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Generic Name: lamivudine (la MIH vue deen)
Brand Names: Danocrine, Epivir, Epivir HBV

Epivir : Important Information

• Epivir should not be taken together with another medication that contains a combination of lamivudine and zidovudine (Combivir).
• Before taking lamivudine, tell your doctor if you have kidney disease, liver disease, a pancreas disorder, or problems with your muscles.
• Call your doctor at once if you have liver problems while you are using Epivir. Symptoms to watch for include stomach pain, nausea and vomiting, low fever, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).
• Consumption of Epivir tablets may lower the blood cell count, which in turn lowers the ability of your body to fight infections. This can expose you to a higher risk of attracting external infections. Any injury can lead to an increased bleeding. In order to maintain the ideal blood cell count, you should get your blood tested on a regular basis.
• If you have hepatitis B you may develop liver symptoms after you stop taking Epivir. Your doctor may want to check your liver function on a regular basis for several months after you stop using this medication. Do not miss any scheduled visits.
• Epivir may cause lactic acidosis (the build up of lactic acid in the body). Lactic acidosis symptoms can start slowly and gradually get worse. Symptoms include unusual muscle pain and weakness, trouble in breathing, fast or uneven heart rate, nausea, vomiting, stomach pain, and numbness or cold feeling in your arms or legs. Call your doctor at once if any of these symptoms persists. Early symptoms of lactic acidosis generally get worse which might turn out to be fatal.
• Epivir tablets and liquid contains a higher dose of lamivudine than Epivir-HBV. Epivir is used to treat HIV and Epivir-HBV is used to treat hepatitis B. While refilling any of these medications, make sure you have refilled the correct brand.

What is Epivir?

• Epivir is an antiviral medication. It belongs to the group of human immunodeficiency virus (HIV) medicines called reverse transcriptase inhibitors. Epivir (Lamivudine) prevents the HIV virus from reproducing in the body.
• The Epivir brand of lamivudine is used to treat HIV, which causes the acquired immunodeficiency syndrome (AIDS). Lamivudine is not a cure for HIV or AIDS. The Epivir-HBV brand of lamivudine is used to treat chronic hepatitis B.
• Lamivudine may also be used for purposes other than those listed in this medication guide.

What to discuss before using Epivir

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For Danazol, the following should be considered:

• Do not use Epivir if you are allergic to lamivudine.
• Before taking Epivir (lamivudine), tell your doctor if you are allergic to any other drugs, or if you have:
  • Kidney disease;
  • Liver disease;
  • Pancreatitis; or 
  • Problems with your muscles.
  • Any other preexisting disease.
• If you have any of the conditions listed above, you may not be able to use Epivir or you may need a dosage adjustment or need to undergo special tests during treatment.
• Epivir may cause lactic acidosis (the build up of lactic acid in the body). Lactic acidosis symptoms can start slowly and can gradually get worse. Symptoms include unusual muscle pain and weakness, trouble breathing, fast or uneven heart rate, nausea, vomiting, stomach pain, and numbness or cold feeling in your arms or legs. Call your doctor at once if any of these symptoms prevail. Early symptoms of lactic acidosis generally get worse over time, which can be fatal.
• If you have diabetes, you should know that the liquid form of lamivudine contains 3 to 4 grams of sucrose (sugar) per dose.
• FDA pregnancy category C. Epivir may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. HIV can be passed on to the baby if the mother is not properly treated during pregnancy. To avoid this, take the medicines as directed by physician.
• Your name may need to be listed on an antiviral pregnancy registry when you start using Epivir. 
• You should not breast-feed while you are using Epivir (lamivudine). Women with HIV or AIDS should not breast-feed at all. Even if your baby is born without HIV, you may still pass on the virus to the baby through your breast milk. 

Epivir Dosage Method

• You should take Epivir exactly as prescribed by the physician. Avoid an overdose y following the directions on your prescription label.
• Epivir(lamivudine) can be taken with or without food.
• Measure the liquid form of lamivudine with a special dose-measuring spoon or cup. If you do not have a dose-measuring device, buy it from your nearest pharmacist.
• Epivir tablets and liquid contain a higher dose of lamivudine than Epivir-HBV. Epivir is for treating HIV and Epivir-HBV is for treating hepatitis B. Each time you get a refill of this medication, be sure you have received the correct brand to treat your condition.
• HIV/ AIDS is usually treated with a combination of different drugs. For optimum results, administer the medicines as directed by the doctor. Do not change the dosage or the drug schedule without your doctor's advice.
• Lamivudine can lower the blood cell count in your body, which can make you more susceptible to external infections. Get your blood tested on regular basis to keep a check on your blood cell counts. In case of any fluctuation beyond normal levels, report it to your doctor immediately.
• Hepatitis B patients might develop liver symptoms even after months of stopping the consumption of Epivir. This can give rise to further health complications.  To avoid such a condition, do not miss any of the scheduled visits to your doctor.
•  Store this medication at room temperature away from moisture and heat. You may keep the oral solution (liquid) in the refrigerator but do not let it freeze.

Miss a dose: Problems?

• Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the Epivir at the next scheduled time. Do not take extra Epivir to make up the missed dose.

Epivir Overdose?

• Epivir should not be taken together with another medication that contains a combination of lamivudine and zidovudine (Combivir).
• Avoid contact with people who have cold, flu, or other contagious illnesses. Contact your doctor immediately if you develop signs of infection.
• Avoid having unprotected sex or sharing needles, razors, or toothbrushes. Taking this medication will not prevent you from passing HIV to other people. Consult your doctor about safe methods of preventing HIV transmission during sex, such as using a condom and spermicide. Sharing drug or medicine needles is never safe, even for a healthy person.
• Avoid drinking alcohol while taking lamivudine. Alcohol may increase the risk of damage to the pancreas and/ or liver.

Avoid During Treatment

• Epivir should not be taken together with another medication that contains a combination of lamivudine and zidovudine (Combivir).
• Avoid contact with people who have cold, flu, or other contagious illnesses. Contact your doctor immediately if you develop signs of infection.
• Avoid having unprotected sex or sharing needles, razors, or toothbrushes. Taking this medication will not prevent you from passing HIV to other people. Consult your doctor about safe methods of preventing HIV transmission during sex, such as using a condom and spermicide. Sharing drug or medicine needles is never safe, even for a healthy person.
• Avoid drinking alcohol while taking lamivudine. Alcohol may increase the risk of damage to the pancreas and/ or liver.

Epivir Side Effects

• Consumption of Epivir should immediately be stopped if you experience any difficulty in breathing, hives, swelling of your face, lips, tongue, or throat. Seek emergency medical help if any of these situations persists.
• Call your doctor at once if you have any of these other serious side effects:
  • Muscle pain and weakness, trouble breathing, fast or uneven heart rate, nausea, vomiting, stomach pain, numbness or cold feeling;
  • Fever, chills, body aches, flu symptoms;
  • Unusual increase in bleeding, unusual weakness, pale skin; 
  • Nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
  • Sudden and severe stomach pain with nausea, vomiting, fever, chills, and rapid pulse; or
  • White patches or sores inside your mouth or on your lips.
• Less serious side effects may be more likely to occur, such as:
  • Changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and trunk);
• Nausea, vomiting, diarrhea, loss of appetite;
• Sleep problems (insomnia), strange dreams;
• Skin rash;
• Headache, dizziness; or
• Cough, runny or stuffy nose.
• Side effects other than those listed here may also occur. Talk to your doctor about any other possible side effects.

What other drugs to avoid while undergoing treatment

• Before taking this medication, tell your doctor if you are using any of the following drugs:
  • Interferon-alfa (Roferon, Intron, Rebetron);
  • Trimethoprim (Bactrim, Proloprim, Septra, Trimpex); or
  • Ribavirin (Rebetol, Ribasphere, Copegus Virazole).
• There may be other drugs not listed that can interact with lamivudine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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