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Administer using a calibrated oral syringe to give an accurate dosageAvoid chronic coadministration of lamivudine oral solution with sorbitol-containing medicines as decreased lamivudine concentrations may occur.

Pharmacokinetic parameters of lamivudine are not altered by diminishing hepatic functionthereforeno dosage adjustment is required with impaired hepatic functionSafety and efficacy have not been established in patients with decompensated hepatic diseaseTreatment should be discontinued in any patient who develops clinical or laboratory findings suggestive of lactic acidosis or pronounced hepatotoxicity.

Lactic acidosis and severe hepatomegaly with steatosisincluding fatal caseshave been reported with the use of nucleoside analogues and other antiretroviralsA majority of these cases have been in womenObesity and prolonged nucleoside exposure may be risk factorsMost of these reports have described patients receiving nucleoside analogues for treatment of HIV infectionbut there have been reports of lactic acidosis in patients receiving lamivudine for hepatitis BCaution should be exercised when administering Epivir-HBV to any patient with known risk factors for liver diseasehowevercases also have been reported in patients with no known risk factorsTreatment with Epivir-HBV should be suspended in any patient who develops clinical or laboratory findings suggestive of lactic acidosis or pronounced hepatotoxicitywhich may include hepatomegaly and steatosis even in the absence of marked transaminase elevations

HIV/AIDS is usually treated with a combination of drugsUse all medications as directed by your doctorRead the instructions provided with each medicationDo not change your doses or medication schedule without your doctor’s adviceEvery person with HIV or AIDS should remain under the care of a doctor.

Hepatic decompensationsome fatalreported in HIV-1/HCV co-infected patients receiving interferon and ribavirin-based regimensmonitor for treatment-associated toxicitiesdiscontinue therapy as medically appropriate and consider dose reduction or discontinuation of interferon alfaribavirinor both.

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epivir-hbv is not appropriate for patients co-infected with hbv and hiv-1.