Lamivudine: A Comprehensive Overview

Lamivudine is a prescription nucleoside reverse transcriptase inhibitor (NRTI) that is used in combination with other drugs as antiviral treatment for human immunodeficiency virus type-1 (HIV-1) and as a monotherapy for hepatitis B virus (HBV).^[1]

Uses

Lamivudine is a prescription nucleoside reverse transcriptase inhibitor (NRTI) that is used in combination with other drugs as antiviral treatment for human immunodeficiency virus type-1 (HIV-1) and as a monotherapy for hepatitis B virus (HBV).

Mechanism of Action

Lamivudine is a dideoxynucleoside cytosine analog that inhibits viral DNA synthesis via reverse transcriptase DNA chain termination post phosphorylation. Once inside the cell, lamivudine, 2'-deoxy-3'-thiacytidine, is metabolized to the triphosphate form, lamivudine triphosphate (abbreviated as 3TC-TP or L-TP), and the monophosphate form, lamivudine monophosphate (abbreviated as 3TC-MP or L-MP), during intracellular kinase phosphorylation. Both forms, L-TP and L-MP, inhibit viral DNA synthesis. Lamivudine is advantageous as an antiviral drug because it is primarily not recognized by human polymerase as a substrate.

Side effects

Minor side effects may include nausea, fatigue, headaches, diarrhea, cough and nasal congestion.

Do not prescribe lamivudine/zidovudine, abacavir/lamivudine, or abacavir/lamivudine/zidovudine to patients taking emtricitabine.

Long-term use of lamivudine can trigger a resistant hepatitis B virus (YMDD) mutant.

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