Epivir, formerly known at 3TC, is the brand name for the drug
lamivudine produce by Glaxo Wellcome Inc. Lamivudine is a
synthetic nucleoside analogue that is active against HIV. It is
produced as a tablet and solution, both for oral adminstration.
Mechanism
Lamivudine is phosphorylated to an active form that inhibits
HIV reverse transcription by DNA chain termination. It can also
serve to inhibit the RNA- and DNA-dependent DNA polymerase activities of
reverse transcriptase.
Indications
Epivir is indicated in combination with Retrovir for
treatment of HIV infection.
Usage/Dosage
The recommended dosage for adults and adolescents is 150 mg
twice daily adminstered with Retrovir. For adults with low body
weight, the recommendation is 2 mg/kg twice a day in combination
with reduced Retrovir adminstration. For pediatric patients from
3 months to 12 years of age, 4 mg/kg twice daily (up to 150 mg
twice a day total)is recommended in combination with Retrovir.
For patients olde than 16 years of age, the following adjustment
can be made to dosage as a function of renal clearance:
Creatine clearance mL/min>
Recommended Dosage of Epivir
>50
150 mg twice daily
30-49
150 mg once daily
15-29
150 mg first dose, then 100 mg once daily
5-14
150 mg first dose, then 50 mg once daily
<5
50 mg first dose, then 25 mg once daily
Precautions
Cautions should be exercised shen treating patients with
liver or renal dysfunction. Patients should know that Epivir is
not a cure for HIV disease and progressive development of HIV
infection is still possible while taking Epivir as is transmission of HIV.
Patients should remain under a physicians care while being treated. Most
long-term effects are unknown at this time.
Contraindications
Epivir is contraindicated for any patients with clinically
proven hypersensitivities to any of the drug components.
Pediatric patients with histories of pancreatitis or risk factors
associated with pancreatitis should be treated with caution.
Epivir treatment should be halted immediately is any signs or
symptoms related to pancreatitis develop.
Potential Adverse Effects
The most common side effects of Epivir treatment are
headache, malaise, fatigue, nasua, diarrhea, nasal signs and
symptoms, and cough. More serious complications have been
reported, including lactic acidosis and severe hepatomegaly with
steatosis.