Description
Epivir HBV contains an active ingredient called Lamivudine – a synthetic guanosine nucleoside reverse transcriptase inhibitor (NRTI).
Indications:
- chronic hepatitis B virus (HBV) in HIV-negative patients;
- human immunodeficiency virus type 1 (HIV-1) infection in combination with other anti-retroviral agents (like Abacavir) (only 150 mg formulation of Lamivudine is used for HBV).
Note, patients infected with both HBV and HIV should consult doctor who will determine appropriate regimen.
MOA (mechanism of action):
Lamivudine is a new generation orally active nucleoside analogue. It is activated intracellularly by phosphorylations catalyzed by cellular enzymes. The triphosphate inhibits HBV polymerase activity by terminating newly synthesized viral DNA chains. Treatment with Lamivudine provides a rapid decrease in serum HBV DNA, clearance of HBeAg, improvement in liver histology, and normalization of serum transaminases in many cases. Lamivudine isn't active against HIV-2.
Dosage
For Chronic Hepatitis B (HBV):
The recommended adult dose is 100 mg orally once a day.
Children 2 years or older: 3 mg/kg orally once a day. Maximum dose: 100 mg/day. Duration is established by doctor.
For HIV-1 Infection:
Adults: the recommended dose is 150 mg tablet twice daily or one 300 mg tablet once daily. May be taken with or without food. Used in combination with other anti-retroviral agents. Duration is established by doctor.
Children 3 months or older:
14-20 kg: 75 mg orally twice a day or 150 mg orally once a day.
20-25 kg: 75 mg orally in the morning and 150 mg in the evening, or 225 mg orally once a day.
25 kg or more: 150 mg orally twice a day or 300 mg orally once a day.
Duration is established by doctor.
Note, that not everyone responds to treatment with Epivir HBV in the same way. Your doctor should monitor the effectiveness of your treatment.
Precautions:
HIV and HBV can be transmitted through sexual contact with infected partner, blood (e.g., sharing needles, handling blood instruments, receiving blood transfusions, blood products, or organ/tissue transplants that were infected with HIV/HBV), childbirth, toiletries (razors and toothbrushes). Therefore, both infected and non-infected individuals are advised to have any kind of sex using a latex or polyurethane condom, avoid sharing needles or other things like toothbrushes or razors. It is important to discuss with doctor the precautions needed to avoid infecting other people as well as take precautions not to get infected.
Before and during the use of the Epivir HBV formulation, all patients should be offered HIV screening and have their HIV serum status determined.
If Epivir HBV is administered to patients who have unrecognized or untreated HIV infection, or who acquire HIV infection during treatment, the virus may rapidly develop resistance to Lamivudine and limit potential treatment benefits. In a similar way, HBV screening should be offered to patient with HIV infection to provide appropriate treatment.
Patients with hepatitis B and HIV co-infection should be started on a fully suppressive anti-retroviral (ART) therapy with activity against both viruses (regardless of CD4 counts).
Women who are HBV- or HIV-positive must not breastfeed because HIV and HBV infections can be passed on to the baby in breast milk.
Some people who take Epivir HBV may experience:
- Lactic acidosis (a buildup of lactic acid in the blood) and hepatic steatosis (excess fat in the liver). The symptoms are unexpected tiredness or weakness, nausea or vomiting, constant abdominal pain, pancreatitis. If any of these symptoms occur, seek emergency medical attention immediately.
- Severe acute exacerbations of hepatitis B have been reported in patients who have stopped anti-hepatitis B therapy (including Lamivudine tablets). Thus, people with HBV who are taking Epivir HBV should be carefully controlled if they stop taking the drug.
Missing a dose
If you miss a dose you should take it as soon as you remember about your missing. If it is the time for the next dose you should continue your regular dosing schedule. Do not take a double dose of Epivir HBV to compensate the missed dose.
Overdose
If an overdose occurs and you are not feeling well, stop taking the medication immediately. You should seek emergency medical attention or contact your healthcare provider immediately.
Storage
Store at 25 C (77 F); excursions permitted to 15-30 C (59-86 F). Keep away from excess moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.
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