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MORE INFORMATION ON: EPIVIR

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3TC, trade name Epivir (also known as lamivudine), is an anti-HIV treatment in the same class of drugs as AZT, ddI, ddC and d4T. These drugs are called nucleoside analogs. The body breaks down these drugs into chemicals that stop HIV from infecting uninfected cells in the body, but they do not help cells that have already been infected with the virus. As people with AIDS lose T4 cells - one of the immune systems main defenses - they become more likely to get infections and illnesses.

Studies have shown that when taken alone 3TC has a strong anti-HIV effect at first, but the virus can quickly become resistant and the anti-HIV effects wear off. Many studies have now shown that using 3TC in combination with two other anti-HIV drugs can prevent the virus from getting resistant, and this has helped people live longer and get less opportunistic infections. 3TC is an important part of combination anti-HIV treatment. Ideally, 3TC should be used as part of a carefully chosen combination of anti-HIV treatments in order to get the most benefit.

New Public Health Service HIV treatment guidelines say that the best way to use 3TC is in combination with other anti-HIV drugs. The guidelines recommend combinations of three or four anti-HIV drugs as first treatment for HIV:

Two nucleoside analogs (AZT+3TC, d4T+3TC, d4T+ddI, AZT+ddI, or AZT+ddC) with one of the following: Crixivan, Fortovase, Norvir, Sustiva, Viracept or Norvir and Fortovase combined.
If one of the above combinations cannot be used, an alternative is two nucleoside analogs (same combinations as listed above) with Viramune or Rescriptor.
Studies have also shown that 3TC can reduce the amount of hepatitis B virus to very low levels, although this effect does not always last. 3TC is not yet approved for the treatment of hepatitis B.

Dosage: The recommended dosage of 3TC is 150 mg twice a day. 3TC is also available in a syrup form for children. 3TC can be taken with or without food. There is also a pill that combines 3TC with another nucleoside analog drug made by the same manufacturer. This pill is called Combivir and combines 150mg of 3TC with 300mg of AZT.

Side effects: 3TC has few side-effects, mainly nausea, vomiting, headaches, and rare cases of hair loss. Although not as common as with some other anti-HIV drugs, 3TC can cause damage to the nerves in the hands and feet. This condition is called peripheral neuropathy. The symptoms of peripheral neuropathy are burning or numbing sensations in the hands and feet which can become very painful. If 3TC causes this problem, it may be necessary to switch to another anti-HIV drug to prevent permanent nerve damage.

In children, 3TC can cause a side effect called pancreatitis. Pancreatitis is a dangerous swelling of an organ in the body called the pancreas. Children taking 3TC should be carefully monitored for this side effect.

A rare but serious side effect of nucleoside analog anti-HIV drugs is called lactic acidosis. This side effect is caused by the drugs damaging liver cells. The symptoms are severe nausea and vomiting that does not get better. If you're taking anti-HIV drugs and experiencing these symptoms, make sure your provider has checked for lactic acidosis.

Warning: If you're going to use 3TC, it's important to check for infection with hepatitis B. If you have active hepatitis B when you start 3TC, you may feel sick for a month or two because liver cells infected with hepatitis B die off. Liver enzymes may also increase temporarily. These symptoms are a lot like some drug side effects, and knowing your hepatitis status can help tell the difference. There have also been several reports of hepatitis B flare-ups when 3TC treatment is stopped. Symptoms of hepatitis B flare-ups are high liver enzymes, yellow skin (jaundice), nausea and vomiting.

Glaxo-Wellcome has a patient assistance program for people having problems getting the drug. The number to call is (800) 722-9294. People that have been receiving the drug through the expanded access program and who now need help with reimbursement should call (800) 513-3028.

1 Based on information obtained from manufacturer's/retailer's website.
2 Reflects approximately average retail price as provided by popular online drugstores and other supplement outlets.
3 Reflects approximately average shipping costs as provided by popular online drugstores and other supplement outlets.
4 Our opinion only, not based on statistical analysis of study results supplied by manufacturer or other source.
5 Based on our opinion only, calculated by considering its price, shipping costs, efficacy, ingredients/content, value or any combination of the categories.