Epivir: Side Effects, Dosage, Information

Written by Rachel Nall, RN, BSN | Published on October 3, 2014
Medically Reviewed by Susan J. Bliss, RPh, MBA on October 3, 2014

What Is Epivir?

Brand Name: Epivir
Generic Name: Lamivudine, 3TC

Epivir is a medication that is a used to treat HIV. The U.S. Food and Drug Administration has approved Epivir for use by patients ages 3 months and older.  

Read the FDA description of Epivir.

What Does Epivir Do?

Epivir belongs to a class of medications known as nucleoside reverse transcriptase inhibitors (NRTIs). Epivir works to block an enzyme called reverse transcriptase, which HIV needs to replicate. As a result, HIV cannot multiply as quickly. Epivir does not cure HIV but instead slows the disease’s progression. Epivir is used in combination with at least two other antiretroviral agents. These two combinations are referred to as “backbone” dual nucleoside options. One more drug from another class is added to these to suppress HIV viral load, increase CD4 cell counts, and delay progression of the disease. Resistance to HIV may occur, especially if the patient does not take the drug every day and according to directions. 

A different formulation and dosage of lamivudine is used to treat patients with hepatitis B, but hepatitis may quickly become resistant to lamivudine and it should be used only if there are no other alternatives.    

What Are the Typical Doses?

The adult dose is usually 150 milligrams (mg) twice a day or 300 mg once a day, with or without food. Doses need to be adjusted for patients with kidney disease. Epivir is approved for children ages 3 months or older. The dose is based on age and weight. Children who can’t swallow tablets can be given oral solution. 

This information is a summary. Before starting this medication, discuss questions with your healthcare provider and make sure you understand dosage instructions.

What Should I Tell My Doctor Before Starting Epivir?

Tell your doctor if you:

  • have an allergy to lamivudine or other medications
  • are breastfeeding or are planning on breastfeeding
  • are pregnant or are thinking of becoming pregnant
  • have a medical history of pancreatitis (in children)
  • have kidney problems
  • have a history of liver disease, such as hepatitis B or hepatitis C

What Medications May Interact with Epivir?

Always tell your physician about any prescription medications or herbal remedies you are taking.

Medications that can adversely interact with Epivir include:

  • emtricitibine (Emtriva)
  • other medications that contain lamiduvine

Possible Side Effects of Epivir

Epivir has fewer side effects with fewer symptoms than many antiretrovirals.

Possible Adverse and Emergency Side Effects

The following are severe and emergent side effects of Epivir. Report to your medical provider immediately if you experience:

  • severe or worsening liver disease, particularly if you have the hepatitis B or hepatitis C. Symptoms of this condition include dark urine, decrease in appetite, fatigue, jaundice or yellowing skin, nausea, and tenderness over the liver.
  • immune reconstitution syndrome, a condition that causes an inflammatory response in viruses in the blood, such as pneumonia or tuberculosis
  • lactic acidosis, a condition that causes excess amounts of acid to build up in your blood. This causes symptoms such as weakness, tiredness, difficulty breathing, stomach pain, feeling cold, and feeling dizzy.
  • pancreatitis, or inflammation of the pancreas; pancreatitis symptoms include stomach pain, nauseavomiting, and tenderness when touching the stomach.  Patients with history of pancreatitis may have risk of recurrence. 

Possible Nonemergency Side Effects

The following common side effects may occur but do not usually represent an emergency. Discuss with your doctor if they continue or are bothersome:

  • changes in the distribution of body fat, such as an increasing amount of fat on the neck
  • cough
  • diarrhea
  • fatigue
  • headache
  • malaise
  • nasal symptoms, such as runny nose
  • nausea

This list may not describe all possible side effects. Call your doctor or healthcare provider for advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Where Should I Keep Epivir?

In tablet form, Epivir should be stored at 77 degrees (25 degrees Celsius), with brief storage between 59 and 86 degrees Fahrenheit (15 to 30 degrees Celsius). Epivir oral solution should be stored at room temperature (77 degrees Fahrenheit/25 degrees Celsius) and kept tightly closed.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Important FDA Warnings

FDA WARNING: EPIVIR CARRIES A BLACK BOX WARNING DUE TO A RISK FOR LIFE-THREATENING EFFECTS, INCLUDING LACTIC ACIDOSIS, SEVERE LIVER PROBLEMS, AND PANCREATITIS. NOTIFY YOUR PHYSICIAN IMMEDIATELY IF YOU SUSPECT YOU ARE EXPERIENCING ANY OF THESE CONDITIONS.

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