Nucleoside Reverse Transcriptase Inhibitors: Lamivudine
Contents Introduction Information card Pharmacokinetics Dosing Pediatric dose Side effects Drug interactions

Introduction

The information represented on this drug does not necessarily correspond with the information that can be found in the Belgian scientific leaflet.
Lamivudine was approved by the FDA in December of 1995. (106) Compared with other antiretroviral drugs, it is relatively weak when used alone, as viral resistance develops within 1 month; therefore, monotherapy is not recommended with lamivudine. The utility of this drug is its ability to modify viral resistance to zidovudine and produce a synergistic effect when used together with either zidovudine or stavudine, with or without a Protease Inhibitor. (100) In addition to its anti-HIV activity, lamivudine is effective in suppressing hepatitis B replication.(106)

Abbreviation(s):  Generic name: Brand name: 3TC lamivudine Epivir®		USA (FDA) Adult approval date: Pediatric approval date: November 17, 1995 November 17, 1995
Pharmaceutical co.: Glaxo Wellcome Inc.		Belgium: Reimbursable since April 1997
	Active Ingredient	Dosage form; Route		Strength
	Lamivudine	Solution; Oral		10MG/ML
	Lamivudine	Tablet; Oral		150MG

Pharmacokinetics

The intracellular half-life is approximately 10 to 15 hours, allowing twice daily dosing. The drug is rapidly absorbed after oral dosing. Because the drug is renally cleared, the dose should be reduced in patients with significant renal impairment. (106)

Dosing

The recommended dosage is 150 mg every 12 hours, in combination with other drugs. (100)

Pediatric Dose: (111)

• 12 to 16 years: same dosing as adults.
• 3 months to 12 years: 4 mg/kg twice daily.

In one study, 14% of pediatric patients being treated with lamivudine monotherapy developed pancreatitis. Pancreatitis was seen in less than 0,5% of adult patients who received lamivudine. Paresthesias and peripheral neuropathy are also reported more frequently in children. Other adverse effects that have been reported include rash, cough, dizziness, fatigue, gastrointestinal distress, headache, insomnia, and hair loss.(100,114,123)

Drug interactions

Concurrent administration of trimetoprim resulted in a 44% increase in lamivudine AUC and a 30% decrease in lamivudine renal clearance.(123) No adjustment in dose is necessary unless the patient has impaired renal function. Because lamivudine has been shown to cause pancreatitis and peripheral neuropathy, medications associated with the development of pancreatitis and peripheral neuropathy should be avoided during lamivudine therapy.(114)
 

Interactions with other antiretroviral agents

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