Lamivudine therapy should be stopped in patients who develop abdominal pain, nausea, or vomiting or with abnormal biochemical test results until pancreatitis has been excluded.
Treatment with lamivudine may be associated with lactic acidosis and should be discontinued if there is a rapid increase in aminotransferase concentrations, progressive hepatomegaly, or metabolic or lactic acidosis of unknown aetiology. Lamivudine should be used with caution in patients with hepatomegaly or other risk factors for hepatic disease. In patients with chronic hepatitis B, there is a risk of rebound hepatitis when lamivudine is discontinued, and liver function should be monitored in such patients. The possibility of HIV infection should be excluded before beginning lamivudine therapy for hepatitis B, since the lower doses used to treat the latter may permit the development of lamivudine resistant strains of HIV.
Dosage reduction may be necessary in patients with impaired renal function.
Effects on ability to drive and use machines: None known.