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Database of Antiretroviral Drug Interactions

All Interactions with Lamivudine (Epivir)

Coadministered DrugDose of DrugDose of LamivudineEffect on Drug LevelsEffect on Lamivudine LevelsPotential Clinical EffectsMechanism of InteractionManagement
Abacavir66, 67
(ABC)(Ziagen)
600 mg x 1 dose150 mg x 1 doseNo significant changeLamivudine Cmax: decreased 35%; AUC: decreased 15%- Delayed lamivudine absorption

No dose adjustment necessary

Adefovir263
(Hepsera)
10 mg QD-No significant change---

No dose adjustment necessary

Amprenavir60
(APV)(Agenerase)
150 mg x 1 dose150 mg x 1 doseNo significant changeNo significant change- -

No dose adjustment necessary

Atazanavir106,
(ATV)(Reyataz)
400 mg QD x 6 days150 mg BID with zidovudine 300 mg BID x 6 daysNot studiedNo significant change--

No dose adjustment necessary

Buprenorphine442
(Suboxone)(Buprenex)
14 mg QD300 mg QDNo significant change---

No dose adjustment necessary

Coadministered DrugDose of DrugDose of LamivudineEffect on Drug LevelsEffect on Lamivudine LevelsPotential Clinical EffectsMechanism of InteractionManagement
Chlorpropamide469
(others)(Diabinese)
250 mg x 1150 mg QD x 1Chlorpropamide AUC: decreased 45%; Cmax: decreased 30%-Potentially increased serum glucose concentrations-

Consider alternative agent

Alternative Agents:
Glyburide, glipizide, metformin

Co-trimoxazole332, 333
(TMP/SMX, Trimethoprim/Sulfamethoxazole)(Bactrim, Septra)
160 mg/800 mg QD x 5 days300 mg QD x 1doseNot studiedLamivudine AUC: increased 44%Increased lamivudine effects-

No dose adjustment necessary

Efavirenz90
(EFV)(Sustiva)
600 mg x 14 days150 mg Q12H x 14 daysNot studiedNo significant change--

No dose adjustment necessary

Entecavir391
(Baraclude)
--No significant changeNo significant change--

No dose adjustment necessary

Indinavir16
(IDV)(Crixivan)
800 mg Q8H x 1 week150 mg BID x 1 weekNo significant changeNo significant change- -

No dose adjustment necessary

Methadone202
(Dolophine)(Dolophine)
-150 mg lamivudine/300 mg zidovudine (combination tablet)No significant effectNot studied--

No dose adjustment necessary

Coadministered DrugDose of DrugDose of LamivudineEffect on Drug LevelsEffect on Lamivudine LevelsPotential Clinical EffectsMechanism of InteractionManagement
Nelfinavir24
(NFV)(Viracept)
750 mg Q8h x 7-10 days150 mg x 1 doseNot studiedLamivudine AUC: no significant change; Cmax: increased 31%Increased lamivudine effects-

No dose adjustment necessary

Ribavirin236
(Rebetol, Virazole)
800 mg QD150 mg BID-No significant change--

No dose adjustment necessary

Stavudine86
(d4T)(Zerit)
--No significant changeNo significant change--

No dose adjustment necessary

Tenofovir disoproxil fumarate96, 97
(TDF)(Viread)
300 mg QD x 7 days150 mg BID x 7 daysNo significant changeLamivudine Cmax: decreased 24%- -

No dose adjustment necessary

Tipranavir154
(TPV)(Aptivus)
1250 mg BID with 100 mg ritonavir BID x 42 doses150 mg BID x 43 doses-Lamivudine Cmax: decreased 29%--

No dose adjustment necessary

Tipranavir154
(TPV)(Aptivus)
250 mg BID with 200 mg ritonavir BID150 mg BID x 43 doses-No significant change--

No dose adjustment necessary

Tipranavir154
(TPV)(Aptivus)
750 mg BID with 100 mg ritonavir BID x 42 doses150 mg BID x 43 doses-No significant change--

No dose adjustment necessary

Zidovudine81
(AZT, ZDV)(Retrovir)
--Zidovudine Cmax: increased 39%No significant changeIncreased zidovudine effects-

No dose adjustment necessary

"-" indicates that there are no data available
 16:Crixivan [package insert]. Whitehouse Station, NJ: Merck & Co., Inc.; Oct 2005.
 24:Viracept [package insert]. La Jolla, CA: Agouron Pharmaceuticals, Inc.; Sept 2004.
 60:Agenerase [package insert]. Research Triangle Park, NC: Glaxo Wellcome Inc; 2004.
 66:Ziagen [package insert]. Research Triangle Park, NC: GlaxoWellcome Inc.; Sept 2005.
 67:Wang LH, Chittick GE, McDowell JA. Single-dose pharmacokinetics and safety of abacavir (1592U89), zidovudine and lamivudine administered alone and in combination in adults with human immunodeficiency virus infection. Antimicrob Agents Chemother 1999;43:1708-15.
 81:Retrovir [package insert]. Research Triangle Park, NC: GlaxoWellcome; Sept 2005.
 86:Zerit [package insert]. Princeton, NJ: Bristol-Myers Squibb Immunology; Sept 2005.
 90:Sustiva [package insert]. Princeton, NJ: Bristol-Myers Squibb Company; Dec 2011.
 96:Viread [package insert]. Foster City, CA: Gilead Sciences, Inc.; March 2006.
 97:Kearney B, Flaherty J, Sayre J, et al. A multiple-dose, randomized, crossover, drug interaction study between tenofovir DF and lamivudine or didanosine [abstract #337]. 1st International AIDS Society Conference on HIV Treatment and Pathogenesis; 2001 July 8-11th; Buenos Aires, Argentina.
 106:Mummaneni V, Randall D, Geraldes M, et al. Steady-state pharmacokinetic (PK) interaction study of atazanavir (ATV) with lamivudine (3TC) and zidovudine (ZDV) in healthy subjects. [abstract #H-1713]. 42nd Interscience Conference on Antimicrobial Agents and Chemotherapy; 2002 September 27-30; Chicago, Illinois.
 154:Aptivus [package insert]. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc.; Nov 2005.
 202:Rainey PM, Friedland GH, Snidow JW, et al. The pharmacokinetics of methadone following co-administration with a lamivudine/zidovudine combination tablet in opiate-dependent subjects. Am J Addictions 2002;11:66-74.
 236:Gries J-M, Torriani FJ, Rodriguez-Torres M, et al. Effect of ribavirin on intracellular and plasma pharmacokinetics of nucleoside reverse transcriptase inhibitors in patients with HCV/HIV co-infection: final results of a randomized clinical study [abstract #136LB]. 11th Conference on Retroviruses and Opportunistic Infections; 2004 Feb 8-11; San Francisco, California.
 263:Hepsera [package insert]. Foster City, CA: Gilead Sciences, Inc. 2002.
 332:Moore KH, Yuen GJ, Raasch RH, et al. Pharmacokinetics of lamivudine administered alone and with trimethoprim-sulfamethoxazole. Clin Pharmacol Ther 1996;59:550-58.
 333:Epivir [package insert]. Research Triangle Park, NC: GlaxoWellcome; Nov 2005.
 391:Baraclude [package insert]. Princeton, NJ: Bristol-Myers Squibb Company; 2005.
 442:Gruber VA, Baker J, Moody DE, et al. Interactions between buprenorphine and antiretrovirals: nucleos(t)ide reverse transcriptase inhibitors didanosine, lamivudine and tenofovir [abstract A1-1306]. 49th Interscience Conference on Antimicrobial Agents and Chemotherapy; 2009 September 12-15; San Francisco, California.
 469:Bakare-Odunola MT, Enemaili I, Garba M, et al. The influence of lamivudine, stavudine and nevirapine on the pharmacokinetics of chlorpropamide in human subjects. Eur J Drug Metab Pharmacokinet 2008; 33: 165-71.