How
Does EPIVIR-HBV Work?
The
lamivudine in EPIVIR-HBV can reduce the ability of the hepatitis B virus to multiply
and infect new liver cells. It may help to lower the amount of hepatitis B virus
in your body.
EPIVIR-HBV
does not cure chronic hepatitis B and does not reduce the risk of spreading hepatitis
B to others.
Important
Safety Information About EPIVIR-HBV
Please
read this information before you start taking EPIVIR-HBV (pronounced EP-i-veer
h-b-v). Re-read it each time you get your prescription, in case some information
has changed. This information does not take the place of careful discussions
with your doctor when you start this medication and at checkups. Stay under a
doctors care when you take EPIVIR-HBV and do not change or stop treatment
without first talking with your doctor.
What
is EPIVIR-HBV?
EPIVIR-HBV is the brand name of a product that contains
lamivudine, a drug used to treat chronic hepatitis B in patients with actively
growing virus and liver inflammation. Hepatitis B can cause damage to cells in
the liver. Eventually, this can scar the liver.
The
lamivudine in EPIVIR-HBV can reduce the ability of the hepatitis B virus to multiply
and infect new liver cells. It may help to lower the amount of hepatitis B virus
in your body. EPIVIR-HBV contains a lower dose of lamivudine than the dose in
EPIVIR®, COMBIVIR®, and TRIZIVIR®.
Why
should I consider HIV testing before starting treatment with EPIVIR-HBV?
Your
doctor or healthcare provider should offer you counseling and testing for HIV
infection (sometimes called the AIDS virus) before treatment for hepatitis B is
started with EPIVIR-HBV, and periodically during treatment. EPIVIR-HBV Tablets
and EPIVIR-HBV Oral Solution contain a lower dose of the medicine than other lamivudine-containing
drugs, such as EPIVIR, COMBIVIR, and TRIZIVIR which are used to treat HIV. Treatment
with EPIVIR-HBV in HIV-infected patients may cause the HIV virus to be less treatable
with lamivudine and some other drugs.
If
I am HIV-positive, can I take EPIVIR-HBV?
People who have both chronic
hepatitis B and HIV should not take EPIVIR-HBV. EPIVIR-HBV Tablets and EPIVIR-HBV
Oral Solution contain a lower dose of the same drug (lamivudine) as EPIVIR Tablets,
EPIVIR Oral Solution, COMBIVIR Tablets, and TRIZIVIR Tablets. If you have both
hepatitis B and HIV, make sure that your doctor or healthcare provider is aware
that you have both infections. If you are prescribed lamivudine as part of your
combination treatment for HIV, you should use only the products and doses that
are intended for treatment of HIV infection, because the lower dose of lamivudine
in EPIVIR-HBV could cause the HIV virus to be less responsive to treatment. If
you are planning to change your HIV treatment to a regimen that does not include
EPIVIR, COMBIVIR, or TRIZIVIR, you should first discuss this change with your
doctor or healthcare provider.
Does
EPIVIR-HBV cure hepatitis B infection?
EPIVIR-HBV is not a cure for hepatitis
B. In studies comparing EPIVIR-HBV with placebo (an inactive sugar pill) for 1
year, more people treated with EPIVIR-HBV had reductions in liver inflammation.
It is not known whether EPIVIR-HBV will reduce the risk of getting liver cancer
or cirrhosis that may be caused by the hepatitis B virus.
In
studies, some patients developed hepatitis B viruses that are resistant to EPIVIR-HBV.
These patients generally had less benefit from treatment with EPIVIR-HBV. Some
patients have had worsening of hepatitis after resistant virus appears. The long-term
importance of a resistant virus is not known.
What
happens if I stop taking EPIVIR-HBV?
After stopping treatment with EPIVIR-HBV,
some patients have had symptoms or blood tests showing that their hepatitis has
gotten worse. Therefore, your doctor should check your health, which may include
blood tests, for at least several months after stopping treatment with EPIVIR-HBV.
Tell your doctor right away about any new or unusual symptoms that you notice
after stopping treatment.
Who
should not take EPIVIR-HBV?
You should not take EPIVIR-HBV if you have
or may have HIV infection (sometimes called the AIDS virus). EPIVIR-HBV does not
contain an appropriate dose of lamivudine for treatment of HIV infection, and
using EPIVIR-HBV could cause the HIV virus to become less treatable with lamivudine
and some other drugs.
You
should not take EPIVIR-HBV if you are also taking EPIVIR, COMBIVIR, or TRIZIVIR.
These drugs all contain lamivudine.
You
should not take EPIVIR-HBV if you have had an allergic reaction to lamivudine.
EPIVIR-HBV
has not been studied in children less than 2 years old.
Can
pregnant women and nursing mothers take EPIVIR-HBV?
There are no studies
of EPIVIR-HBV in pregnant women. If you are pregnant or if you become pregnant
while taking EPIVIR-HBV, notify your doctor or healthcare provider immediately.
EPIVIR-HBV
has not been shown to prevent the spread of the hepatitis B virus from mother
to infant.
It
is not known whether lamivudine is passed to the infant in breast milk. If there
is lamivudine in the breast milk, this could cause side effects in nursing infants.
Mothers should not breastfeed while taking EPIVIR-HBV or other forms of lamivudine.
How should
I take EPIVIR-HBV?
Your doctor will tell you how much EPIVIR-HBV to take.
The usual dose is 1 EPIVIR-HBV Tablet orally (by mouth) once a day. Your doctor
may prescribe a lower dose if you have problems with your kidneys. EPIVIR-HBV
may be taken with food or on an empty stomach. To help you remember to take your
EPIVIR-HBV as prescribed, you should try to take EPIVIR-HBV at the same time each
day. You must not skip doses or stop treatment without first talking with your
doctor or healthcare provider. A strawberry-banana-flavored liquid of EPIVIR-HBV
is available for patients who need a liquid.
If
you miss your regular time for taking your dose, but then remember it during that
same day, take your missed dose immediately. Then, take your next dose at the
regularly scheduled time the following day. Do not take 2 doses of EPIVIR-HBV
at once to make up for missing a dose. If you are not sure what to do if you miss
taking your medication, check with your doctor or healthcare provider for further
instructions.
EPIVIR-HBV
can usually be taken with many other medications; however, be sure to tell your
doctor or healthcare provider about all medications (including over-the-counter
and prescription drugs) that you are taking. EPIVIR-HBV Tablets and EPIVIR-HBV
Oral Solution contain a lower dose of the same drug (lamivudine) as EPIVIR Tablets,
EPIVIR Oral Solution, COMBIVIR Tablets, and TRIZIVIR Tablets; therefore, EPIVIR-HBV
should not be taken together with EPIVIR, COMBIVIR, or TRIZIVIR.
You
should talk to your doctor about any changes in your treatment.
What
are the possible side effects of EPIVIR-HBV?
You should stay under the
care of a doctor during treatment so you can be checked for possible serious side
effects. Serious side effects such as inflammation of the pancreas can occur with
EPIVIR-HBV. Lactic acid buildup in the body and an enlarged liver have been reported
with EPIVIR-HBV; this is not common but can result in death.
Hepatitis
B virus sometimes becomes resistant to EPIVIR-HBV during treatment, and some people
have had tests showing that their hepatitis was getting worse around the time
the virus became resistant. Some people also have worsening of hepatitis after
stopping EPIVIR-HBV. You should discuss any change in treatment with your doctor.
In
studies, the most common side effects seen during treatment with EPIVIR-HBV were
ear, nose, and throat infections; malaise and fatigue (feeling tired and run down);
headache; abdominal discomfort and pain; nausea and vomiting; diarrhea; muscle
pain; sore throat; joint pain; fever or chills; and skin rash.
This
list of possible side effects is not complete. Your doctor or pharmacist can discuss
with you a more complete list of possible side effects with EPIVIR-HBV. Talk to
your doctor right away about any side effects or other unusual symptoms that occur
when taking EPIVIR-HBV.