Lamivudine

Lamivudine is antiretroviral approved for the treatment of advanced HIV infection. It may also be effective against other viral infections. Lamivudine is similar in structure to other nucleoside analogs such as zidovudine, zalcitabine, and didanosine. Although Lamivudine is initially effective as monotherapy, HIV resistance develops within 12 weeks. Combining it with zidovudine counteracts this resistance. It received priority review from the FDA and accelerated approval on November 17, 1995, for first-line therapy, in combination with zidovudine, of HIV infection. Preliminary data suggest that it may also be an effective alternative to interferon for the treatment of chronic hepatitis. Lamivudine is a potent reverse-transcriptase inhibitor. It has been shown to inhibit both type 1 and type 2 HIV reverse transcriptase. It can also inhibit replication of hepatitis B virus because this replication depends on reverse transcription of RNA to a minus-stranded DNA, which then serves as the template for synthesis of the plus-stranded DNA

Brands
LAMIZID ZEFFIX LADWIN ZILAM LAMRIN LAMRIN GUIDE LAMUDINE BECOTEC BECOTEC HEPAID BELUM VIROGEN LAMIDIN LUMOVID LAMIWIN TRIOMUNE TRIOMUNE LAMIVIR B-FIX VUCLODIR VUCLODIR LAMICOT LAMIWEL
Adult Dose
Dose: 100 mg
Single Dose: 100 (100)
Frequency: 24 hourly
Route: PO
Instructions:
Neonatal
Dose:
Single Dose:
Frequency:
Route:
Instructions: Not recommended in this age group
Paedriatic
Dose: 4 mg/kg
Single Dose: 4 (4)
Frequency: 12 hourly
Route: Oral
Instructions:
Characteristics
. It is of Semi Synthetic origin and belongs to Cytosine. It belongs to Antiviral Agents and Antiretroviral Agent-Nucleoside pharmacological group.The Molecular Weight of Lamivudine is 229.30.
Contraindications
Lamivudine is contraindicated in conditions like Hypersensitivity.
Effects
The severe or irreversible adverse effects of Lamivudine, which give rise to further complications include Hepatomegaly, Lactic acidosis.The symptomatic adverse reactions produced by Lamivudine are more or less tolerable and if they become severe, they can be treated symptomatically, these include Headache, Fatigue, Alopecia, Diarrhea, Fever, Abdominal pain, Rashes, Malaise, Cough, Nausea and vomiting, Respiratory tract infections, Abdominal discomfort, Alopecia.
Indications
Lamivudine is primarily indicated in conditions like Hepatitis B, and can also be given in adjunctive therapy as an alternative drug of choice in AIDS, HIV infection.
Interactions
Lamivudine is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementCo-TrimoxazoleInterferon AlphaStrontium-89 ChlorideThe concomitant use of bone marrow depressants and strontium-89 chloride may have additive myelosuppressive effects. ModeratePatients should be monitored for excessive bone marrow suppression during treatment with strontium-89 chloride. Dose reductions of the other bone marrow depressants may be necessary.SulphamethoxazoleTrimethoprimTrimethoprimZalcitabineZidovudine These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Elevation in ALT or AST
Risks
Drug should not be given to Pregnant Mothers.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Tab, Soln Store Below 40°C. Protect from Sunlight, Moisture and Heat.
Warnings
Lamivudine should be used with caution in patients with kidney disease, pancreatic disorders or any drug allergies. Lamivudine in combination with zidovudine should be used with extreme caution in children with pancreatitis. It should be used only if clearly needed during pregnancy. Lactation is not recommended while taking lamivudine. Patient should be monitored regulary during treatment by a physician experienced in the management of chronic Hepatitis B. If drug is discontinued, patient should be clearly monitored both clinically and by assessment of serum liver function tests, for at least four months for evidence of recurrent hepatitis; patient should then be followed as clinically indicated. Patients should be advised that therapy with lamivudine has not been proven to reduce the risk of transmission of Hepatitis B virus to others and therefore appropriate precautions should still be taken.
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