Avilam

Indications

Lamivudine is an antiviral medicine used for:

• HIV-1 infection in adults and children, always together with other anti-HIV medicines;
• long-term (chronic) hepatitis B infection in adults, where the doctor decides it is suitable.

It does not cure HIV or hepatitis B, but it keeps the virus under control when taken every day.

How It Works

Lamivudine is a nucleoside reverse transcriptase inhibitor (NRTI). HIV and the hepatitis B virus need an enzyme called reverse transcriptase to copy themselves. Lamivudine blocks this enzyme, so the virus cannot multiply as easily and the amount of virus in the blood falls.

Dosage and Administration

HIV, adults and children weighing 25 kg or more: 300 mg a day, taken either as 300 mg once a day or 150 mg twice a day, together with other anti-HIV medicines.

Chronic hepatitis B, adults: usually 100 mg once a day, as prescribed. The HIV-strength tablets are not used for hepatitis B alone.

Children under 25 kg: dose by body weight, as prescribed. Kidney problems: the dose is lowered according to kidney function. It can be taken with or without food.

Take it every day at the same time. If a dose is missed, take it when you remember unless the next dose is near; never take two doses together. Do not stop without your doctor.

Interactions

• Trimethoprim-Sulfamethoxazole (Co-trimoxazole) at high doses can raise Lamivudine levels; tell your doctor.
• Emtricitabine works the same way and is not taken together with Lamivudine.
• Cladribine may not work as well with Lamivudine.
• Medicines containing sorbitol (some syrups) can lower Lamivudine absorption when taken regularly.

Tell your doctor about all medicines and herbal products you use.

Contraindications

Do not use Lamivudine if you are allergic to Lamivudine or any ingredient of the product.

Side Effects

Common: headache, nausea, diarrhoea, stomach pain, tiredness, trouble sleeping, cough, hair thinning and joint or muscle aches.

Get urgent medical help if you have:

• severe stomach pain with nausea or vomiting (possible pancreatitis);
• fast breathing, unusual tiredness, muscle pain and feeling very unwell (possible lactic acidosis);
• yellow skin or eyes, dark urine or pale stools, especially after stopping the medicine;
• signs of a severe allergic reaction, such as swelling of the face, lips or throat or difficulty breathing.

Pregnancy and Lactation

Lamivudine is widely used in pregnancy as part of HIV treatment to protect the mother and lower the risk of passing HIV to the baby. Do not stop it on your own if you become pregnant; talk to your doctor. Breastfeeding with HIV or hepatitis B needs specialist advice, because the decision depends on your treatment and local guidance.

Precautions and Warnings

• If you have hepatitis B, stopping Lamivudine can cause a serious flare of liver inflammation. Your doctor will check your liver for several months after stopping.
• Tell your doctor if you have kidney or liver disease.
• As the immune system recovers, old hidden infections can show up (immune reconstitution); report any new symptoms.
• Lamivudine does not stop HIV from passing to other people. Use condoms and never share needles.
• Regular blood tests are needed.

Overdose

Experience with overdose is limited. If too much is taken, contact a doctor or go to the nearest hospital. Treatment is supportive, and the medicine can be partly removed by dialysis.

Therapeutic Class

Antiviral; nucleoside reverse transcriptase inhibitor (NRTI).

Storage

Store below 30°C in a dry place, away from light. Keep out of the reach of children.