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Lamivudine is a prescription antiviral medication used to treat:
Lamivudine is the generic equivalent of the brand-name medication Epivir. It belongs to a class of drugs known as nucleoside reverse transcriptase inhibitors (NRTIs). Lamivudine works by blocking viral replication, helping reduce the amount of virus in the body. For HIV treatment, it must always be used as part of combination antiretroviral therapy (ART). For chronic hepatitis B, it is used to reduce viral replication and liver inflammation.
Important information:
The 100 mg formulation is approved for chronic hepatitis B, while the 150 mg and 300 mg tablets are used for HIV-1 infection. These doses are not interchangeable.
Below is a quick overview of important facts for patients and caregivers:
| Product Name (Generic) | Lamivudine |
|---|---|
| Strengths | 100 mg, 150 mg, 300 mg |
| Drug Class | Nucleoside Reverse Transcriptase Inhibitor (NRTI) |
| Primary Use | HIV-1 infection (150 mg & 300 mg); Chronic Hepatitis B (100 mg) |
| Dosage Form | Oral tablet |
| Prescription Required | Yes |
| Storage | Store at 68°F-77°F (20°C-25°C); excursions permitted between 59°F and 86°F (15°C-30°C). Protect from moisture. |
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Lamivudine is indicated for the treatment of:
HIV-1 Infection (150 mg & 300 mg Tablets):
Chronic Hepatitis B (HBV) Infection (100 mg Tablets):
Important Considerations:
Warning: Lactic Acidosis, Severe Hepatomegaly, and Hepatitis B Exacerbation
Lactic acidosis and severe hepatomegaly with steatosis:
Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with Lamivudine and other nucleoside analogues. Discontinue lamivudine immediately if clinical or laboratory findings suggest lactic acidosis or pronounced hepatotoxicity.
Severe acute exacerbations of hepatitis B:
Severe acute exacerbations of hepatitis B have been reported in patients who discontinue lamivudine therapy. Monitor hepatic function closely for several months after stopping treatment.
Incorrect formulation/dose risk:
Lamivudine 100 mg tablets (HBV formulation) contain a lower dose than HIV-1 treatment formulations. Use of an incorrect formulation or dose may increase the risk of viral resistance.
Lamivudine is an antiviral medication classified as a nucleoside reverse transcriptase inhibitor (NRTI).
For HIV-1 infection:
Inside the body, Lamivudine is converted to its active form, Lamivudine triphosphate (3TC-TP). It works by:
This lowers the amount of HIV in the body but does not cure HIV infection.
HIV resistance:
Resistance may develop during treatment, most commonly due to the M184V/I mutation, which can reduce the effectiveness of the drug.
For chronic hepatitis B (HBV):
Lamivudine triphosphate inhibits HBV reverse transcriptase by interfering with viral DNA synthesis, leading to DNA chain termination and reduced viral replication.
HBV Resistance:
HBV resistance may develop during long-term therapy, commonly due to YMDD mutations, which can reduce treatment effectiveness.
Always follow your healthcare provider’s instructions. General guidelines include:
If you also have hepatitis B virus (HBV) infection, stopping Lamivudine tablets may cause severe worsening of liver disease. Liver function should be monitored after discontinuation.
Lamivudine dosing depends on the condition being treated and kidney function. Use only as prescribed by a healthcare provider.
Adults:
Recommended dose: 300 mg daily, administered as:
Lamivudine must be used in combination with other antiretroviral medications.
Pediatric patients (3 months and older):
Oral solution dose: 4 mg/kg twice daily (maximum 300 mg daily)
The total daily dose should not exceed 300 mg. It is for pediatric patients unable to swallow tablets.
Tablet dosing (for children ≥14 kg who can swallow tablets):
| Weight (kg) | AM Dose | PM Dose | Total Daily Dose |
|---|---|---|---|
| 14 to <20 | 75 mg | 75 mg | 150 mg |
| ≥20 to <25 | 75 mg | 150 mg | 225 mg |
| ≥25 | 150 mg | 150 mg | 300 mg |
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Tablets are preferred in children who can swallow solid dosage forms.
Renal dose adjustment - HIV (Adults & adolescents ≥25 kg):
| Creatinine Clearance (mL/min) | Initial Dose, then Maintenance Dose |
|---|---|
| ≥50 | 150 mg twice daily or 300 mg once daily |
| 30-49 | 150 mg once daily |
| 15-29 | 150 mg first dose, then 100 mg once daily |
| 5-14 | 150 mg first dose, then 50 mg once daily |
| <5 | 50 mg first dose, then 25 mg once daily |
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No additional dosing is required after routine hemodialysis or peritoneal dialysis.
Adults:
Recommended dose: 100 mg once daily
Pediatric patients (2 to 17 years):
3 mg/kg once daily (maximum 100 mg daily)
It is administered once daily, and it is not recommended for children under 2 years of age. Oral solution should be used if the required dose is less than 100 mg.
Renal Dose Adjustment - HBV (Adults):
| Creatinine Clearance (mL/min) | Initial Dose, then Maintenance Dose |
|---|---|
| Less than 5 | 35 mg first dose, then 10 mg once daily |
| 5 to 14 | 35 mg first dose, then 15 mg once daily |
| 15 to 29 | 100 mg first dose, then 25 mg once daily |
| 30 to 49 | 100 mg first dose, then 50 mg once daily |
| Greater than or equal to 50 | 100 mg once daily |
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No additional dosing is required after routine dialysis.
There is no known specific antidote for Lamivudine overdose. If an overdose occurs, the patient should be monitored, and standard supportive treatment should be provided as needed. Lamivudine is negligibly removed by routine hemodialysis. The clinical benefit of additional dialysis in overdose is unknown. If an overdose is suspected, seek immediate emergency medical help or contact a poison control center.
Like all medications, Lamivudine tablets may cause side effects, although not everyone experiences them. Commonly reported Lamivudine side effects are listed below:
In adults:
In pediatric patients:
Lactic acidosis:
Lamivudine may cause lactic acidosis, a rare but life-threatening condition. Seek immediate medical attention if you experience:
Severe liver problems:
Serious liver injury, including enlargement of the liver and fatty liver changes, has been reported. Contact your healthcare provider if you notice:
Worsening of hepatitis B (HBV flare):
If you are co-infected with HIV and hepatitis B, stopping this medication may cause severe worsening of hepatitis B. Do not discontinue treatment without medical supervision. Liver function should be monitored after stopping therapy.
Pancreatitis (primarily in pediatric patients):
Pancreatitis has occurred in pediatric patients with prior nucleoside exposure or other risk factors. Discontinue lamivudine if pancreatitis is suspected.
Immune reconstitution syndrome (IRS):
It may occur after initiating antiretroviral therapy. As the immune system recovers, it may respond to previously undiagnosed infections, causing inflammatory symptoms. Patients should report new or worsening symptoms to their healthcare provider. Autoimmune disorders such as Graves’ disease have also been reported during immune reconstitution.
Lamivudine should be used under the supervision of a healthcare provider experienced in the management of HIV-1 or chronic hepatitis B infection.
While using this medication, the following warnings should be considered:
Precautions to consider during treatment include:
Pregnancy:
Available data from the Antiretroviral Pregnancy Registry have not shown an increased risk of major birth defects compared to the background rate. Lamivudine crosses the placenta. Use during pregnancy should be based on clinical need and specialist guidance.
Breastfeeding:
Lamivudine is present in human breast milk. In the United States, mothers with HIV should not breastfeed due to the risk of postnatal HIV transmission. For patients treated for hepatitis B, the decision to breastfeed should weigh the benefits of breastfeeding against the mother’s need for therapy.
Lamivudine is primarily eliminated by active renal secretion. Caution is advised when co-administered with medications that affect renal function or share similar elimination pathways.
| Interacting Drug | Do not coadminister | Recommendation |
|---|---|---|
| Trimethoprim/Sulfamethoxazole (TMP/SMX) | Increases Lamivudine levels | Use caution, especially in renal impairment |
| Interferon alfa | No significant interaction | Monitor liver function in co-infected patients |
| Ribavirin | No significant clinical interaction observed | Monitor for liver toxicity in HIV/HCV co-infection |
| Zidovudine | No significant interaction | Commonly used together |
| Other lamivudine- or emtricitabine-containing products | Risk of duplication | Do not coadminister |
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Other antiretroviral agents may be used as part of combination therapy for HIV-1 infection. Selection depends on resistance profile, comorbidities, and treatment guidelines.
| Brand Name | NRTI | Drug Class |
|---|---|---|
| Epivir | Lamivudine | NRTI |
| Epzicom | Abacavir + Lamivudine | NRTI Combination |
| Truvada | Emtricitabine + Tenofovir disoproxil fumarate | NRTI Combination |
| Descovy | Emtricitabine + Tenofovir alafenamide | NRTI Combination |
| Ziagen | Abacavir | NRTI |
| Viread | Tenofovir disoproxil fumarate | NRTI |
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Brand availability may vary by location and supply. Not all products are interchangeable. Therapy selection should be determined by a healthcare provider based on resistance testing and treatment history.
Prescription antiretroviral medications may be costly at many U.S. retail pharmacies. Ordering Lamivudine tablets online from Polar Bear Meds helps reduce overall costs while maintaining safety, quality, and reliability.
All Lamivudine orders require a valid prescription. Medications are dispensed by licensed pharmacies that comply with applicable pharmacy regulations and safety standards.
This content is for informational purposes only and does not replace expert medical guidance, diagnosis, or treatment. Lamivudine is a prescription antiviral medication used as part of combination therapy for HIV-1 infection (and in certain formulations for chronic hepatitis B). Always consult an authorized healthcare professional before starting, stopping, or changing the dosage. Individual results, side effects, and dosing needs may vary.
Dr. Jackson Miller is a board-certified medicine physician & hospitalist. He is a healthcare professional with a strong background in patient care. With years of experience and a patient-first approach, he believes the foundation of good health is a patient who feels informed and empowered. He contributes to medical content review, drawing on his background in clinical practice and patient education. He focuses on presenting health information in a clear, accurate, and accessible way to help readers make informed decisions. His work emphasizes clarity, evidence-based guidance, and understandable explanations of medical topics.
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