Antiretroviral Agents: Nucleoside Reverse Transcriptase Inhibitors

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lamivudine

Detailed Prescribing Information

Epivir = lamivudine = 3TC Also a component of Combivir, Trizivir, & Epzicom
Forms Available	150 mg or 300 mg tablets; liquid 50 mg/5 cc lamivudine 150 mg combined with zidovudine 300 mg as Combivir lamivudine 150 mg combined with zidovudine 300 mg and abacavir 300 mg as Trizivir lamivudine 300 mg combined with abacavir 600 mg as Epzicom
Dosing	150 mg twice a day or 300 mg once a day Reduce dosing for renal failure
	Renal dosing¹	Ccr (cc/min)	Dose (mg)
		> 50	150 twice a day or 300 daily
		30-49	150 daily
		15-29	150 first dose, then 100 daily
		5-14	150 first dose, then 50 daily
		< 5	insufficient data consider 150 first dose, then 25 daily
	Hepatic dosing: no dose adjustment is required
Food dependence	This medication may be taken with or without food.
Adverse Effects	Few if any (hair loss?) Rare lactic acidosis and hepatic steatosis Rarely associated with pancreatitis.
Interactions	None significant
Suggested lab follow-up	Lipase testing as indicated
Warning	Flares of hepatitis B may occur if lamivudine is discontinued suddenly. Low barrier to one-step mutation. Use only with other potent agents.
Suggested Usage	Do not use in combination with emtricitabine, Truvada, Epzicom, Combivir, Atripla, or Trizivir due to identical mechanism of action or duplication of lamivudine dosing. Lamivudine has a very low barrier to resistance. Always ensure that it is used with other potent and active antiretrovirals.
Complete prescribing information	Epivir prescribing information

Links to Antiretroviral Sections (click on anything)

Nucleoside & Nucleotide Reverse Transcriptase Inhibitors (NRTI)

AZT | ddC | ddI | d4T | 3TC | ABC | FTC | TDF | Combivir | Trizivir | Epzicom | Truvada | Atripla

Nonnucleoside Reverse Transcriptase Inhibitors (NNRTI)

efavirenz | nevirapine | delavirdine

Protease Inhibitors (PI) | Boosted Protease Inhibitors

Fusion Inhibitors

enfuvirtide

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Introduction	Principles	Management	NRTI Info	NNRTI Info
PI Info	Fusion Inhibitors	Drug Summary	Investigational	Adherence
Lab Evaluation	Resistance Tests	PEP	Antiretroviral Tables	OI Prevention
Vaccinations	TB Therapy	Hepatitis Therapy	OI Diagnosis	OI Therapy
Bibliography		Links		Palliative Therapy

5.3.2007

1. Renal dosing information from: Ian R. McNicholl & Rudolph A. Rodriguez, MD, Dosing of Antiretroviral Drugs in Renal Insufficiency and Hemodialysis, May 2004
http://hivinsite.ucsf.edu/InSite?page=md-rr-18