Generic Name: lamivudine (la MIV yoo deen)
Brand Names: Epivir, Epivir HBV

What is Epivir?

Epivir (lamivudine) is an antiviral medication that prevents human immunodeficiency virus (HIV) or hepatitis B virus cells from multiplying in your body.

Epivir is for treating HIV, which causes the acquired immunodeficiency syndrome (AIDS). It is not a cure for HIV or AIDS.

Epivir-HBV is for treating hepatitis B. Epivir-HBV should not be used in people who are infected with both hepatitis B and HIV.

Lamivudine may also be used for purposes not listed in this medication guide.

Important information

You should not take Epivir if you are allergic to lamivudine. The Epivir brand of lamivudine (for treating HIV) should not be taken together with any HIV combination medicine that contains lamivudine or emtricitabine. This includes Atripla, Combivir, Complera, Emtriva, Epzicom, Trizivir, and Truvada. The Epivir-HBV brand of lamivudine (for treating hepatitis B) should not be taken together with any other medication that contains lamivudine, which includes Combivir, Epivir, Epzicom, and Trizivir.

Before taking Epivir, tell your doctor if you have kidney disease, liver disease, a history of pancreatitis, or if you have used a medicine similar to lamivudine in the past, such as abacavir (Ziagen), didanosine (Videx), emtricitabine (Atripla, Complera, Emtriva, Truvada), stavudine (Zerit), tenofovir (Viread), zalcitabine (Hivid), or zidovudine (Retrovir).

Slideshow: Flashback: FDA Drug Approvals 2013

Some people develop lactic acidosis while taking Epivir. Early symptoms may get worse over time and this condition can be fatal. Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, fast or uneven heart rate, dizziness, or feeling very weak or tired.

If you have hepatitis B you may develop liver symptoms after you stop taking this medication, even months after stopping. Your doctor may want to check your liver function for several months after you stop using Epivir. Visit your doctor regularly.

Epivir can also cause severe or life-threatening effects on your liver or pancrea. Call your doctor at once if you have any of these symptoms while taking Epivir: severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

Epivir tablets and liquid contain a higher dose of lamivudine than Epivir-HBV. Each time you get a refill of this medication, be sure you have received the correct brand to treat your condition.

Before taking this medicine

You should not take Epivir if you are allergic to lamivudine. Epivir should not be taken together with any HIV combination medicine that contains lamivudine or emtricitabine. This includes:

  • Atripla (efavirenz, emtricitabine, and tenofovir);

  • Combivir (lamivudine and zidovudine);

  • Complera (rilpivirine, emtricitabine, and tenofovir);

  • Emtriva (emtricitabine);

  • Epzicom (abacavir and lamivudine);

  • Trizivir (abacavir, lamivudine, and zidovudine); and

  • Truvada (emtricitabine and tenofovir).

The Epivir-HBV brand of lamivudine (for treating hepatitis B) should not be taken together with any other medication that contains lamivudine, which includes:

  • Combivir (lamivudine and zidovudine);

  • Epivir (lamivudine) for treating HIV;

  • Epzicom (abacavir and lamivudine); and

  • Trizivir (abacavir, lamivudine, and zidovudine).

To make sure you can safely take Epivir, tell your doctor if you have any of these other conditions:

  • liver disease (especially hepatitis B if you also have HIV);
  • kidney disease;
  • a history of pancreatitis; or

  • if you have used a medicine similar to Epivir in the past, such as abacavir (Ziagen), didanosine (Videx), emtricitabine (Atripla, Complera, Emtriva, Truvada), stavudine (Zerit), tenofovir (Viread), zalcitabine (Hivid), or zidovudine (Retrovir).

Some people develop a life-threatening condition called lactic acidosis while taking Epivir. You may be more likely to develop lactic acidosis if you are overweight or have liver disease, if you are a woman, or if you have taken HIV or AIDS medications for a long time. Talk with your doctor about your individual risk.

FDA pregnancy category C. It is not known whether Epivir will harm an unborn baby. HIV can be passed to your baby if you are not properly treated during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Take all of your HIV medicines as directed to control your infection. Lamivudine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Epivir to treat hepatitis B. Women with HIV or AIDS should not breast feed a baby. Even if your baby is born without HIV, the virus may be passed to the baby in your breast milk. If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of Epivir on the baby.

See also: Pregnancy and breastfeeding warnings (in more detail)

If you have diabetes, you should know that the liquid forms of Epivir contain 3 to 4 grams of sucrose (sugar) per dose.

How should I take Epivir?

Take Epivir exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. You should not take Epivir (for treating HIV) together with Epivir-HBV (for treating hepatitis B).

Epivir can be taken with or without food.

You may need to break an Epivir tablet in half when giving this medication to a child for HIV. Call your doctor if the child has any trouble swallowing the tablet.

Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

The Epivir brand contains a higher dose of lamivudine than Epivir-HBV brand. Epivir is for treating HIV and Epivir-HBV is for treating hepatitis B. Each time you get a refill of this medication, be sure you have received the correct brand to treat your condition.

If you have hepatitis B you may develop liver symptoms after you stop taking this medication, even months after stopping. Your doctor may want to check your liver function for several months after you stop using Epivir. Visit your doctor regularly.

To be sure this medicine is helping your condition and is not causing harmful effects, your blood will need to be tested often. Your liver and kidney function may also need to be tested. Visit your doctor regularly.

HIV/AIDS is usually treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice. Every person with HIV or AIDS should remain under the care of a doctor.

Store Epivir at room temperature away from moisture and heat. Do not allow the liquid form of this medicine to freeze. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid?

Taking Epivir will not prevent you from passing HIV to other people. Avoid having unprotected sex or sharing razors or toothbrushes. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

Epivir side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Epivir: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Lamivudine ay cause lactic acidosis (a build-up of lactic acid in the body, which can be fatal). Lactic acidosis can start slowly and get worse over time. Get emergency medical help if you have even mild symptoms of lactic acidosis, such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, fast or uneven heart rate, dizziness, or feeling very weak or tired.

Stop using Epivir and call your doctor at once if you have a serious side effect such as:

  • signs of a new infection such as fever, chills, sore throat, flu symptoms, easy bruising or unusual bleeding, loss of appetite, mouth sores;

  • severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate;

  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • increased sweating, tremors in your hands, anxiety, feeling irritable, sleep problems (insomnia);

  • diarrhea, unexplained weight loss, menstrual changes, impotence, loss of interest in sex;

  • swelling in your neck or throat (enlarged thyroid);

  • problems with walking, breathing, speech, swallowing, or eye movement; or

  • severe lower back pain, loss of bladder or bowel control.

Less serious Epivir side effects may include:

  • cough;

  • headache;

  • mild tired feeling;

  • runny or stuffy nose;

  • mild diarrhea; or

  • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and trunk).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Epivir?

Tell your doctor about all other medicines you use, especially interferons (Alferon, Avonex, Betaseron, Extavia, Intron, Rebetron, Rebif, and others).

This list is not complete and other drugs may interact with Epivir. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about Epivir.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Epivir only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2014 Cerner Multum, Inc. Version: 9.01. Revision Date: 2012-2-14, 12:10:24 PM.

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