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When using lamivudine (Epivir), it is essential to be aware of certain safety warnings and precautions to ensure proper treatment and avoid severe side effects. Below are key points to consider:

• HIV and Hepatitis B Co-infection Risks: If you have both HIV and hepatitis B, it is crucial to use the correct dosage of lamivudine. Using Epivir HBV, which is intended for hepatitis B, may not be sufficient for treating HIV and can lead to the virus becoming resistant. Always consult with your healthcare provider to ensure you are receiving the right treatment for both conditions. If you stop taking lamivudine, your hepatitis symptoms may worsen, so do not stop without medical advice. Your doctor will likely monitor your liver function for several months after discontinuation.

• Liver and Lactic Acidosis Concerns: There is a risk of developing severe liver problems and lactic acidosis, particularly in females or those with a larger body size. Regular blood tests are necessary to monitor liver health. Be vigilant for symptoms such as stomach pain, yellowing skin or eyes, dark urine, weakness, muscle pain, or breathing difficulties, and contact your healthcare provider immediately if they occur.

• Pancreatitis in Children: Lamivudine can cause inflammation of the pancreas, especially in children. Symptoms include upper stomach pain, fever, nausea, and vomiting. If your child experiences these symptoms, seek medical attention promptly.

• Immune Reconstitution Syndrome: When treating HIV with Epivir, your immune system may become overactive and start attacking normal body cells. Symptoms such as fever, pain, hair loss, bulging eyes, or sweating should be reported to your healthcare provider, as they may indicate this condition.

• Sorbitol Interaction: For children taking the oral solution of lamivudine, the presence of sorbitol, a sweetener, can reduce the medication's effectiveness. If your child weighs at least 14 kg (30 pounds), tablets are recommended. If the oral solution is necessary, more frequent blood tests will be needed to ensure the drug is working properly.

Always consult your healthcare provider for any concerns or questions regarding lamivudine treatment, and follow their recommendations closely.

Common side effects:

• Headaches
• Nausea
• Tiredness
• Runny nose
• Congestion
• Cough
• Diarrhea
• Trouble sleeping
• Nerve or muscle pain
• Fever
• Chills
• Dizziness
• Lack of appetite

Less common but important to monitor:

• Belly pain
• Cramps
• Indigestion
• Feelings of depression
• Skin rashes
• Joint and muscle pain

Serious side effects:

• Severe liver problems
• Lactic acidosis
• Serious allergic reactions

Interactions with high risk of serious adverse effects and should be avoided:

• Emtricitabine

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Cabotegravir
• Horsetail

Interactions with low risk that usually do not require a change in therapy:

• Orlistat
• Sorbitol