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Lamivudine: Compreehensive Drug Information
Lamivudine, also known as 3TC, is a nucleoside analogue reverse transcriptase inhibitor (NRTI). It is primarily used in the treatment of chronic hepatitis B virus (HBV) infection and as part of combination therapy for human immunodeficiency virus (HIV) infection.
Composition and Forms of Release
Lamivudine is available in two main forms: oral tablets and an oral solution. The active ingredient is lamivudine. Tablets typically contain 100 mg or 300 mg of lamivudine, while the oral solution is usually concentrated at 10 mg/mL.
Indications
- Chronic Hepatitis B (HBV) infection in adults and pediatric patients.
- HIV-1 infection as part of combination antiretroviral therapy in adults and pediatric patients.
Mechanism of Action
Lamivudine works by inhibiting the activity of viral reverse transcriptase, an enzyme essential for viral replication. In HBV, it prevents the virus from multiplying, thereby reducing viral load and potentially improving liver function. In HIV, it interrupts the viral DNA chain, preventing the virus from making copies of itself.
Safety Profile
Potential Benefits:
- Effective in suppressing HBV and HIV replication.
- Can improve liver histology in patients with chronic HBV.
- Contributes to the management of HIV/AIDS, improving immune function and reducing opportunistic infections.
Common Side Effects:
- Headache
- Nausea
- Diarrhea
- Fatigue
- Insomnia
- Dizziness
- Cough
- Rash
Serious Sde Effects (Rare):
- Lactic acidosis
- Severe hepatomegaly (enlarged liver) with steatosis (fatty liver)
- Pancreatitis
- Peripheral neuropathy
- Hypersensitivity reactions
- Exacerbation of hepatitis B upon discontinuation
Contraindications:
- Known hypersensitivity to lamivudine or any of its components.
Warnings:
- Patients with pre-existing liver disease should be monitored closely.
- Discontinuation of lamivudine in patients with HBV may lead to severe acute exacerbations of hepatitis.
- Risk of lactic acidosis and severe hepatomegaly with steatosis, which can be fatal.
- Monitor for signs and symptoms of pancreatitis.
Dosage Table
| Disease | Recommended Dosage | Treatment Duration |
|---|---|---|
| Chronic Hepatitis B (Adults) | 100 mg once daily | Recommended for at least 1 year; longer duration may be needed based on viral load and HBeAg status. |
| Chronic Hepatitis B (Pediatric Patients < 16 years) | 3 mg/kg once daily, not to exceed 100 mg | Similar to adults, based on clinical response and HBV markers. |
| HIV-1 Infection (Adults) | 150 mg twice daily OR 300 mg once daily (as part of combination therapy) | Lifelong therapy is generally recommended. |
| HIV-1 Infection (Pediatric Patients) | 4 mg/kg twice daily OR 5 mg/kg once daily (as part of combination therapy) | Lifelong therapy is generally recommended. |
Frequently Asked Questions
Q1: Can lamivudine be taken with food?
A1: Yes, lamivudine tablets and oral solution can be taken with or without food. TakIng it consistently at the same time each day is recommended for optimal effectiveness.
Q2: What should I do if I miss a dose of lamivudine?
A2: If you miss a dose, take it as soon as you remember. However, if it is close to the time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Q3: Is lamivudine safe for long-term use?
A3: Lamivudine is generally considered safe for long-term use when prescribed and monitored by a healthcare professional. However, like all medications, it can have side effects, and ongoing monitoring is important to manage potential risks.
Q4: What are the signs of lactic acidosis?
A4: Symptoms of lactic acidosis can include rapid breathing, unusual muscle pain, stomach pain, nausea or vomiting, dizziness or lightheadedness, and a slow or irregular heartbeat. Seek immediate medical attention if you experience these symptoms.