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Lamivudine, Epivir, AIDS/HIV Antivirals

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Lamivudine, (Epivir), AIDSmeds.com:"What is lamivudine? Lamivudine is an antiviral medication. It is in a category of HIV medicines called reverse transcriptase inhibitors. Lamivudine inhibits the reproduction of viruses in the body. The Epivir brand of lamivudine is used to treat the human immunodeficiency virus (HIV), which causes the acquired immunodeficiency syndrome (AIDS). The Epivir-HBV brand of lamivudine is used in the treatment of chronic hepatitis B. Lamivudine may also be used for purposes other than those listed in this medication guide."
http://www.aidsmeds.com/drugs/Epivir.htm

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Lamivudine, (Epivir), AIDS Treatment Data Network:"The recommended dosage of Epivir is 150 mg twice a day. There is also a 300 mg once a day formulation. Epivir is available in a syrup form for children. Epivir can be taken with or without food. There are also two new pills that combines Epivir with other nucleoside analog drugs, making it easier to take. Combivir combines 150mg of Epivir with 300mg of zidovudine (AZT, Retrovir). Trizivir contains the above plus 300 mg of abacavir (Ziagen). People who are allergic to abacavir should not take Trizivir. See the "abacavir (Ziagen)" FactSheet for detailed information about the potentially severe and sometimes fatal allergic reactions associated with this drug."
http://www.atdn.org/simple/lami.html

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Lamivudine, (Epivir), National Institute of Allergy and Infectious Diseases:"How to take it: Lamivudine is taken as one 150 mg tablet two times a day, morning and night. It can be taken with or without food. Lamivudine is also available in a liquid form. Some patients taking lamivudine and zidovudine (AZT) may be able to use a combination product called Combivir™. Each Combivir tablet contains lamivudine 150mg and zidovudine 300mg. The dose of lamivudine may be lowered if you have serious kidney problems. Additional dosing information: It is very important not to miss any doses of your HIV medication in order for it to work effectively against the virus. If you do miss a single dose of lamivudine, take the missed dose immediately. Then, take the next dose at the scheduled time."
http://www.niaid.nih.gov/dir/labs/lir/hiv/lamivudine.htm

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Lamivudine, (Epivir), MEDLINEplus:"IMPORTANT WARNING: Lamivudine, when used alone or in combination with other antiviral medications, can cause serious damage to the liver and a condition called lactic acidosis. If you experience any of the following symptoms, call your doctor immediately: upset stomach, loss of appetite, excessive tiredness, weakness, dark yellow or brown urine, unusual bleeding or bruising, flu-like symptoms, yellowing of the skin or eyes, and pain in the upper right part of your stomach. Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to lamivudine.Epivir tablets and liquid (used to treat human immunodeficiency virus [HIV]) are not interchangeable with Epivir-HBV tablets and liquid (used to treat hepatitis B infection). Epivir contains a higher dose of lamivudine than Epivir-HBV. Treatment with Epivir-HBV in patients infected with HIV may cause the HIV virus to be less treatable with lamivudine and other medicines. If you have both HIV and hepatitis B, you should take only Epivir. If you are taking Epivir-HBV for hepatitis B infection, talk to your doctor about your risks for HIV infection."
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a696011.html

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Lamivudine, (Epivir), U. S. Food and Drug Administration:"The package insert for Epivir Tablets and Epivir Oral Solution has been changed to add the following new information to the section on precautions. "Patients with HIV and Hepatitis B Virus Coinfection: In clinical trials, some patients with HIV infection who have chronic liver disease due to hepatitis B virus infection experienced clinical or laboratory evidence of recurrent hepatitis upon discontinuation of EPIVIR." The following paragraphs explain the basis for this new information."
http://www.fda.gov/medwatch/safety/1997/lamivu.htm

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Lamivudine, (Epivir), Canadian AIDS Treatment Information Exchange (CATIE):"How does 3TC work? HIV infects cells and then replicates with the help of its own enzymes. In the first stage of replication, the enzyme reverse transcriptase converts the genetic material of the virus (RNA) to match the genetic material of the cell (DNA). Nucleoside analogues (NRTIs or "nukes") like 3TC block the building of viral DNA, and may also interfere directly with the action of the reverse transcriptase enzyme, preventing it from working properly."
http://www.catie.ca/facts.nsf/9a83231f2055bda9852566b90004b064/5c9620ad4f249405852566b9000574a7?OpenDocument

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Lamivudine, (Epivir), About, Inc.:"What is Lamivudine and how is it administered? Lamivudine is an antiviral agent that blocks the multiplication of hepatitis B virus. The dose regimen is usually 100mg (one tablet) once a day. The duration of treatment has not been defined. Currently, it seems that a minimum of 1 year treatment is necessary. Treatment may be discontinued in patients who have cleared hepatitis B e antigen and hepatitis B viral DNA. Patients with kidney failure may need reduced dosing while patients with combined HIV and hepatitis B infection require a higher dose."
http://aids.about.com/blepivirhbv.htm

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Lamivudine, (Epivir), Doctor's Guide:"Lamivudine is as effective a treatment as is interferon and may be better tolerated in children with chronic hepatitis. This is the finding of an international, randomized, double-blind, placebo-controlled trial of the efficacy and tolerability of this drug for treating chronic infection with hepatitis B virus (HBV) in children, some without previous response to interferon treatment. Maureen M. Jonas and colleagues from Children's Hospital, Boston, United States, Diana Princess of Wales Hospital, Birmingham, England, and other centres in Europe and South and North America did this work for the International Pediatric Lamivudine Investigator Group."
http://www.docguide.com/news/content.nsf/news/8525697700573E1885256BC900491E28

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Lamivudine, (Epivir), Hepatitis B Foundation:"It has been more than 30 years since hepatitis B was discovered and recognized as a serious health concern. Yet in all that time, patients have had only one treatment on which to rely, most of whom did not even qualify for its use. On December 8, 1998 the Food and Drug Administration gave the green light for lamivudine (3TC), making it only the second approved drug for treatment of chronic HBV and the first to be available in pill form and oral solution. Alpha interferon, approved since the late eighties has its drawbacks. Not only is it an injectable drug, but its use is limited to a small population of HBV carriers. Lamivudine works by inhibiting HBV polymerase, the viral enzyme that mediates DNA synthesis, thereby stopping viral replication. By reducing the HBV viral levels, progressive liver inflammation is suppressed which decreases the risk of further damage to the liver. So, although lamivudine does not appear to be a cure, it will hopefully prolong the good health of chronic carriers. The FDA approved use of lamivudine for adults with chronic HBV after reviewing a final, one year study of four control groups which concluded that the drug reduced viremia and improved liver tissue in a significant number of patients. The controlled studies of 967 adults demonstrated that after a daily dose, 52% of patients showed improved histology as compared to 36% of those taking only interferon and 23-25% taking placebo. Besides the convenience of a once a day tablet, lamivudine is considered to have fewer and less severe side effects than alpha interferon. The most common side effects observed in the above study were fatigue, headache, nausea and abdominal pain, all however, comparable to those receiving placebo. At this point, the safety and effectiveness have not been established beyond one year of treatment. In addition, the virus appears to rebound after treatment is stopped."
http://www.hepb.org/02-0344.hepb

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