Buy Epivir Online

What is Epivir?

Epivir (lamivudine) is an antiviral medication that prevents human immunodeficiency virus (HIV) or hepatitis B virus cells from multiplying in your body.

Epivir is for treating HIV, which causes the acquired immunodeficiency syndrome (AIDS). It is not a cure for HIV or AIDS.

Epivir-HBV is for treating hepatitis B. Epivir-HBV should not be used in people who are infected with both hepatitis B and HIV.

Lamivudine may also be used for purposes not listed in this medication guide.

Important information about Epivir

You should not take Epivir if you are allergic to lamivudine. The Epivir brand of lamivudine (for treating HIV) should not be taken together with any HIV combination medicine that contains lamivudine or emtricitabine. This includes Atripla, Combivir, Complera, Emtriva, Epzicom, Trizivir, and Truvada. The Epivir-HBV brand of lamivudine (for treating hepatitis B) should not be taken together with any other medication that contains lamivudine, which includes Combivir, Epivir, Epzicom, and Trizivir.

Before taking Epivir, tell your doctor if you have kidney disease, liver disease, a history of pancreatitis, or if you have used a medicine similar to lamivudine in the past, such as abacavir (Ziagen), didanosine (Videx), emtricitabine (Atripla, Complera, Emtriva, Truvada), stavudine (Zerit), tenofovir (Viread), zalcitabine (Hivid), or zidovudine (Retrovir).

Some people develop lactic acidosis while taking Epivir. Early symptoms may get worse over time and this condition can be fatal. Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, 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 Epivir. Visit your doctor regularly.

Epivir can also cause severe or life-threatening effects on your liver or pancrea. Call your doctor at once if you have any of these symptoms while taking Epivir: severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

Epivir tablets and liquid contain a higher dose of lamivudine than Epivir-HBV. Each time you get a refill of this medication, be sure you have received the correct brand to treat your condition.

Before taking Epivir

You should not take Epivir if you are allergic to lamivudine. Epivir should not be taken together with any HIV combination medicine that contains lamivudine or emtricitabine. This includes:

  • Atripla (efavirenz, emtricitabine, and tenofovir);

  • Combivir (lamivudine and zidovudine);

  • Complera (rilpivirine, emtricitabine, and tenofovir);

  • Emtriva (emtricitabine);

  • Epzicom (abacavir and lamivudine);

  • Trizivir (abacavir, lamivudine, and zidovudine); and

  • Truvada (emtricitabine and tenofovir).

The Epivir-HBV brand of lamivudine (for treating hepatitis B) should not be taken together with any other medication that contains lamivudine, which includes:

  • Combivir (lamivudine and zidovudine);

  • Epivir (lamivudine) for treating HIV;

  • Epzicom (abacavir and lamivudine); and

  • Trizivir (abacavir, lamivudine, and zidovudine).

To make sure you can safely take Epivir, tell your doctor if you have any of these other conditions:

  • liver disease (especially hepatitis B if you also have HIV);
  • kidney disease;
  • a history of pancreatitis; or

  • if you have used a medicine similar to Epivir in the past, such as abacavir (Ziagen), didanosine (Videx), emtricitabine (Atripla, Complera, Emtriva, Truvada), stavudine (Zerit), tenofovir (Viread), zalcitabine (Hivid), or zidovudine (Retrovir).

Some people develop a life-threatening condition called lactic acidosis while taking Epivir. You may be more likely to develop lactic acidosis if you are overweight or have liver disease, if you are a woman, or if you have taken HIV or AIDS medications for a long time. Talk with your doctor about your individual risk.

FDA pregnancy category C. It is not known whether Epivir will harm an unborn baby. HIV can be passed to your baby if you are not properly treated during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Take all of your HIV medicines as directed to control your infection. Lamivudine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Epivir to treat hepatitis B. Women with HIV or AIDS should not breast feed a baby. Even if your baby is born without HIV, the virus may be passed to the baby in your breast milk. If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of Epivir on the baby.

If you have diabetes, you should know that the liquid forms of Epivir contain 3 to 4 grams of sucrose (sugar) per dose.

How should I take Epivir?

Take Epivir exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. You should not take Epivir (for treating HIV) together with Epivir-HBV (for treating hepatitis B).

Epivir can be taken with or without food.

You may need to break an Epivir tablet in half when giving this medication to a child for HIV. Call your doctor if the child has any trouble swallowing the tablet.

Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

The Epivir brand contains a higher dose of lamivudine than Epivir-HBV brand. Epivir is for treating HIV and Epivir-HBV is for treating hepatitis B. Each time you get a refill of this medication, be sure you have received the correct brand to treat your condition.

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 Epivir. Visit your doctor regularly.

To be sure this medicine is helping your condition and is not causing harmful effects, your blood will need to be tested often. Your liver and kidney function may also need to be tested. Visit your doctor regularly.

HIV/AIDS is usually treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice. Every person with HIV or AIDS should remain under the care of a doctor.

Store Epivir at room temperature away from moisture and heat. Do not allow the liquid form of this medicine to freeze. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Epivir?

Taking Epivir will not prevent you from passing HIV to other people. Avoid having unprotected sex or sharing razors or toothbrushes. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

Epivir side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Epivir: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Lamivudine ay cause lactic acidosis (a build-up of lactic acid in the body, which can be fatal). Lactic acidosis can start slowly and get worse over time. Get emergency medical help if you have even mild symptoms of lactic acidosis, such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, fast or uneven heart rate, dizziness, or feeling very weak or tired.

Stop using Epivir and call your doctor at once if you have a serious side effect such as:

  • signs of a new infection such as fever, chills, sore throat, flu symptoms, easy bruising or unusual bleeding, loss of appetite, mouth sores;

  • severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate;

  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • increased sweating, tremors in your hands, anxiety, feeling irritable, sleep problems (insomnia);

  • diarrhea, unexplained weight loss, menstrual changes, impotence, loss of interest in sex;

  • swelling in your neck or throat (enlarged thyroid);

  • problems with walking, breathing, speech, swallowing, or eye movement; or

  • severe lower back pain, loss of bladder or bowel control.

Less serious Epivir side effects may include:

  • cough;

  • headache;

  • mild tired feeling;

  • runny or stuffy nose;

  • mild diarrhea; or

  • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and trunk).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Epivir?

Tell your doctor about all other medicines you use, especially interferons (Alferon, Avonex, Betaseron, Extavia, Intron, Rebetron, Rebif, and others).

This list is not complete and other drugs may interact with Epivir. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

For the Consumer

Applies to lamivudine: oral solution, oral tablet

Along with its needed effects, lamivudine (the active ingredient contained in Epivir) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking lamivudine:

More common—especially in children
  • Abdominal or stomach pain (severe)
  • feeling of fullness
  • nausea
  • sensation or pins and needles
  • skin rash
  • stabbing pain
  • tingling, burning, numbness, or pain in the hands, arms, feet, or legs
  • unsteadiness or awkwardness
  • vomiting
Rare
  • Abdominal discomfort
  • decreased appetite
  • diarrhea
  • fast, shallow breathing
  • feeling of fullness
  • fever, chills, or sore throat
  • general feeling of discomfort
  • muscle pain or cramping
  • nausea
  • shortness of breath
  • sleepiness
  • unusual tiredness or weakness
Incidence not determined
  • Cough
  • dark urine
  • difficulty swallowing
  • dizziness
  • fast heartbeat
  • fever
  • hives or welts
  • itching
  • light-colored stools
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • redness of skin
  • tightness in chest
  • upper right abdominal pain
  • wheezing
  • yellow eyes and skin

Some side effects of lamivudine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Canker sores
  • difficulty in moving
  • discouragement
  • ear discharge
  • ear swelling
  • feeling sad or empty
  • general feeling of discomfort or illness
  • irritability
  • loss of appetite
  • loss of interest or pleasure
  • nasal discharge or congestion
  • pain in joints
  • sores, ulcers, or white spots on lips or tongue or inside the mouth
  • stomach pain or cramps
  • swollen and painful spots on neck, armpit, or groin
  • swollen joints
  • trouble concentrating
  • trouble sleeping
  • unusually warm skin
  • weight loss
Less common
  • Acid or sour stomach
  • belching
  • cough
  • heartburn
  • indigestion
  • stomach discomfort or upset

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Applies to lamivudine: oral solution, oral tablet

General

The most common side effects reported with lamivudine (the active ingredient contained in Epivir) have included headache, nausea, malaise, fatigue, nasal signs and symptoms, diarrhea, and cough. During clinical studies, HIV-1-infected patients received lamivudine plus zidovudine. Patients with hepatitis B received lamivudine monotherapy.

The adverse effects of lamivudine are sometimes difficult to distinguish from the symptomatology observed during the clinical course of AIDS, as well as from the possible adverse effects of other drugs used in the treatment of HIV-1 infection. Many of the side effects associated with nucleoside reverse transcriptase inhibitor therapy (myopathy, pancreatitis, liver failure, lactic acidosis, etc.) are attributable to their direct toxic effect on mitochondria which causes decreased mitochondrial energy generating capacity.

Nervous system

Nervous system side effects have included headache (up to 35%), neuropathy (12%), insomnia and other sleep disorders (11%), and dizziness (10%). Peripheral neuropathy and paresthesia have been reported during postmarketing experience.

Gastrointestinal

Gastrointestinal side effects have included nausea (33%), diarrhea (up to 18%), abdominal discomfort and pain (16%), nausea and vomiting (up to 15%), anorexia and/or decreased appetite (10%), abdominal pain (9%), abdominal cramps (6%), and dyspepsia (5%). Oral ulcerations and lesions have been observed. Pancreatitis has been rarely reported in adults (less than 0.5%), but may be more common in pediatric patients (up to 18% in 2 limited studies). Pancreatitis and stomatitis have been reported during postmarketing experience.

Hepatic

Hepatic side effects have included elevated ALT (greater than 3 times ULN: 11%; greater than 5 times ULN: up to 3.8%), AST (greater than 5 times ULN; up to 4%), and bilirubin (greater than 2.5 times ULN; up to 0.8%). Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of lamivudine (the active ingredient contained in Epivir) and other nucleoside analogs alone or in combination with other antiretroviral agents. Severe acute exacerbations of hepatitis B, including fatalities, have been reported in patients with HBV (including those coinfected with HIV-1) who have discontinued lamivudine. The causal relationship to stopping lamivudine treatment is unknown. Hepatic decompensation (some fatal) has been reported in patients coinfected with HIV-1 and hepatitis C receiving combination antiretroviral therapy for HIV-1 and interferon alfa with or without ribavirin. Lactic acidosis and hepatic steatosis and posttreatment exacerbation of hepatitis B have been reported during postmarketing experience.

Other

Other side effects have included malaise and fatigue (up to 27%); ear, nose, and throat infections (25%); sore throat (13%); and fever or chills (up to 10%). Weakness has been reported during postmarketing experience.

Respiratory

Respiratory side effects have included nasal signs and symptoms (20%) and cough (18%). Abnormal breath sounds/wheezing have been reported during postmarketing experience.

Hematologic

Hematologic side effects have included decreased absolute neutrophil count (less than 750/mm3; up to 15%), platelets (less than 50,000/mm3; up to 4%), and hemoglobin (less than 8 g/dL; up to 2.9%). Anemia (including pure red cell aplasia and severe anemias progressing on therapy), lymphadenopathy, and splenomegaly have been reported during postmarketing experience.

Musculoskeletal

Musculoskeletal side effects have included myalgia (up to 14%), musculoskeletal pain (12%), increased creatine phosphokinase (greater than or equal to 7 times baseline; 9%), and arthralgia (up to 7%). Muscle weakness, elevated creatine phosphokinase, and rhabdomyolysis have been reported during postmarketing experience.

Metabolic

Although progressive subcutaneous fat wasting has been attributed to the use of protease inhibitors, nucleoside reverse transcriptase inhibitors may have an independent contribution. This syndrome has been observed in patients naive to protease inhibitors, however, not to the same degree as in patients on a combination regimen that includes a protease inhibitor.

Metabolic side effects have included increased serum lipase (greater than or equal to 2.5 times ULN; 10%) and amylase (greater than 2 times ULN: up to 4.2%; greater than 3 times ULN: less than 1%). Redistribution/accumulation of body fat including central obesity, dorsocervical fat enlargement, peripheral wasting, facial wasting, breast enlargement, and "cushingoid appearance" have been observed in patients receiving antiretroviral agents; however, a causal relationship has not been established. Progressive subcutaneous fat wasting has been reported. Hyperglycemia and redistribution/accumulation of body fat have been reported during postmarketing experience.

Dermatologic

Dermatologic side effects have included skin rashes (up to 9%). Paronychia and periungual pyogenic granulomata have been reported. Alopecia, rash, and pruritus have been reported during postmarketing experience.

Psychiatric

Psychiatric side effects have included depressive disorders (9%).

Hypersensitivity

Hypersensitivity side effects have infrequently included angioedema and anaphylactoid reaction. Anaphylaxis and urticaria have been reported during postmarketing experience.

Immunologic

Immunologic side effects have included immune reconstitution syndrome. Autoimmune disorders (e.g., Graves' disease, polymyositis, and Guillain-Barre syndrome) have been reported in the setting of immune reconstitution.

Renal

Renal side effects have included at least one case of Fanconi syndrome.

Ocular

Ocular side effects have included eye redness.