Neonatal Drug Therapy Manual


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.

Alternate Name(s): 
3TC, Heptovir
Original Date: 
December 2008
Revised Date: 
November 2020
  • 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
  • PO
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: 




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

- 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

- 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: (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

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