Lamivudine

Indications
Oral
HIV infection
Adult: 150 mg bid or 300 mg once daily, in combination with other antiretrovirals.
Child: 3 mth-12 yr: 4 mg/kg bid. Max: 300 mg/day.
Renal impairment: Dialysis patients: Not recommended.
CrCl (ml/min)Dosage Recommendation
30-491st dose 150 mg, then 150 mg once daily.
15-291st dose 150 mg, then 100 mg once daily.
5-141st dose 150 mg, then 50 mg once daily.
<51st dose 50 mg, then 25 mg once daily.

Oral
Chronic hepatitis B
Adult: 100 mg once daily. For patients with concomitant HIV infection: 300 mg once daily or in 2 divided doses.
Child: >2 yr: 3 mg/kg once daily. Max: 100 mg/day.
Renal impairment: Haemodialysis patients: Dose adjustment in accordance with CrCl. Peritoneal dialysis patients: Not recommended.
CrCl (ml/min)Dosage Recommendation
30-491st dose 100 mg, then 50 mg once daily.
15-291st dose 100 mg, then 25 mg once daily.
5-141st dose 35 mg, then 15 mg once daily.
<51st dose 35 mg, then 10 mg once daily.


Special Populations: Reduce dose in patients with renal impairment.
Contraindications
Hypersensitivity. Lactation.
Warnings / Precautions
Discontinue use if there is rapid increase in aminotransferase levels, progressive hepatomegaly, or metabolic or lactic acidosis of unknown origin. Discontinue use if clinical signs, symptoms or lab abnormalities suggestive of pancreatitis develop. Hepatomegaly or other risk factors for hepatic impairment. Monitor hepatic function in chronic hepatitis B patients. Exclude HIV infection prior to hepatitis B therapy. Renal impairment. Pregnancy.
Adverse Reactions
Abdominal pain, nausea, vomiting, diarrhoea, insomnia, cough, nasal symptoms, arthralgia, muscle pain, headache, fever, rash, alopecia, malaise, increased creatinine phosphokinase and alanine aminotransferase, peripheral neuropathy. Rarely rhabdomyolysis, pancreatitis, hepatitis. Neutropenia and anaemia (in combination with zidovudine), thrombocytopenia, increases in LFTs. Paronychia. Angioedema, urticaria, and anaphylactoid reaction.
Potentially Fatal: Lactic acidosis associated with severe hepatomegaly and hepatic steatosis.
Drug Interactions
Renal excretion may be inhibited by high doses of trimethoprim (co-trimoxazole). May antagonise the antiviral action of zalcitabine.
See Below for More lamivudine Drug Interactions
Mechanism of Actions
Lamivudine, a nucleoside analogue, is phosphorylated in the body to the active triphosphate form. In the active form, it inhibits hepatitis B virus polymerase and HIV reverse transcriptase enzymes.
Absorption: Rapidly absorbed from the GI tract, delayed if taken with food (oral); peak plasma concentrations after 1 hr.
Distribution: Crosses the blood-brain barrier and placenta; enters breast milk. Protein-binding: Up to 36%.
Metabolism: Intracellular; low hepatic metabolism.
Excretion: Via urine (as unchanged drug); 5-7 hr (elimination half-life).
Administration
May be taken with or without food.
Storage Conditions
Oral: Store at 25°C (77°F).
ATC Classification
J05AF05 - lamivudine ; Belongs to the class of nucleoside and nucleotide reverse transcriptase inhibitors. Used in the systemic treatment of viral infections.
Storage
Oral: Store at 25°C (77°F).
Available As
  • Lamivudine 100 mg
  • Lamivudine 150 mg
  • Lamivudine IP 150 mg
  • Lamivudine 30 mg
  • Lamivudine 300 mg
  • Lamivudine 40 mg
  • Lamivudine 50 mg
  • Lamivudine 60 mg
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