Lamivudine Teva (Lamivudine)

Lamivudine is used in viral infections that involve reverse transcriptase activity, primarily HIV and hepatitis B.

• HIV infection: suppresses viral replication as part of combination antiretroviral therapy.
• Chronic hepatitis B infection: reduces viral load and improves liver function.
• Prevention of mother‑to‑child transmission of HIV: lowers the risk of vertical transmission when given to pregnant women.

• Lamivudine is a nucleoside analog that is phosphorylated inside cells to its active triphosphate form. The triphosphate competitively inhibits HIV reverse transcriptase and hepatitis B virus DNA polymerase, causing premature chain termination during viral DNA synthesis and thereby preventing viral replication.

Lamivudine may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Nausea: mild to moderate gastrointestinal upset.
• Headache: transient and usually self‑limiting.
• Fatigue: generalized tiredness.
• Diarrhea: loose stools, often mild.
• Insomnia: difficulty falling or staying asleep.
• Dizziness: occasional light‑headedness.

Serious or Rare Side Effects

• Lactic acidosis: rare but potentially life‑threatening metabolic disturbance.
• Severe hepatomegaly with steatosis: marked liver enlargement and fat accumulation.
• Pancreatitis: inflammation of the pancreas, presenting with abdominal pain.
• Severe skin reactions: such as Stevens‑Johnson syndrome.
• Neutropenia: significant reduction in neutrophil count.
• Anemia: decreased red blood cell levels.

Before initiating lamivudine therapy, several safety considerations should be observed.

• Liver function monitoring: assess hepatic enzymes regularly.
• Renal function assessment: evaluate creatinine clearance, especially in patients with renal impairment.
• Hepatitis B reactivation risk: monitor viral load in co‑infected individuals.
• Hypersensitivity caution: discontinue if signs of allergic reaction appear.
• Pregnancy and breastfeeding: use only if benefits outweigh potential risks.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Lamivudine can interact with other medications, influencing efficacy or safety.

Major Interactions (Avoid)

• Didanosine: concurrent use increases risk of pancreatitis.
• Stavudine: combined therapy may exacerbate peripheral neuropathy.
• Ribavirin: may enhance hematologic toxicity.

Moderate Interactions (Monitor Closely)

• Tenofovir: monitor renal function due to additive nephrotoxicity.
• Efavirenz: observe for increased central nervous system side effects.
• Protease inhibitors (e.g., ritonavir): may alter lamivudine plasma concentrations.