Lamivudine Teva Pharma B.V (Lamivudine)

Lamivudine is used in antiretroviral and antiviral therapy for viral infections affecting the immune and hepatic systems.

• HIV-1 infection: reduces viral load and improves immune function when used in combination regimens.
• HIV-2 infection: contributes to viral suppression as part of combination therapy.
• Chronic hepatitis B infection: suppresses HBV replication and helps prevent liver disease progression.

• Lamivudine is phosphorylated intracellularly to its active triphosphate form, which competes with natural deoxycytidine triphosphate for incorporation into viral DNA. Incorporation leads to premature chain termination, thereby inhibiting HIV reverse transcriptase and hepatitis B virus DNA polymerase, preventing viral replication.

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

Common Side Effects

• Nausea: mild to moderate gastrointestinal discomfort.
• Headache: transient cranial pain.
• Fatigue: general feeling of tiredness.
• Diarrhea: loose stools, usually self‑limiting.
• Insomnia: difficulty falling or staying asleep.
• Rash: mild skin eruptions.

Serious or Rare Side Effects

• Lactic acidosis: metabolic disturbance requiring urgent care.
• Severe hepatomegaly with steatosis: significant liver enlargement.
• Pancreatitis: inflammation of the pancreas.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hypersensitivity: systemic allergic response.
• Bone marrow suppression: anemia, neutropenia, or thrombocytopenia.

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

• Liver function monitoring: assess baseline enzymes and watch for hepatitis flare.
• Renal function assessment: adjust dosing in impaired clearance.
• Pregnancy counseling: discuss potential risks and benefits with a healthcare provider.
• Adherence reinforcement: emphasize importance of consistent dosing to prevent resistance.
• Hypersensitivity screening: avoid in patients with known allergic reactions to lamivudine.
• Store at room temperature: keep in the original packaging, protect from moisture and direct sunlight.

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

Major Interactions (Avoid)

• Didanosine: concurrent use increases risk of pancreatitis.
• Stavudine: combined therapy may enhance mitochondrial toxicity.
• Other NRTIs: may lead to additive bone marrow suppression.

Moderate Interactions (Monitor Closely)

• Tenofovir: monitor renal function due to combined nephrotoxic potential.
• Efavirenz: observe for central nervous system side effects.
• Protease inhibitors (e.g., ritonavir): may alter lamivudine plasma levels.
• Alcohol: increased hepatic strain warrants caution.