Select therapeutic use:
Indications for EPIVIR:
HIV-1 infection, in combination with other antiretrovirals.
CrCl ≥50mL/min: 300mg once daily or 150mg twice daily; CrCl 30–49mL/min: 150mg once daily; CrCl 15–29mL/min: 150mg for 1st dose then 100mg once daily; CrCl 5–14mL/min: 150mg for 1st dose then 50mg once daily; CrCl <5mL/min: 50mg for 1st dose then 25mg once daily.
<3mos: not established. ≥3mos (oral soln): 5mg/kg twice daily or 10mg/kg once daily; max 300mg/day. Use all-tablet regimen when possible, unless unable to swallow tabs (14–<20kg): 150mg once daily or 75mg twice daily; (≥20–<25kg): 225mg once daily or 75mg in the AM and 150mg in the PM; (≥25kg): 300mg once daily or 150mg twice daily. Renal impairment: consider dose reduction and/or increase dosing interval.
Not interchangeable with Epivir-HBV. Women, obesity, or prolonged nucleoside exposure: increased risk of lactic acidosis, hepatomegaly with steatosis. Other liver disease risk factors. Suspend therapy if lactic acidosis or pronounced hepatotoxicity (including hepatomegaly, steatosis) occurs. Hepatitis B virus co-infection: monitor for post-treatment exacerbation, emergence of lamivudine-resistant HBV variants. Children with prior antiretroviral nucleoside exposure, history of pancreatitis or risk factors for pancreatitis. Discontinue if signs/symptoms of pancreatitis occurs. Oral soln: lower virologic suppression rates and increased risk of viral resistance; consider monitoring HIV-1 viral load more frequently. Pregnancy. Nursing mothers: not recommended.
Avoid concomitant sorbitol-containing products. Caution with drugs eliminated by active organic cationic secretion (eg, trimethoprim). Monitor for treatment-associated toxicities (esp. hepatic decompensation) with interferon-alpha with or without ribavirin.
Nucleoside analogue (reverse transcriptase inhibitor).
Adults: headache, nausea, malaise, fatigue, nasal signs/symptoms, diarrhea, cough; lactic acidosis, severe hepatomegaly with steatosis, fat redistribution, immune reconstitution syndrome. Children: fever, cough, rash; pancreatitis, paresthesias, peripheral neuropathy.
Register pregnant patients exposed to lamivudine by calling (800) 258-4263.
Tabs 150mg—60; 300mg—30; Soln—240mL