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Epivir HBV
Epivir HBV (generic name: lamivudine) is an antiviral medication used to treat chronic hepatitis B infection in adults and children aged 2 years and older. It belongs to the class of drugs known as nucleoside reverse transcriptase inhibitors (NRTIs). Lamivudine works by reducing the amount of hepatitis B virus (HBV) in the body and slowing down the progression of the disease, but it is not a cure for hepatitis B. Epivir HBV is different from Epivir, which is also used to treat HIV; these two formulations differ in dosage.
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Frequently Asked Questions
Can Epivir HBV cure hepatitis B?
No, Epivir HBV does not cure hepatitis B. It helps manage the infection by reducing the viral load and slowing the progression of the disease.
How long will I need to take Epivir HBV?
Treatment with Epivir HBV is usually long-term and may continue for several years, depending on your doctor’s recommendations and the response to the treatment.
What should I do if I miss a dose of Epivir HBV?
If you miss a dose, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double up doses.
Can I take Epivir HBV if I have HIV?
Epivir HBV is not sufficient for treating HIV. If you have both HIV and hepatitis B, you will need to take the appropriate higher dose of lamivudine (Epivir) for HIV treatment, along with other antiretroviral drugs.
Are there any dietary restrictions while taking Epivir HBV?
There are no specific dietary restrictions. Epivir HBV can be taken with or without food.
Comprehensive Drug Guide
How Does Epivir HBV Work?
Epivir HBV works by inhibiting the action of the reverse transcriptase enzyme of the hepatitis B virus. This enzyme is crucial for viral replication, and by blocking it, lamivudine reduces the production of viral DNA, decreasing the overall viral load in the body. This helps slow the progression of the infection and reduces liver damage.
Common Dosages
- Adults: The typical dose for chronic hepatitis B infection is 100 mg once daily.
- Pediatric dosing (children aged 2 to 17 years): Based on weight, 3 mg/kg once daily (up to a maximum of 100 mg/day).
Typical Dosing
FDA Approved Indications
- Chronic hepatitis B virus (HBV) infection in adults and children aged 2 years and older with evidence of active viral replication and liver inflammation.
Who Shouldn't Take Epivir HBV?
- Known hypersensitivity to lamivudine or any of the ingredients in the formulation
- HIV infection (without the correct dose for HIV treatment, which is higher than the dose for HBV)
Advice From The Pharmacist
- Do not switch between Epivir HBV and Epivir (for HIV), as the dosages are different. Using the incorrect dose can lead to the development of resistance to lamivudine.
- Take Epivir HBV at the same time every day with or without food.
- Regular liver function tests and viral load monitoring are essential to track the effectiveness of the medication and to check for any signs of resistance.
- Do not stop taking Epivir HBV without consulting your doctor, as this can lead to a flare-up of hepatitis B.
Side Effects of Epivir HBV
Common Side Effects
- Headache
- Fatigue
- Nausea
- Diarrhea
- Cough
Uncommon/Severe Side Effects
- Lactic acidosis (symptoms include fatigue, muscle pain, shortness of breath, and stomach pain)
- Liver problems (evidenced by jaundice, dark urine, or abdominal pain)
- Pancreatitis (especially in children)
Risks and Warnings of Epivir HBV
- Hepatitis B flare-up: Discontinuation of Epivir HBV can lead to a flare-up of hepatitis B symptoms, which may cause serious liver damage. Patients should be closely monitored for several months after stopping treatment.
- Lactic acidosis and severe hepatomegaly: Lamivudine, like other NRTIs, can cause lactic acidosis and enlargement of the liver (hepatomegaly), which can be life-threatening. Symptoms include unusual fatigue, muscle pain, difficulty breathing, and abdominal pain.
- Resistance Development: Prolonged use of lamivudine can lead to the development of resistance in some patients, reducing its effectiveness over time.
Interactions with Epivir HBV
Common Drug Interactions
- Trimethoprim/Sulfamethoxazole (Bactrim): May increase lamivudine levels in the blood, but the combination is usually well-tolerated.
- Interferon alfa: Used to treat hepatitis B, combining it with lamivudine may increase the risk of peripheral neuropathy (nerve pain).
- HIV treatment regimens: Using Epivir HBV in patients with co-infection of HIV without adjusting the dose can lead to the development of resistance to lamivudine.
Alternatives to Epivir HBV
- Tenofovir (Viread): An antiviral that can be used to treat chronic hepatitis B.
- Entecavir (Baraclude): A nucleoside analog used to treat chronic hepatitis B in adults and children.
- Adefovir (Hepsera): Another antiviral used to manage chronic hepatitis B, often as an alternative to lamivudine.
- Peginterferon alfa-2a (Pegasys): An immune modulator used in the treatment of hepatitis B.
