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Other drugs may interact with lamivudineincluding prescription and over-the-counter medicinesvitaminsand herbal productsSome drugs should not be used together with lamivudineTell your doctor about all your current medicines and any medicine you start or stop using.
To make sure Epivir HBV is safe for youtell your doctor if you have ever had:
The safety and efficacy of Epivir-HBV have not been established in patients with decompensated hepatic disease or organ transplantand patients dually infected with hepatitis B virusHBVand hepatitis C virusor hepatitis deltaObesity and prolonged nucleoside exposure may be risk factors for hepatotoxicity or lactic acidosis during lamivudine therapyFatalities have been reported with use of antiretroviral agents alone or in combinationincluding lamivudineA majority of these cases occurred in femalesit is unknown if pregnant women are at increased riskClinicians need to be alert for early diagnosis of this syndromePregnant women receiving nucleoside analogs should have LFTs and serum electrolytes assessed more frequently during the last trimester and any new symptoms should be evaluated thoroughlyMost of these reports describe patients receiving lamivudine for HIV treatmentbut there have been reports of lactic acidosis in patients receiving lamivudine for hepatitis BLamivudine should be used with caution in patients with hepatic disease or in those with known risk factors for liver diseasee.galcoholismhowevercases of lactic acidosis or liver problems have been reported in patients with no risk factorsTreatment should be discontinued in any patient who develops clinical or laboratory findings suggestive of lactic acidosis or pronounced hepatotoxicity which may include hepatomegaly and steatosiseven in the absence of marked increases in transaminasesFollowing discontinuation of lamivudine in patients with HBV or HIV infectionsome patients experienced clinical or laboratory evidence of recurrent hepatitiswhich has been fatal in some casesThis reaction may be more severe in patients with decompensated hepatic diseaseThuspatients should be closely monitored for several months after stopping lamivudine therapy for hepatitis B.
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