Discontinue use if rapidly elevating aminotransferase levels, progressive hepatomegaly or metabolic/lactic acidosis of unknown aetiology occur. Not to be used for HIV/HBV co-infected patients not receiving highly active antiretroviral therapy. Not to be used to reduce risk of HBV transmission. Not recommended for HIV infection. Lactic acidosis associated w/ severe hepatomegaly & hepatic steatosis; known risk factors of liver disease; pancreatitis; higher levels of serum lactate; pre-existing lamivudine-resistant HBV. Co-infection w/ hepatitis C or D; HIV w/ low CD4 cell counts (<200 cells/mm3
). Monitor hepatic function at repeated intervals for at least 6 mth after last dose. Frequently monitor virological response & perform resistance testing in lamivudine-refractory patients. Not to be used in galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. May affect ability to drive & use machines. Advance hepatic disease or cirrhosis; hepatitis exacerbation; Child-Turcotte-Pugh class C disease; liver transplant recipients. Renal impairment. Women of childbearing potential should use effective contraception. Not to be used during pregnancy & lactation. Ped & adolescents <16 yr.