Epivir® (Lamivudine) for Chronic Hepatitis B and HIV Care

What Lamivudine Is and How It Works

Lamivudine is a nucleoside reverse transcriptase inhibitor (NRTI) used to treat chronic hepatitis B and, in combination with other antiretrovirals, HIV-1. The common hepatitis B strength is lamivudine 100mg once daily. Many people compare lamivudine cost without insurance when choosing where to fill their prescription. Youdrugstore.com is a licensed Canadian pharmacy headquartered in Manitoba, and prescriptions are reviewed by licensed pharmacists before dispensing.

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Lamivudine works by blocking viral reverse transcriptase. This reduces viral replication. For hepatitis B (HBV), it suppresses HBV DNA and may normalize ALT. For HIV, it forms part of a combination regimen to drive viral load down and increase CD4 counts. Forms include film‑coated tablets and an oral solution. Dosing is once or twice daily depending on the indication and regimen.

Dosage and Usage

• Chronic hepatitis B (adults): 100 mg by mouth once daily.
• HIV-1 (adults): 300 mg once daily or 150 mg twice daily in combination with other antiretrovirals.
• Pediatrics: weight‑based dosing for the oral solution; follow the prescriber’s instructions.
• Renal impairment: dose adjustment is required based on creatinine clearance.
• Do not use lamivudine alone for HIV or in HBV/HIV coinfection without a fully suppressive HIV regimen due to resistance risk.
• Tablets may be taken with or without food; swallow with water. The oral solution is available for those who cannot swallow tablets.
• Missed dose: a missed dose may be taken when remembered unless it is near the time of the next dose; do not double doses.
• Stopping therapy can cause severe hepatitis flares in HBV. Discontinuation should be medically supervised with liver monitoring.
• Drug interactions are uncommon, but complete medication lists should be reviewed to avoid duplicate NRTIs (e.g., emtricitabine).

• Store your tablets at 15–30 °C (59–86 °F) in a dry place.
• Keep in the original child‑resistant container with the label.
• Avoid bathroom humidity; protect from moisture and direct heat.
• For travel, keep doses in your carry‑on with your prescription label.
• Do not leave medicine in a parked car or near windows.
• If using the oral solution, keep the cap tightly closed and use the proper measuring device.
• Set phone reminders to help maintain a steady dosing schedule.

Benefits and Savings

Lamivudine helps reduce HBV DNA and improves liver enzyme trends in responsive patients. It is a simple, once‑daily HBV regimen and is well tolerated. In HIV treatment, lamivudine is a core NRTI paired with other agents and has a favorable safety profile. Tablets are small, and the oral solution supports those with swallowing difficulties.

Buying through a Canadian pharmacy can lower costs substantially. Many customers see 60–80% savings versus typical US prices when they buy lamivudine online. If paying out of pocket, comparing the lamivudine cost without insurance can help in selecting a sustainable long‑term supplier.

To check deals before you order, see our lamivudine coupon page.

Side Effects and Safety

• Common effects: headache, nausea, diarrhea, abdominal pain, fatigue, dizziness.
• Less common: cough, nasal symptoms, insomnia, rash.
• Laboratory changes: transient ALT/AST elevations, especially after discontinuation in HBV.
• Pediatric notes: risk of pancreatitis has been reported; monitor abdominal symptoms.
• When combined with other antiretrovirals, overall tolerability remains high; monitor per regimen.

Serious risks are rare but include lactic acidosis and severe hepatomegaly with steatosis, severe acute exacerbations of hepatitis B after stopping therapy, pancreatitis, and hypersensitivity reactions. Immune reconstitution inflammatory syndrome can occur in HIV after starting effective combination therapy. HBV/HIV coinfected patients require a fully suppressive HIV regimen to avoid HIV resistance.

Onset Time

For hepatitis B, HBV DNA typically begins to fall within 2–4 weeks, with ALT trends improving over 1–3 months. HBeAg seroconversion, when it occurs, may take several months or longer. Stopping lamivudine can lead to hepatitis flares, so follow the prescriber’s monitoring plan.

For HIV, lamivudine is used with other antiretrovirals. In a complete regimen, viral load reductions are usually seen within 2–8 weeks, with CD4 increases following over months. Time to target depends on baseline viral load, adherence, and companion agents.

Compare With Alternatives

Tenofovir disoproxil fumarate has a higher barrier to resistance for hepatitis B and is often preferred as first‑line HBV therapy. If your prescriber recommends switching due to resistance or response, Viread® may be considered based on clinical history and kidney/bone health.

Entecavir is another common HBV alternative with strong potency and a higher resistance barrier. It is typically used when prior lamivudine exposure or resistance is a concern, or when tenofovir is not appropriate. Dosing and monitoring differ by indication and prior treatment history.

For HIV regimen design, backbone options may pair an NRTI like lamivudine with an integrase inhibitor such as Isentress®. Protease inhibitors, including atazanavir (see Atazanavir), are used in selected cases. Choice depends on resistance, comorbidities, and drug‑interaction profiles.

Combination Therapy

• HBV monotherapy: lamivudine 100 mg daily is used; lack of response or resistance may prompt a switch to tenofovir or entecavir.
• HBV/HIV coinfection: use a fully suppressive HIV regimen that includes two NRTIs active against HBV (e.g., tenofovir plus lamivudine) to prevent HIV resistance.
• HIV regimens: lamivudine is paired with an additional NRTI and an anchor agent (integrase inhibitor, NNRTI, or protease inhibitor) per guidelines.
• Renal dosing: adjust lamivudine for reduced creatinine clearance; companion drugs may also need adjustment.
• Hepatic monitoring: after changes to therapy, monitor for HBV flare and liver enzymes.

Patient Suitability and Cost-Saving Tips

Lamivudine is used for adults and pediatric patients with chronic hepatitis B and for adults, adolescents, and children with HIV as part of combination therapy. It should not be used alone in HIV or in HBV/HIV coinfection without a complete HIV regimen. Hypersensitivity to lamivudine is a contraindication.

Use caution with severe renal impairment and in those with a history of pancreatitis. After stopping lamivudine in HBV, close liver monitoring is needed because flares can occur. In pregnancy, lamivudine is widely used; the decision to treat should be individualized by the prescriber. Breastfeeding guidance varies by indication and locale.

To lower out‑of‑pocket costs, consider a multi‑month supply when appropriate. A longer fill can reduce the per‑month lamivudine price and simplify scheduling. Reorder reminders can help prevent gaps in therapy. If paying cash, comparing the lamivudine cost without insurance and asking about lamivudine bulk purchase promotions may further reduce monthly spending.

Authoritative Sources

FDA Application 020564 (Epivir, lamivudine) overview

FDA Application 020698 (Epivir-HBV) overview

Health Canada Drug Product Database (Lamivudine) search

Order lamivudine from Youdrugstore.com: add to cart, upload your prescription, and we ship with prompt, express, cold-chain handling.

This information is educational and does not replace the advice of your healthcare provider. Always follow your prescriber’s instructions for your specific condition.