Lamivudine (Systemic)

Brand name(s): Epivir

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For lamivudine, the following should be considered:

Allergies-Tell your doctor if you have ever had any unusual or allergic reaction to lamivudine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy-Lamivudine crosses the placenta. Studies in animals have shown that lamivudine causes birth defects when given in very high doses. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant. Ask your doctor to register you with the Pregnancy Registry, to monitor the effect of treatment on you and your baby.

Breast-feeding- Lamivudine passes into the breast milk. If your baby does not already have the AIDS virus, there is a chance that you could pass it to your baby by breast-feeding or your baby could have serious adverse reactions. Talk to your doctor first if you are thinking about breast-feeding your baby.

Children-Lamivudine can cause serious side effects. In one study, children with advanced AIDS were more likely than children who were less ill to develop pancreatitis (inflammation of the pancreas) and peripheral neuropathy (a problem involving the nerves). Therefore, it is especially important that you discuss with your child's doctor the good that this medicine may do as well as the risks of using it. Your child must be seen frequently and your child's progress carefully followed by the doctor while the child is taking lamivudine.

Older adults-Lamivudine has not been studied specifically in older people. Therefore, it is not known whether it causes different side effects or problems in the elderly than it does in younger adults. Talk to your doctor first if you have liver, kidney, heart problems or other diseases. Your doctor may need to adjust your dose.

Other medicines-Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking lamivudine, it is especially important that your health care professional knows if you are taking any of the following:

• Lamivudine with zidovudine (e.g., Combivir)-Should not be used at the same time that you are taking lamivudine tablets or oral solution

• Zalcitabine (e.g., Hivid)-May cause problems with how lamivudine or zalcitabine work when used together

Other medical problems-The presence of other medical problems may affect the use of lamivudine. Make sure you tell your doctor if you have any other medical problems, especially:

• Combined infection of HIV and hepatitis B-May make the condition of either of these infections worse

• Diabetes mellitus (sugar diabetes)-Lamivudine oral solution contains sucrose

• Hepatitis C or
• Hepatitis delta-Caution should be used; lamivudine safety has not been determined in patients who have hepatitis infections

• Human immunodeficiency virus-For patients with hepatitis B virus, your physician will talk to you about HIV before you begin taking lamivudine. You may be tested for HIV. Lamivudine tablets and oral solution for hepatitis B virus contain lower amounts of the drug than the tablets and solution for HIV. If you start on the lower-dose medication and later learn that you have HIV, the higher-dose lamivudine may not then be effective against the infection caused by HIV.
• Inflamed pancreas or
• Problems with inflamed pancreas in the past or
• Other risk factors for developing an inflamed pancreas or
• Nerve damage-These conditions may occur or worsen when taking lamivudine

• Kidney disease-Patients with kidney disease may have an increased chance of side effects

• Liver disease or
• Risk factors for liver disease or
• Obesity (being overweight)-This medicine may make liver disease worse in patients with liver disease, obesity and other HIV medicine use.

• Organ transplant-Caution should be used; lamivudine safety has not been determined in patients who have received an organ transplant

Last Revised: 02/04/2005