LYCOS RETRIEVER 
Lamivudine: Patients
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Lamivudine is an effective antiviral agent for treatment of patients with chronic hepatitis B and advanced liver diseases. However, long-term lamivudine monotherapy leads to the emergence of lamivudine-resistant hepatitis B virus (HBV) mutants in some patients chronically infected with HBV. Sensitive methods for early detection of lamivudine-resistant mutants will help physicians make clinical decisions in treating patients with HBV infection ...(continued)
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Lamivudine is not a cure for hepatitis B virus infection. It is unknown if Lamivudine reduces the risk of liver cancer or cirrhosis that may be caused by hepatitis B virus. Some patients developed hepatitis B virus that is resistant to Lamivudine . These patients had less benefit from Lamivudine and some experienced worsening of hepatitis after the resistant virus appeared.
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Lamivudine dosage should be adjusted in accordance with renal function in patients with creatinine clearance below 50 ml/min. No additional dosing of lamivudine is required after routine (4-hour) hemodialysis or peritoneal dialysis.[12]
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Lamivudine has been well studied in the treatment of chronic hepatitis B infection. Potential compliance problems, frequency of administration, and adverse effects should be discussed with patients before initiating therapy to help prevent the emergence of resistance.
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High levels of lactic acid in the blood and severe, life-threatening liver problems have been reported with the use of Lamivudine alone or with other medicines. HIV counseling and testing should be offered to all patients before treatment for hepatitis B virus is started with Lamivudine and periodically during treatment. Lamivudine has a lower dose of the same active ingredient (lamivudine) than in Epivir, a medicine used to treat HIV infection. These formulations are not interchangeable. If Lamivudine is prescribed for a patient with hepatitis B virus and undiagnosed or untreated HIV infection, the HIV infection will be less treatable with Lamivudine and other medicines. Worsening of hepatitis B virus infection has been reported in patients who stop taking Lamivudine . Patients should have their liver function monitored closely for at least several months after stopping use of Lamivudine .
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Lamivudine is widely distributed after administration. Lamivudine crosses the blood-brain barrier and is distributed into the cerebrospinal fluid (CSF) to a limited extent. In children, CSF concentrations have ranged from 10% to 17% of the corresponding non-steady-state serum concentration.[18] Apparent volume of distribution after intravenous (IV) administration in 20 patients was 1.3 +/- 0.4 l/kg, suggesting that lamivudine distributes into extravascular spaces. The volume of distribution was independent of dose and did not correlate with body weight.[19]
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