Drug reference

Lamivudine

Antiviral · Antiviral Agent

AntiviralAntiviral AgentATC null

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

8 major

SEVERE in our sources

PREGNANCY

(see Useful

FDA category + note

Top interactionssee all 8 →

BexaroteneSevereDatabaseDDInter
EmtricitabineSevereDatabaseDDInter
LeflunomideSevereDatabaseDDInter
LomitapideSevereDatabaseDDInter

Mechanism

Lamivudine (3TC) is a cytidine nucleoside analogue (2',3'-dideoxy-3'-thiacytidine) that is phosphorylated intracellularly to lamivudine triphosphate, which competitively inhibits both HIV-1 reverse transcriptase and HBV DNA polymerase. It is incorporated into the growing viral DNA chain where the absence of a 3'-hydroxyl group causes obligate chain termination. Lamivudine has a favorable safety profile but a low genetic barrier to resistance, with the M184V mutation in HIV reverse transcriptase emerging rapidly during monotherapy.

Indications

Chronic hepatitis B (initial treatment)Chronic hepatitis B in patients with decompensated liver disease (in combination with adefovir dipivoxil or tenofovir disoproxil)HIV and chronic hepatitis B (as part of highly active antiretroviral therapy, often with tenofovir disoproxil and emtricitabine)Chronic HBV hepatitis in adults and children 2 years or older (alternative agent)Indefinite treatment for patients with cirrhosisHIV in adults and children ≥3 monthschronic hepatitis BProphylaxis for HIV infection (health care workers exposed to blood by needle stick injury)HIV infection (in combination with other anti-HIV drugs, essential component of NACO first line regimens)chronic hepatitis B (first line drug)

Dosing

Adult: is given by mouth for the treatment of chronic hepatitis C infection, in double therapy with peginterferon alfa, interferon alfa, or sofosbuvir, or in triple therapy with peginterferon alfa and one protease inhibitor or sofosbuvir. Ribavirin is also effective in Lassa fever [unlicensed indication].…
Pediatric: 3 mg/kg per day, maximum 100 mg/day, for children 2 to 17 years old
Renal adjustment: Dose reduction considered for patients with renal impairment