Epivir-hbv 100 mg once daily or placebo.
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Geriatric patients are more likely to have decreased renal function and may require dose reduction and special monitoringClinical studies of Epivir-HBV did not contain significant numbers of elderly patients to determine if they would respond differently from younger patients.
Unplanned lamivudine therapy interruption may be necessary in specific situationssuch as serious drug toxicityintercurrent illness or surgery precluding oral intakesevere hyperemesis gravidarum unresponsive to antiemeticsor drug non-availabilityIf short-term treatment interruptioni.eless than 1 to 2daysis necessaryin general it is recommended that all antiretroviral agents be discontinued simultaneouslyespecially if the interruption is because of serious toxicityHoweverif a short-term treatment interruption is anticipated in the case of elective surgerythe pharmacokinetic properties and food requirements of specific drugs should be consideredWhen the antiretroviral regimen contains drugs with differing half-livesstopping all drugs simultaneously may result in functional monotherapy of the drug with the longest half-lifeFor exampleafter discontinuationthe duration of detectable drug concentrations of efavirenz and nevirapine range from less than 1 week to more than 3 weeksSimultaneously stopping all drugs in a regimen containing these agents may result in functional monotherapy with the NNRTI and may increase the risk of NNRTI-resistant mutationsPlanned long-term treatment interruptions are not recommended due to the potential for HIV disease progressioni.edeclining CD4 countsviral reboundacute viral syndromedevelopment of minor HIV-associated manifestations or serious non-AIDS complicationsdevelopment of drug resistanceincreased risk of HIV transmissionand increased risk for opportunistic infectionsIf therapy must be discontinuedcounsel patient on the potential risks and closely monitor for any clinical or laboratory abnormalities.
Epivir-HBV is not FDA approved for treatment of HIV-1 infectionlamivudine dosage in EPIVIR-HBV is subtherapeutic and monotherapy is inappropriate for the treatment of HIV-1 infection and the safety and efficacy of this drug have not been established in patients co-infected with HBV and HIVsevere acute exacerbations of hepatitis B reported in patients who have discontinued anti-hepatitis B therapyincluding HBV formulationhepatic function should be monitored closely with both clinical and laboratory follow-up for at least several months in patients who discontinue anti-hepatitis B therapyif appropriateinitiation of anti-hepatitis B therapy may be warranted.
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