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Epivir-HBV

Epivir-HBV
Epivir (Lamivudine) is a nucleoside reverse transcriptase inhibitor, an antiviral agent used in combination antiretroviral therapy, active against HIV and hepatitis B.

Brand: Lamivudine

Availability: In Stock
Average Delivery Time: 9 Days
Exp. Date: November 2023
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Epivir-HBV 150 mg
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30 pills - 150 mg $58.95 $1.97 No Add to cart
Epivir-HBV 100 mg
360 pills - 100 mg
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270 pills - 100 mg
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Product description

Pharmacological action of Epivir

Buy Epivir in Canada

Antiviral agent, nucleoside reverse transcriptase inhibitor. Penetrating into cells, it is metabolized to 5-triphosphate, which inhibits HIV reverse transcriptase, which leads to inhibition of viral replication. It is active against strains resistant to zidovudine, and when used in combination with it, it slows down the development of viral resistance to zidovudine (in previously untreated patients). It has a higher in vitro therapeutic index than zidovudine (weaker than zidovudine, it inhibits bone marrow progenitor cells, and also has a less pronounced cytotoxic effect on peripheral blood lymphocytes, lymphocytic and monocytic-macrophage cell lines). It slightly affects the metabolism of cellular deoxynucleotides and the DNA content in the mitochondria of undamaged cells.

Lamivudine is highly active against hepatitis B virus (HBV) in all studied cell lines and in all experimentally infected animals.

Pharmacokinetics

Rapidly absorbed from the gastrointestinal tract. Bioavailability is 80-88%. Cmax in blood plasma is reached 1 hour after administration. Lamivudine crosses the BBB, the placental barrier. Plasma protein binding - 36%. It is metabolized by phosphorylation to form 5-triphosphate. T1/2 - 5-7 hours. 68-71% is excreted in the urine unchanged.

Indications for the active substances of Epivir®

Epivir hepatitis b treatment

Treatment of HIV infection in adults and children (as part of combination therapy with other antiretroviral drugs).

Chronic viral hepatitis B associated with HBV replication in patients aged 16 years and older.

Dosage regimen of Epivir

Appearance of Epivir packaging

The dose and treatment regimen are set depending on the indications.

Contraindications for use

Hypersensitivity to lamivudine.

Use during pregnancy and lactation

Despite the absence of direct indications of teratogenic effects and changes in reproductive function, lamivudine should be used during pregnancy only after a careful assessment of the expected benefits and potential risk of side effects.

If it is necessary to use lamivudine during lactation, breastfeeding should be discontinued.

Application for violations of liver function

Correction of the dosage regimen in patients with impaired liver function is not required. However, it should be used with caution in patients with severe liver cirrhosis caused by hepatitis B virus, given the risk of exacerbation of the disease after discontinuation of lamivudine.

Application for impaired renal function

Use with caution in impaired renal function. If QC is less than 50 ml / min, dose adjustment is necessary.

Pediatric use

There is no experience with lamivudine in children under 3 months of age. In children with impaired renal function, it is recommended to adjust the dosage regimen in the same proportions as in adults.

Special instructions

Use with caution in case of impaired renal function. If QC is less than 50 ml / min, dose adjustment is necessary.

Given that lamivudine is eliminated almost exclusively by the kidneys, no dosage adjustment is required in patients with impaired liver function. However, it should be used with caution in patients with severe liver cirrhosis caused by hepatitis B virus, given the risk of exacerbation of the disease after discontinuation of lamivudine.

Lamivudine is not used in combination with zidovudine for neutropenia (neutrophil count less than 750 / μL) or anemia (hemoglobin less than 7.5 g / dL or 4.65 mmol / L).

If abdominal pain, nausea, vomiting or an increase in the level of pancreatic enzymes in the blood plasma occurs, lamivudine should be discontinued and not resumed until the diagnosis of pancreatitis has been ruled out.

The use of lamivudine does not prevent the possibility of infection through sexual contact or blood.

During the period of treatment, the possibility of developing a secondary infection should be borne in mind.

Pediatric use

There is no experience with lamivudine in children under 3 months of age. In children with impaired renal function, it is recommended to adjust the dosage regimen in the same proportions as in adults.

Drug interaction

With the simultaneous use of lamivudine increases the duration of action of zidovudine by 13%, and its Cmax in blood plasma - by 28%. Zidovudine does not affect the pharmacokinetics of lamivudine.

Synergism with zidovudine and other antiviral agents used in the treatment of HIV infections in relation to HIV replication in cell culture has been noted.

With simultaneous use with didanosine, sulfonamides, zalcitabine, the risk of developing pancreatitis increases.

With simultaneous use with dapsone, didanosine, isoniazid, stavudine, zalcitabine, the risk of developing peripheral neuropathy increases.

Trimethoprim increases the plasma concentration of lamivudine.

Side effect

From the digestive system: pain and discomfort in the epigastric region, nausea, vomiting, diarrhea, decreased appetite, increased activity of hepatic transaminases.

From the side of the central nervous system: increased fatigue, headache.

From the respiratory system: respiratory tract infections.

Others: general malaise.