.

Lamivudine tablets (HBV) are a different type of lamivudine product approved by FDA for the treatment of chronic HBV. You should not take lamivudine tablets (HBV) if you have or may have HIV, unless your health care provider has instructed you to.

What should I tell my health care provider before taking lamivudine?What should I tell my health care provider before taking lamivudine?

What should I tell my health care provider before taking lamivudine?

Before taking lamivudine, tell your health care provider:

• If you are allergic to lamivudine or any other medicines.
• If you have ever had liver problems, including hepatitis B virus infection (HBV) or hepatitis C virus infection (HCV).
• If you have kidney problems.
• If you have diabetes. Each 15-mL dose (150 mg) of lamivudine oral solution contains 3 grams of sucrose (common table sugar).
• If you have any other medical conditions.
• If you are pregnant or plan to become pregnant. Talk to your health care provider about the benefits and risks of taking lamivudine during pregnancy. For more information on the use of lamivudine during pregnancy, please refer to the Recommendations for the Use of Antiretroviral Drugs During Pregnancy and Interventions to Reduce Perinatal HIV Transmission in the United States.
• If you are breastfeeding or plan to breastfeed. For mothers with HIV in the United States, the Guideline recommends speaking with your health care provider to discuss options for feeding your baby. Mothers with suppressed viral load have a less than 1% chance of transmitting HIV to their baby via their own milk. Although most medicines are safe to use while breastfeeding, some medicines should be avoided. Always let your health care provider know about all the medicines and supplements you are using before you start breastfeeding.
• If you are using hormone-based birth control (such as injections, vaginal rings, implants, a contraceptive patch, or birth control pills). For more information about using birth control and HIV medicines at the same time, view the HIVinfo HIV and Birth Control infographic.
• About other prescription and nonprescription medicines, vitamins, nutritional supplements, and herbal products you are taking or plan to take.

How should I take lamivudine?How should I take lamivudine?

How should I take lamivudine?

Lamivudine comes in the following forms and strengths:

• 150-mg scored tablets
• 300-mg tablets
• 10-mg/mL oral solution

Take lamivudine according to your health care provider’s instructions. Do not miss a dose of lamivudine, and do not change your dose or stop taking lamivudine without first talking with your health care provider. While taking lamivudine, it is important to keep all your appointments with your health care provider.

Take lamivudine by mouth, with or without food. Tell your health care provider if you or your child has trouble swallowing tablets. Lamivudine also comes as a liquid oral solution.

For children, their health care provider will prescribe a dose of lamivudine based on their body weight. Tell your health care provider if your child’s weight changes.

Always take lamivudine in combination with other HIV medicines.

If you have taken too much lamivudine, contact your health care provider or local poison control center (1-800-222-1222 or online) right away, or go to the nearest hospital emergency room.

For more information on how to take lamivudine, see the FDA drug label.

What should I do if I forget a dose?What should I do if I forget a dose?

What should I do if I forget a dose?

If you miss a dose of lamivudine, take the missed dose as soon as you remember it. But if it is almost time for your next dose, skip the missed dose and just take your next dose at the regular time. Do not take two doses at the same time to make up for a missed dose.

What side effects can lamivudine cause?What side effects can lamivudine cause?

What side effects can lamivudine cause?

Lamivudine may cause side effects. Many side effects from HIV medicines, such as lamivudine, are temporary or manageable. See the HIVinfo fact sheet on HIV Medicines and Side Effects for more information. Some side effects of lamivudine can be serious, as described below.

Important warning:

• Worsening of hepatitis B virus infection (HBV). Your health care provider will test you for HBV before you start treatment with lamivudine. If you have both HIV and HBV and take lamivudine, your HBV may get worse (flare up) if you stop taking lamivudine. Do not stop taking lamivudine without first talking with your health care provider. If you stop taking lamivudine, you will need blood tests regularly for several months to check your liver function and monitor your HBV.
• Resistant hepatitis B virus. If you take lamivudine and have both HIV and HBV, the hepatitis B virus can change (mutate) during treatment with lamivudine and become harder to treat (resistant).

Other possible serious side effects:

• Changes in your immune system (called immune reconstitution inflammatory syndrome or IRIS). IRIS is a condition that sometimes occurs when the immune system begins to recover after treatment with an HIV medicine. As the immune system gets stronger, it may have an increased response to a previously hidden infection.
• Inflammation of the pancreas (pancreatitis). Pancreatitis is uncommon but may occur in some children who have certain risk factors for developing pancreatitis. Contact your health care provider right away if your child develops the following symptoms: severe pain in the upper stomach/abdominal area, with or without nausea and vomiting.
• A buildup of lactic acid in the blood (lactic acidosis). Lactic acidosis is a serious but very uncommon occurrence. Contact your health care provider right away if you have any of the following symptoms: unusual weakness or tiredness; unusual muscle pain; shortness of breath or fast breathing; stomach pain with nausea and vomiting; cold or blue hands and feet; dizziness or lightheadedness; or fast or abnormal heartbeat.
• Severe liver problems. In rare cases, severe liver problems may occur. Contact your health care provider right away if you have any of the following symptoms: yellowing of your skin or the whites of your eyes (jaundice); dark-colored urine; light-colored bowel movements; loss of appetite for several days or longer; nausea or vomiting; pain, aching, or tenderness on the right side of your stomach/abdominal area; or itching.

Tell your health care provider if you have any side effects that bother you or that do not go away.

These are not all the possible side effects of lamivudine. To learn more about possible side effects of lamivudine, read the drug label or package insert or talk to your health care provider or pharmacist.

You can report side effects to FDA at 1-800-FDA-1088 (1-800-332-1088) or online.

What medicines can interact with lamivudine?What medicines can interact with lamivudine?

What medicines can interact with lamivudine?

HIV medicines may interact with other medicines and supplements. Before starting lamivudine, tell your health care provider about all the prescription and nonprescription medicines, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Other medicines or products may affect how lamivudine works, and lamivudine may affect the way other medicines or products work. Taking lamivudine together with certain medicines or products may cause serious side effects.

For a list of medicines that may interact with lamivudine, see the drug label or ask your health care provider or pharmacist. You can also look up potential interactions between your HIV medicines and other drugs using the HIV Drug Interaction Checker online.

How should lamivudine be stored?How should lamivudine be stored?

How should lamivudine be stored?

• Store lamivudine tablets and oral solution at room temperature, 68°F to 77°F (20°C to 25°C).
• Keep lamivudine in the container that it came in and keep the container tightly closed.
• Do not use lamivudine if the original seal over the container opening is broken or missing.
• Throw away lamivudine that is no longer needed or expired (out of date). Follow FDA guidelines on how to safely dispose of unused medicine.
• Keep lamivudine and all medicines out of reach of children.

Where can I find more information about lamivudine?Where can I find more information about lamivudine?

Where can I find more information about lamivudine?

• For more information on the use of lamivudine in people with HIV, please refer to the Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV and the Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection.
• For more information on the use of lamivudine to prevent perinatal transmission of HIV, please refer to the Recommendations for the Use of Antiretroviral Drugs During Pregnancy and Interventions to Reduce Perinatal HIV Transmission in the United States.
• Recommendations on the use of lamivudine in people with HIV and HBV, from the Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents With HIV and the Guidelines for the Prevention and Treatment of Opportunistic Infections in Children With and Exposed to HIV.
• This Patient Version drug summary is based on the following FDA label(s): Solution, tablet (film coated). The Patient Package Insert includes information for people taking lamivudine.
• The American Hospital Formulary Service (AHFS) Patient Medication Information for lamivudine available from MedlinePlus.
• Lamivudine-related research studies, from ClinicalTrials.gov. (The ClinicalTrials.gov search can be modified so that you can get results that better match your interests.)
• A list of FDA-approved HIV medicines, from HIVinfo.