How does this medication work? What will it do for me?

Lamivudine is used in combination with other medications to treat the infection caused by the human immunodeficiency virus (HIV). HIV is the virus responsible for acquired immune deficiency syndrome (AIDS). Lamivudine is one of a class of medications called nucleoside reverse transcriptase inhibitors (NRTIs). Reverse transcriptase is a part of HIV required to infect cells and make more viruses. Lamivudine prevents reverse transcriptase from working properly.

Lamivudine does not cure AIDS and does not prevent it from being spread to others. It does slow further growth or reproduction of HIV when used in combination with other medications, and it seems to slow down the destruction of the immune system. This may help to delay the development of problems that are related to AIDS or HIV disease.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

150 mg
Each white-to-off-white, film-coated, diamond-shaped tablet, debossed with "Z" and "25" on either side of the score line on one side and plain with a score line on the other side, contains lamivudine 150 mg.  Nonmedicinal ingredients: microcrystalline cellulose (Avicel pH101), sodium starch glycolate (Promojel Type A), microcrystalline cellulose (Avicel pH102), magnesium stearate (Ligarned MF-2-V), hypromellose (Methocel E5 LV Premium), macrogol (Polyglykol 400), titanium dioxide, and polysorbate (Tween 80).

300 mg
Each grey, film-coated, diamond-shaped tablet, debossed with "Z26" on one side and plain on the other, contains lamivudine 300 mg.  Nonmedicinal ingredients: microcrystalline cellulose (Avicel pH 101), sodium starch glycolate (Promojel Type A), microcrystalline cellulose (Avicel PH 102), magnesium stearate (Ligarned MF-2-V), hypromellose (3cps), hypromellose (6cps), titanium dioxide, macrogol, polysorbate 80, and iron oxide black JPE.

How should I use this medication?

The recommended dose for adults and adolescents 12 years of age and older, weighing at least 30 kg, is 150 mg twice daily or 300 mg once daily, taken with or without food. Doses for children between the ages of 3 months up to 12 years are based on age and body weight, as calculated by the doctor.

Lamivudine may be taken with or without food.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

The effectiveness of the medication depends on there being the right amount of lamivudine in your blood. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost 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. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Use an oral syringe to measure each dose of the solution, as it gives a more accurate measurement than household teaspoons.

Store this medication at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take lamivudine if you are allergic to lamivudine or any of the ingredients of the medication.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • abdominal or stomach pain
  • cough
  • decreased appetite
  • diarrhea
  • dizziness
  • headache
  • nausea
  • rash
  • tiredness
  • trouble sleeping
  • vomiting

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • increased body fat in the back and neck (buffalo hump), breasts, and torso; and a loss of fat from the legs, arms, and face
  • joint pain
  • severe muscle pain or cramping
  • signs of anemia (low red blood cells; e.g., dizziness,  pale skin, unusual tiredness or weakness, shortness of breath)
  • signs of poor blood clotting (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don't stop bleeding)
  • symptoms of ear, nose, or throat infection such as fever, chills, cough, or sore throat
  • tingling; burning; numbness; or pain in the hands, arms, feet, or legs
  • unusual tiredness or weakness

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • symptoms of a severe allergic reaction (e.g., swelling of the eyes, face, lips, throat, sudden wheezing, hives)
  • symptoms of lactic acidosis (e.g., weight loss, fatigue, nausea, vomiting, abdominal pain, shortness of breath, generally feeling unwell)
  • symptoms of liver problems (e.g., nausea, vomiting, abdominal pain, weakness, diarrhea)
  • signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, chills, fever, nausea, rapid heartbeat, swollen abdomen)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Diabetes: People with diabetes need to know that an adult dose of the oral (by mouth) solution of lamivudine contains 3 g of sucrose.

Hepatitis B: For people with hepatitis B, your doctor will talk to you about HIV treatment before you begin taking lamivudine. If you have not been tested already, your doctor will suggest that you be tested for hepatitis B before starting this medication. People with HIV and hepatitis B who stop taking lamivudine may experience a recurrence of hepatitis B.

Immune reconstitution syndrome: This medication may cause immune reconstitution syndrome, where signs and symptoms of inflammation from previous infections appear. These symptoms occur soon after starting anti-HIV medication and can vary. They are thought to occur as a result of the immune system improving and being able to fight infections that have been present without symptoms (such as pneumonia, herpes, or tuberculosis). Report any new symptoms to your doctor immediately.

Kidney function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. People with reduced kidney function may need a lower dose of the medication. If you have kidney disease or decreased kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Lactic acid and enlarged liver: Lamivudine can cause a rare, but serious condition called lactic acidosis (buildup of lactic acid in the blood) together with an enlarged liver. If you experience weight loss, fatigue, nausea, vomiting, abdominal pain, shortness of breath, generally feeling unwell, weakness, or diarrhea, contact your doctor immediately. Your doctor will monitor your liver function periodically by ordering laboratory tests.

Pancreatitis: Lamivudine may cause pancreatitis (inflammation of the pancreas). If you develop abdominal pain, nausea or vomiting while taking this medication, contact your doctor immediately. Parents of children who have received anti-HIV medications in the past, have a history of or are at risk of pancreatitis should discuss with their child's doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Red blood cells: Pure red cell aplasia is a rare bone marrow disorder characterized by a reduction in red blood cells produced by the bone marrow. Symptoms include pallor, weakness, shortness of breath, heart palpitations, and decreased blood pressure. Be sure to contact your doctor immediately if you experience any of these symptoms.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. Since HIV can be transmitted by breast milk, women who have HIV should not breast-feed.

Children: The safety and effectiveness of lamivudine in combination with other antiretroviral medications have not been established for children less than 3 months of age.

What other drugs could interact with this medication?

There may be an interaction between lamivudine and any of the following:

  • co-trimoxazole (sulfamethoxazole/trimethoprim)
  • emtricitabine
  • ganciclovir
  • ribavirin
  • trimethoprim
  • valganciclovir
  • zalcitabine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.