Lamivudine

Details About Generic Salt ::  Lamivudine 

Main Medicine Class:: Anti Infectives   Sub Medicine Class ::  Anti Retrovirals (Drugs for HIV)

13N. ANTI-RETROVIRALS (DRUGS FOR HIV) in 13. ANTI-INFECTIVES
LAMIVUDINE
NRTI | ANTI-RETROVIRAL
also comes under 9B. Drugs for Hepatitis in 9. Hepatobiliary System
PK: A: Rapid D: 1.3 L/kg (Vd) M: Hepatic E: Urine (as unchanged drug)

Indications & Dose: HEPATITIS B PO Adult 100mg/day Child 2-17 yr: 3mg/kg/dose OD, max 100mg/day | HEPATITIS B IN HIV PATIENTS PO Adult HAART regimen: 150mg/dose BID or 300mg/dose OD in combination with other anti-retrovirals Child HAART regimen: 4mg/kg/dose BID, max 150 mg/dose in combination with other anti-retrovirals | HIV INFECT PO Adult 150mg BID or 300mg OD along with at least 2 other anti-retrovirals Child Neonates <30 days: 2mg/kg/dose BID, 14-21 kg: 75mg/dose BID, 22-29 kg: 75mg in morning, 150mg in evening, >30 kg: 150mg/dose BID | PREVENTION OF MATERNAL-FETAL HIV TRANSMISSION Combination therapy PO Adult Mother: 150mg BID starting at onset of labor, continued through 1 wk postpartum is given with zidovudine & nevirapine Child Neonate: 2mg/kg/dose BID given at birth, continued up to 1 wk

Contra: Hypersensitivity

Precautions: Impaired renal function, hepatomegaly/history of hepatic disease, obesity, granulocyte count below 1000/mm3, long-term therapy, elderly, hold the drug if patient develop abdominal pain/nausea/vomiting/abnormal biochemical test, exclude pancreatitis, hold the drug if rapid increase in aminotransferase concentrations/progressive hepatomegaly/metabolic/lactic acidosis of unknown aetiology

ADR: Serious: peripheral neuropathy, pancreatitis, lactic acidosis, raised liver enzymes, raised serum amylase, blood disorders, Others: Nausea, vomiting, diarrhea, abdominal pain, cough, headache, fatigue, insomnia, malaise, fever, rash, alopecia, muscle disorders, nasal symptoms

DDI: Serious Azathioprine causes pancreatitis, Trimethoprim/Cotrimoxazole reduces the renal clearance of drug

Diet: With/without food

Monitor: LFTs (q3months during therapy), CBC, HIV viral load, & CD4 count, signs/symptoms of pancreatitis, HBV DNA (every 3-6months during therapy), HBeAg & anti-HBe (after 1 year of therapy & q3-6months thereafter)