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Epivir is also approved for the treatment of hepatitis B (Epivir HBV). Studies have shown that Epivir can reduce the amount of hepatitis B virus to very low levels, although this effect does not always last. The treatment of Hepatitis B will likely require using combination therapy.


The recommended dosage of Epivir is 150 mg twice a day. There is also a 300 mg once a day formulation. Epivir is available in a syrup form for children. Epivir can be taken with or without food. There are also two new pills that combines Epivir with other nucleoside analog drugs, making it easier to take. Combivir combines 150mg of Epivir with 300mg of zidovudine (AZT, Retrovir). Trizivir contains the above plus 300 mg of abacavir (Ziagen). People who are allergic to abacavir should not take Trizivir. See the “”abacavir (Ziagen)”” FactSheet for detailed information about the potentially severe and sometimes fatal allergic reactions associated with this drug. ||||| Side


Epivir has few side-effects, mainly nausea, vomiting, headaches, and rare cases of hair loss. Although not as commonly as with some other anti-HIV drugs, Epivir 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 Epivir causes this problem, it may be necessary to switch to another anti-HIV drug to prevent permanent nerve damage. See the FactSheet “”Peripheral Neuropathy”” for other treatment options which might be helpful. Epivir can cause a side effect called pancreatitis, especially in children. Pancreatitis is a dangerous swelling of an organ in the body called the pancreas. People taking Epivir should be carefully monitored for this side effect.


A set of rare but serious side effects of nucleoside analog anti-HIV drugs is called lactic acidosis and severe hepatomegaly with steatosis (an enlarged fatty liver). Women, especially those who are oveweight, are particularly at risk. This set of side effects is probably the result of mitochondrial toxicity. Mitochondria are cell’s power organs that supply the energy needed for normal cell growth. Anti-HIV nucleoside analogs impair the function of mitochondria. This can lead to increased acid levels in the blood, and an enlarged fatty liver. The symptoms are severe nausea, shortness of breath and vomiting that does not get better. If you are taking anti-HIV drugs and experience these symptoms, tell your provider immediately. If you’re going to use Epivir, it’s important to check for infection with hepatitis B. If you have active hepatitis B when you start Epivir, 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 Epivir treatment is stopped. Symptoms of hepatitis B flare-ups are high liver enzymes, yellow skin (jaundice), nausea, vomiting, fatigue, abdominal and joint pain. Call The Network at 212-260-8868 or 800-734-7104 for more information on Hepatitis and HIV co-infection. GlaxoSmithKline, the maker of lamivudine (3TC, pivir), has a patient assistance program for people having problems getting the drug. The number to call is (800) 722-9294.

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