Drug Interaction Report

GENERALLY AVOID: Sorbitol may decrease the serum concentration of lamivudine. The mechanism of interaction has not been established. In an open-label, randomized sequence, 4-period, crossover study of 16 healthy adult subjects, a single 300 mg dose of lamivudine oral solution was administered alone or in combination with a single 3.2 g, 10.2 g, or 13.4 g dose of sorbitol oral solution. Coadministration of lamivudine with sorbitol resulted in dose-dependent decreases in lamivudine AUC (14%, 32%, and 36%) and Cmax (28%, 52%, and 55%).

MANAGEMENT: When possible, avoid use of lamivudine with products that contain osmotic polyalcohols (e.g., sorbitol) or monosaccharide alcohols (e.g., lactitol, mannitol). If coadministration cannot be avoided, more frequent monitoring of viral load should be considered.