Lamivudine Teva Pharma (Lamivudine)

Lamivudine is an antiretroviral medication that targets viral replication in specific infections.

• HIV infection: reduces plasma HIV‑1 RNA levels and helps restore immune function.
• Chronic hepatitis B infection: suppresses hepatitis B virus replication and improves liver enzyme profiles.
• HIV‑1 infected patients receiving combination antiretroviral therapy: contributes to overall viral suppression as part of a multi‑drug regimen.

• Lamivudine is phosphorylated intracellularly to its active triphosphate form, which competes with natural deoxycytidine nucleotides for incorporation into viral DNA. By acting as a chain terminator, it inhibits HIV reverse transcriptase and also blocks hepatitis B virus polymerase, preventing elongation of the viral genome and halting replication.

Lamivudine is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Headache: mild to moderate intensity.
• Nausea: occasional and usually transient.
• Fatigue: persistent tiredness reported by some patients.
• Diarrhea: loose stools without severe dehydration.
• Insomnia: difficulty falling or staying asleep.
• Dizziness: sensation of light‑headedness.

Serious or Rare Side Effects

• Lactic acidosis: buildup of lactic acid leading to metabolic disturbances.
• Severe hepatotoxicity: marked elevation of liver enzymes or liver failure.
• Pancreatitis: inflammation of the pancreas with abdominal pain.
• Severe skin reactions: including Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hypersensitivity: rash, fever, or eosinophilia.
• Peripheral neuropathy: tingling or numbness in extremities.

When prescribing lamivudine, clinicians should consider several safety measures.

• Liver function monitoring: assess baseline enzymes and follow periodically.
• Renal function assessment: adjust dosing in patients with impaired clearance.
• Hepatitis B flare vigilance: watch for reactivation when therapy is stopped.
• Pregnancy considerations: evaluate risk‑benefit before use.
• Concomitant medication review: avoid drugs that increase mitochondrial toxicity.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Lamivudine may interact with other medicines, requiring attention to avoid reduced efficacy or increased toxicity.

Major Interactions (Avoid)

• Didanosine: combined use raises risk of pancreatitis and peripheral neuropathy.
• Stavudine: concurrent therapy can enhance mitochondrial toxicity.

Moderate Interactions (Monitor Closely)

• Protease inhibitors (e.g., ritonavir): may increase lamivudine plasma levels.
• Non‑nucleoside reverse transcriptase inhibitors (e.g., efavirenz): may affect viral suppression dynamics.
• Nephrotoxic agents (e.g., aminoglycosides): require renal function monitoring.
• Alcohol: can exacerbate liver toxicity.
• Herbal supplements (e.g., St. John’s wort): may alter drug metabolism.