Neonatal Drug Therapy Manual

LamiVUDine

Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Updated January 26, 2022 - 6:00pm

Alternate Name(s): 
3TC, Heptovir
Classification: 
Antiretroviral
Original Date: 
December 2008
Revised Date: 
November 2020
Indications: 
  • Prevention of vertical transmission in a baby considered at high risk, when:
    • mother has a viral load that is not optimally suppressed at the time of delivery
    • mother is not on antiretroviral medications
Administration: 
  • PO
Dosage: 
Gestational Age (GA) Dose Duration
> 32 weeks 2 mg/kg/dose po q12h 4 weeks
Followed by:
4 mg/kg/dose po q12h 2 weeks
 
25 to < 32 weeks

1.5 mg/kg/dose po q12h *

 3 weeks
Followed by:
2 mg/kg/dose po q12h * 3 weeks

 * dose based on expert opinion

*** Lamivudine is used in combination with Zidovudine and Nevirapine for a six weeks course.  Lamivudine should be started as soon as possible after birth and no later than 2-6 hours after delivery.

Side Effects: 
  • Dermatologic: rash
  • GI: abdominal pain, diarrhea
  • Hematologic: hemoglobinemia, neutropenia, thrombocytopenia
  • Hepatic: elevated liver enzymes
Parameters to Monitor: 
  • CBC with differential (hemoglobin, absolute neutrophil count)
  • Liver transaminases (ALT, AST)
  • Lactic acid
Reconstitution and Stability: 

N/A

Compatibility: 

N/A

Notes: 
  • Must be ordered in consultation with Infectious Disease Department at CHEO
References: 

- Panel on Antiretroviral Therapy and Medical Management of Children Living with HIV.  Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. Versio Date: April 14, 2020. Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/pediatricguidelines.pdf.

- Panel on Treatment of HIV-Infected pregnant Women and Prevention of Perinatal Transmission.  Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1 Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in The United States. Version Date: Apr 14, 2020. Available at: http://aidsinfo.nih.gov/contentfiles/lvguideliens/PerinatalGL.pdf (Table 7)

- Guidelines for the Prevention of Mother-to-Child HIV Transmission.  Information and Practice Guidance for Health Practitioners in Ontario.  Working with HIV-infected Women with Inadequate Control of HIV, and Women with Unknown HIV Status Who Present in Labor. Version Date: January 20, 2017

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.