Epivir (Lamivudine) for HIV

What Members Say Top Tips Side Effects Copay Help FAQs

Epivir (lamivudine) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat human immunodeficiency virus type 1 (HIV-1) infection in adults and children aged 3 months and older.

What Members Say

MHT logo These insights are based on 59 comments about Epivir from myHIVteam members. These are the experiences of a small number of people and are not meant to be medical advice.

Benefits:

Once-daily dosing can make treatment routines feel simpler.
Taking Epivir with other HIV medicines can support undetectable viral load results.
Epivir tablets can be taken with or without food.

Considerations:

Peripheral neuropathy and sleep problems are listed side effects and come up often.
HIV can become resistant to lamivudine, especially if treatment stops working.
Kidney problems require dose adjustments and ongoing monitoring.

How Epivir Works and How It’s Taken

Epivir is a type of antiviral medicine called a nucleoside analog. It blocks an enzyme called reverse transcriptase that HIV-1 needs to make copies of itself. This helps reduce the virus’s ability to make more copies.

Doctors prescribe Epivir with other antiretroviral medicines to treat HIV-1 infection in adults and children aged 3 months and older.

HIV-1 is the virus that causes acquired immune deficiency syndrome (AIDS).

Epivir comes as tablets and an oral solution. It is taken by mouth once or twice a day. For children who weigh at least 14 kilograms and can swallow tablets, Epivir tablets with a line down the middle so they can be split into equal parts are the preferred form. Children who cannot safely and reliably swallow tablets may take the oral solution.

Typical Dosing for HIV

For adults, the recommended dose of Epivir is 300 milligrams each day. It may be taken as 150 milligrams twice daily or 300 milligrams once daily. Epivir is used with other antiretroviral medicines.

For children aged 3 months and older who take the oral solution, the recommended dose is 5 milligrams per kilogram twice daily or 10 milligrams per kilogram once daily. The total dose should not be more than 300 milligrams each day.

For children who can take tablets, dosing is based on body weight:

14 to less than 20 kilograms — 150 milligrams once daily, or 75 milligrams in the morning and 75 milligrams in the evening
20 to less than 25 kilograms — 225 milligrams once daily, or 75 milligrams in the morning and 150 milligrams in the evening
25 kilograms or more — 300 milligrams once daily, or 150 milligrams in the morning and 150 milligrams in the evening

Doctors should adjust the dose for people with reduced kidney function.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Epivir

MHT logo These insights are based on 59 comments about Epivir from myHIVteam members.

Members who use Epivir often talk about staying in close contact with their HIV care team, especially when side effects, lab changes, or treatment switches come up. They also mention the value of keeping up with blood work, watching for how a regimen affects daily life, and asking about simpler or more affordable treatment options when needed.

1

Get blood work when your doctor orders it.
“I get my bloodwork done every three to four months and have been doing so for the past 25 years. My viral load has been undetectable for 25 years and my CD4 hovers around 1,000. My lab results look good.”
2

Pay attention to how you feel after changing medications.
“Adjusting to new meds is always a challenge. So far so good, I didn’t have any side effects at all from Epivir, then only a little nauseous the first evening and I gained more than 4 kilo in weight. Today I had my checkup in the hospital and everything was alright, still undetectable.”
3

Keep track of changes after switching treatments.
“Been monitoring my blood glucose, but since I discontinued a regimen that included lamivudine a couple months ago, my glucose levels, on average, seem to be dropping.”

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Epivir Side Effects

In clinical studies of Epivir, the most common side effects occurred in about 15 percent to 35 percent of people.

Side effects in adults include:

Headache
Nausea
Malaise and fatigue (feeling unwell, tired, or low energy)
Nasal symptoms, such as a runny or stuffy nose
Diarrhea
Cough

Side effects in children include:

Fever
Cough

Serious Side Effects and Warnings

Epivir can cause serious side effects that may require immediate medical attention. These include:

Lactic acidosis with severe liver problems — A buildup of lactic acid in the blood, sometimes with an enlarged liver and fatty liver, can be life-threatening.
Severe worsening of hepatitis B after stopping Epivir — This worsening can occur in people who also have hepatitis B, and liver inflammation can become severe.
Pancreatitis — Inflammation of the pancreas can be fatal in some cases.
Immune reconstitution syndrome — An inflammatory reaction as the immune system gets stronger can uncover hidden infections.
Severe allergic reactions — Hypersensitivity reactions can occur, including anaphylaxis and urticaria (hives).

Get medical help right away if you think you are having a serious reaction.

How To Save on Epivir

ViiV Healthcare, the manufacturer of Epivir, offers the ViiVConnect Savings Card. Eligible people with commercial insurance may pay as little as $0 per prescription fill.

The ViiVConnect Savings Card also offers reimbursement for eligible people whose pharmacy is unable to process the savings card at the time of purchase.

To learn more, visit the ViiVConnect Savings Card website or call 866-279-4705.

What To Know Before Taking Epivir

Before taking Epivir, tell your doctor if you:

Have or have had liver problems, including hepatitis B
Have kidney problems
Have diabetes (Epivir oral solution contains sucrose, a type of sugar. Each 15-milliliter dose contains 3 grams of sucrose.)
Are pregnant or plan to become pregnant
Are breastfeeding or plan to breastfeed
Have any allergies to lamivudine or any ingredients in Epivir
Take zalcitabine (Note that this medication is no longer sold or distributed.)

Do not take Epivir if you:

Are allergic to lamivudine or any of the ingredients in Epivir
Are taking zalcitabine

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Do not stop taking Epivir or let your supply run out without talking with your healthcare provider. Do not let your supply run out. If you run out of Epivir, the amount of virus in your blood may increase and the virus may become harder to treat.

If you are pregnant or plan to become pregnant, talk with your doctor about taking Epivir.

People with HIV-1 should not breastfeed while taking Epivir.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Epivir for HIV?

In one adult study, HIV-1 disease progression or death occurred in 9.6 percent of people taking Epivir plus their current treatment. This compared with 19.6 percent of people taking their current treatment without Epivir.

In another 48-week study of adults who were new to HIV treatment, 61 percent of people taking Epivir 300 milligrams once daily had HIV-1 RNA below 50 copies per milliliter. This compared with 63 percent of people taking Epivir 150 milligrams twice daily.

CD4 cells, which are immune cells that HIV can damage, increased by a median of 144 cells per cubic millimeter with once-daily Epivir and 146 cells per cubic millimeter with twice-daily Epivir.

Can Epivir be used with other medicines for HIV?

Yes. Epivir is used with other antiretroviral medicines to treat HIV-1.

Clinical studies included lamivudine with other HIV medicines such as zidovudine, efavirenz, abacavir, didanosine, zalcitabine, and ritonavir. These study combinations do not mean that each medicine is recommended for everyone.

Tell your healthcare provider about all the medicines you take. Your healthcare provider will decide which HIV medicines should be used with Epivir.

What tests or monitoring are needed with Epivir for HIV?

Your healthcare provider may use blood tests, such as HIV-1 viral load and CD4 cell count, to see how your HIV treatment is working.

Your kidney function is important because your Epivir dose may need to be changed if your kidneys are not working well.

If you have both HIV-1 and hepatitis B and stop taking Epivir, your healthcare provider should closely monitor your liver with checkups and blood tests for at least several months. Hepatitis B can become worse after Epivir is stopped.

For children taking Epivir oral solution, healthcare providers should consider checking HIV-1 viral load more often because lower viral suppression and more resistance were seen with the oral solution in a pediatric study.