Common uses

Epivir is used in combination with other medications to treat human immunodeficiency virus (HIV) infection in patients with acquired immunodeficiency syndrome (AIDS). Epivir is not a cure and may not decrease the number of HIV-related illnesses. Epivir does not prevent the spread of HIV to other people. Epivir is used to treat hepatitis B infection. Epivir is in a class of medications called nucleoside reverse transcriptase inhibitors. It works by stopping the spread of the HIV and hepatitis B viruses.
Before using

Do not use this medication if you are allergic to lamivudine. Before taking Epivir, tell your doctor if you are allergic to any drugs, or if you have:
• kidney disease;
• liver disease;
• pancreatitis; or
• problems with your muscles.
If you have any of the conditions listed above, you may not be able to use Epivir or you may need a dosage adjustment or special tests during treatment.
This medication may cause lactic acidosis (the build up of lactic acid in the body). Lactic acidosis symptoms can start slowly and gradually get worse. Symptoms include unusual muscle pain and weakness, trouble breathing, fast or uneven heart rate, nausea, vomiting, stomach pain, and numbness or cold feeling in your arms or legs. Call your doctor at once if you have any of these symptoms, even if they are only mild. Early signs of lactic acidosis generally get worse over time and this condition can be fatal.
If you have diabetes, you should know that the liquid forms of this medication contain 3 to 4 grams of sucrose (sugar) per dose.
FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. HIV can be passed to the baby if the mother is not properly treated during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Take all of your HIV medicines as directed to control your infection while you are pregnant.
Your name may need to be listed on an antiviral pregnancy registry when you start using this medication.
• You should not breast-feed while you are using Epivir. Women with HIV or AIDS should not breast-feed at all. Even if your baby is born without HIV, you may still pass the virus to the baby in your breast milk.

Directions

Lamivudine comes as a tablet and liquid to take by mouth. Lamivudine (Epivir) is usually taken every 12 hours (twice a day). Lamivudine (Epivir-HBV) is usually taken once a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take lamivudine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Continue to take lamivudine even if you feel well. Do not stop taking lamivudine without talking to your doctor.

Cautions

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.
Possible side effects

Lamivudine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
• diarrhea
• headache
• fatigue
• chills
• upset stomach
• vomiting
• loss of appetite
• dizziness
• trouble sleeping
• depression
• stuffy nose
• cough
If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:
• rash
• stomach pain
• vomiting (in children)
• upset stomach (in children)
• fever
• muscle pain
• numbness, tingling, or burning in the fingers or toes


If you take too much

Seek emergency medical attention if you think you have used too much of this medicine. The symptoms of a Epivir overdose are not known.

Additional information

This medication should not be taken together with another medication that contains a combination of lamivudine and zidovudine (Combivir).
Avoid contact with people who have colds, the flu, or other contagious illnesses. Contact your doctor immediately if you develop signs of infection.
Avoid having unprotected sex or sharing needles, razors, or toothbrushes. Taking this medication will not prevent you from passing HIV to other people. Talk with your doctor about safe methods of preventing HIV transmission during sex, such as using a condom and spermicide. Sharing drug or medicine needles is never safe, even for a healthy person.
Avoid drinking alcohol while taking Epivir. Alcohol may increase the risk of damage to the pancreas and/or liver.

Drug interactions

• TMP/SMX (Bactrim; Septra), a treatment used to prevent Pneumocystis pneumonia (PCP), can increase the amount of Epivir in the body. However, it is not necessary to change the doses of either TMP/SMX or Epivir.

• Epivir should not be taken at the same time as Emtriva or Truvada (containing Viread and Emtriva). This is because Epivir and Emtriva are very similar and it is not believed that combining these two anti-HIV drugs will make a regimen any more effective against the virus.

• Other drug interactions might be possible. However, it is believed that Epivir can be safely taken at the same time as most drugs used to treat HIV and AIDS-related complications.