Lamivudine
Antiviral, Systemic · Nucleoside reverse transcriptase inhibitor
Indications
Adjunct to other antiretroviral agents in progressive HIV disease.
Dosage
Adults: 300 mg daily preferably without food. Children: Under 3 mth, not recommended. Over 3 mth, 4 mg/kg twice daily, max 300 mg daily.
Adverse Effects
Neutropenia, anaemia, thrombocytopenia. Raised liver enzymes, serum amylase. Headache, malaise, fatigue, GI upset, abdominal pain, insomnia, cough, nasal symptoms, musculoskeletal pain, pancreatitis, peripheral neuropathy, fever, rash, alopecia, muscle disorders, lactic acidosis, mitochondrial dysfunction in children exposed in utero.
Risk Factor (Pregnancy/Lactation)
Pregnancy: No evidence of risk in humans. Lactation: Caution advised or effect undetermined. Precautions: Initiate treatment under specialist supervision. Renal impairment, advanced liver disease due to Hep. B, pancreatitis. Risk of wt gain and raised blood lipids and glucose. Severe immune deficiency; risk of immune reactivation syndrome and autoimmune disorders. Risk of osteonecrosis; monitor for signs of joint pain or immobility. Elderly.
Interactions
IV ganciclovir, foscarnet, co-trimoxazole, sugar alcohols, other cytidine analogues.
Advice to Patient
Take with or without meals. Do not take antacids within 1 hour of taking lamivudine. To make solution, mix four tabs into 3-5 ounce water, allow to stand for some time, stir and drink. Complete full course of therapy even if you feel better. Frequent blood tests are required to adjust dosage for maximum effect of medication.
Pharmacokinetics
Absorption: Rapid. Metabolism: Minor, only known metabolite is trans-sulfoxide metabolite. Bioavailability: Absolute. Children: Oral soln: 66% ± 26%; relative bioavailability is 40% lower than with tabs. Adolescents and Adults: Oral soln: 87% ± 13%; Tab 150 mg: 86% ± 16%. Half-life: Intracellular: 10-15 hrs. Elimination: Children 4 mths-14 yrs: 2 ± 0.6 hrs. Adults: 5-7 hrs; increased with renal impairment. Time to peak, plasma: Paediatric patients 0.5-17 yrs: Median: 1.5 hrs. Adolescents 13-17 yrs: 0.5-1 hr. Adults: Fed: 3.2 hrs. Fasted: 0.9 hrs. Excretion: Primarily urine.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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