Treating Hepatitis B With Lamivudine

Lamivudine is an antiviral drug used to treat chronic hepatitis B. It's sold under the brand name Epivir-HBV as well as the brand name Epivir for treating HIV infection, usually in combination with other antiviral drugs.

3D illustration of the hepatitis B virus

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In fact, Lamivudine was originally developed as a drug treatment for HIV and was then found to be an effective antiviral for the treatment of hepatitis B. The goal of treating chronic hepatitis B is to contain the virus's replication and thereby prevent liver damage. There currently is no generic version of this drug in the United States. Most doctors in the United States do not usually use lamivudine as a first-choice therapy for patients with hepatitis B (HBV), as there are other drugs that are more effective, and most people develop drug resistance in one to two years. However, it may be a good choice for select individuals.

One of the advantages of lamivudine compared to other treatment options is that it is relatively inexpensive: One year of treatment with lamivudine for hepatitis B can cost around $865. However, drug costs vary considerably based on many factors, such as whether you have health insurance, where you live and which pharmacy you use.

How Lamivudine Is Taken

Lamivudine is available in liquid form and as a pill. The drug is usually taken daily for one year, and it can be taken with or without food. The typical dosage may be adjusted for those with kidney problems.

Side Effects

A rare and potentially fatal condition called lactic acidosis can develop in patients taking lamivudine. Patients taking lamivudine who experience the following symptoms should get emergency medical help: muscle pain or weakness, numb or cold feeling in the arms and legs, breathing trouble, stomach pain, nausea with vomiting, fast or uneven heart rate, dizziness, or feeling very weak or tired.

If you have hepatitis B you may develop liver symptoms after you stop taking this medication, even months after stopping. Your doctor may want to check your liver function for several months after you stop using lamivudine. Visit your doctor regularly.

In addition, it is important not to switch between various preparations of lamivudine, and care should be taken each time a refill is given that the same preparation is given. Epivir tablets and liquid contain a higher dose of the drug than Epivir-HBV.

Finally, those on the drug may also experience drug resistance, meaning that the drug may over time become less effective.

Who Should Not Take Lamivudine

Anyone who is allergic to lamivudine shouldn't take this drug. Also, it's important to know your HIV status because taking lamivudine can significantly complicate treating HIV. If you have HIV and HBV, do not start therapy for either infection without consulting a physician experienced in treating both infections.

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Article Sources
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  1. WHO. Recommendations: First-line antiviral therapies for chronic hepatitis B. In: Guidelines for the Prevention, Care and Treatment of Persons with Chronic Hepatitis B Infection. Updated March 2015.

  2. Jung TY, Jun DW, Lee KN, et al. Fatal lactic acidosis in hepatitis B virus-associated decompensated cirrhosis treated with tenofovir: A case report. Medicine (Baltimore). 2017;96(25):e7133. doi:10.1097/MD.0000000000007133

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