Lamivudine

Caitlin Soto, PharmD, BCIDP, Paul G. Auwaerter, M.D.

INDICATIONS

FDA

  • Treatment of HIV-1 infection in combination with other antiretrovirals.
  • Treatment of chronic HBV infection associated with evidence of HBV replication and active liver inflammation (EPIVIR-HBV).

NON-FDA APPROVED USES

  • Treatment of HBV in patients with HIV/HBV coinfection as part of fully suppressive ART containing 3TC plus TAF or TDF.
    • Do not use 3TC as the sole HBV-active agent.

FORMS

brand name

preparation

manufacturer

route

form

dosage^

cost*

Epivir

Lamivudine (3TC)

ViiV Healthcare

oral

solution

10 mg/mL (240 mL)

$102.21

oral

tablet

150 mg

$8.31

oral

tablet

300 mg

$16.63

Lamivudine

Lamivudine (3TC)

Generics

oral

solution

10 mg/mL (240 mL)

$73.02

oral

tablet

150 mg

300 mg

$0.61

$1.21

Epivir HBV (for HBV infection)

Lamivudine (3TC)

GSK

oral

tablet

100 mg

$8.93

oral

solution

5 mg/mL

$0.10 per mL

Generic AZT/3TC (brand Combivir discontinued)

Lamivudine (3TC)/Zidovudine (AZT)

ViiV Healthcare and generic manufacturer (Aurobindo Pharma Limited)

oral

tablet

150 mg 3TC/300 mg AZT

$1.92

Trizivir (US discontinued)

Abacavir/3TC/AZT

ABC 300 mg + 3TC 150 mg + AZT 300 mg

No longer available in the US (2023)

Generic ABC/3TC

Lamivudine (3TC)/Abacavir (ABC)

Generic

oral

tablet

ABC 600 mg + 3TC 300 mg

$1.08

Kivexa (brand name available in Europe, previously Epzicom in the US)

ABC + 3TC

ViiV Healthcare

oral

tablet

ABC 600 mg + 3TC 300 mg

variable

Dovato

Lamivudine (3TC)/Dolutegravir (DTG)

ViiV Healthcare

oral

tablet

DTG 50 mg + 3TC 300 mg

$99.88

Triumeq

Dolutegravir/ABC/3TC

ViiV Healthcare

oral

tablet

ABC 600 mg + DTG 50 mg +3TC 300 mg

$160.67

Triumeq PD

Dolutegravir/ABC/3TC

ViiV Healthcare

oral

tablet for oral suspension

ABC 60 mg + DTG 5 mg +3TC 30 mg

$26.61-$31.00

Cimduo

Lamivudine (3TC)/Tenofovir disoproxil (TDF)

Viatris

oral

tablet

TDF 300 mg + 3TC 300 mg

$38.24

Delstrigo

Doravirine + 3TC + TDF

Merck & Co.

oral

tablet

DOR 100 mg + 3TC 300 + TDF 300 mg

$114.82

Symfi

EFV + 3TC + TDF

Viatris

oral

tablet

EFV 600 mg + 3TC 300 mg + TDF 300 mg

$80.90

EFV + 3TC + TDF

Generic

oral

tablet

EFV 600 mg + 3TC 300 mg + TDF 300 mg

$57.33

Symfi Lo (brand discontinued)

EFV + 3TC + TDF

Generic

oral

tablet

EFV 400 mg + 3TC 300 mg + TDF 300 mg

$57.33

*Prices represent the cost per unit specified and are representative of the "Average Wholesale Price" (AWP).
^Dosage is indicated in mg unless otherwise noted.

USUAL ADULT DOSING

  • Oral lamivudine, also known as 3TC.
    • Note: Lamivudine formulations used for HIV contain higher lamivudine doses than Epivir-HBV formulations; Epivir-HBV should not be substituted for HIV treatment.
    • For combination tablets, be certain to understand the drugs and dosages contained in each.
  • Review baseline and prior resistance results when selecting a lamivudine-containing regimen.
    • Some lamivudine-containing fixed-dose products (e.g., ABC/3TC or TDF/3TC) are NRTI backbones and are not complete HIV regimens.
  • Severe hepatitis B exacerbations may occur when lamivudine or other HBV-active therapy is stopped in patients with chronic HBV infection, including HIV/HBV coinfection; monitor clinical status and liver tests for several months after discontinuation.
  • HIV treatment: in combination with other antiretroviral agents.
    • 150 mg twice daily or 300 mg once daily
    • ABC/3TC, including DTG/ABC/3TC, is no longer recommended for most initial ART but may be considered when tenofovir-containing regimens or DTG/3TC cannot be used.
      • Test for HLA-B*5701 before use and consider potential cardiovascular risk with ABC.
  • HIV post-exposure prophylaxis (off-label): initiate as soon as possible, ideally within 24 h and no later than 72 h after exposure; give as part of an appropriate 3-drug regimen.
    • Duration: 28 days
  • HBV: 100 mg once daily
    • Lamivudine monotherapy is generally not preferred for chronic HBV because of its low genetic barrier to resistance.
    • Duration is generally prolonged and should follow current HBV treatment guidance; abrupt discontinuation may result in HBV reactivation/hepatitis flare.
      • Lamivudine monotherapy is generally not preferred for chronic HBV because of its low genetic barrier to resistance.
    • HIV/HBV coinfection:
      • 3TC 300 mg once daily (or 150 mg twice daily) as part of fully suppressive ART that also contains TAF or TDF.
  • Combination tablet dosings:
    • Abacavir 600 mg/3TC 300 mg (previously known as Epzicom): 1 tablet PO once daily (with or without food)
    • Cimduo: 1 tablet PO once daily
      • Combine with a third active ARV because 3TC/TDF alone is not a complete HIV regimen.
      • FDA label for adults and pediatric patients ≥35 kg.
    • Combivir (3TC 150 mg/AZT 300 mg): 1 tab PO twice daily
    • Delstrigo: 1 tablet PO once daily
      • Doravirine is a CYP3A substrate; rifabutin is a moderate CYP3A inducer that lowers doravirine exposure.
        • If Delstrigo is coadministered with rifabutin, continue Delstrigo once daily and add doravirine 100 mg approximately 12 hours after Delstrigo for the duration of rifabutin therapy.
    • Dovato: 1 tab PO once daily
      • DTG/3TC is not recommended for:
        • HIV RNA >500,000 copies/mL
        • HBV coinfection unless another HBV-active agent is given
        • When ART must begin before genotype/HBV results are available
        • After CAB-LA PrEP unless INSTI susceptibility has been documented.
    • Epivir:
      • 3TC 300 mg PO once daily or 150 mg PO twice daily
    • Trizivir: 1 tablet PO twice daily
    • Triumeq: 1 tablet PO once daily
    • Symfi: 1 tablet PO once daily on an empty stomach, preferably at bedtime
    • Symfi Lo: 1 tablet PO once daily on an empty stomach, preferably at bedtime

ADULT RENAL DOSING

General

  • Renal dosing below refers to HIV-dose lamivudine.
  • Epivir-HBV uses different renal dose reductions; see HBV module or Epivir-HBV FDA prescribing information.

DOSING IN HEMODIALYSIS

  • iHD: 50 mg x1, then 25 mg once daily (post-HD)
    • No additional lamivudine dose is required after routine 4-hour HD session.

DOSING IN PERITONEAL DIALYSIS

  • 50 mg x1, then 25 mg once daily.
    • No additional lamivudine dose is required after routine PD session.

DOSING IN RENAL REPLACEMENT THERAPY

  • No data; consider 150 mg PO once daily in continuous RRT.

Other Adult Renal Dosing

  • CrCl
    • ≥50 mL/min: Usual dosing
    • 30-49 mL/min: 150 mg PO daily
    • 15-29 mL/min: 150 mg PO on day 1, then 100 mg once daily
    • 5-14 mL/min: 150 mg PO on day 1, then 50 mg once daily
    • < 5 mL/min: 50 mg PO on day 1, then 25 mg once daily

PEDIATRIC DOSING

USUAL PEDIATRIC DOSING

  • Once-daily dosing is NOT recommended when initiating 3TC in infants and young children.
    • Simple oral solution weight bands apply to children ≥4 weeks and ≥3 kg, as reflected in the NIH pediatric dosing guidance.
  • Neonate/Infant (< 4 weeks old):
    • For prevention of transmission or treatment of HIV: 2 mg/kg/dose oral solution twice daily
  • Pediatrics
    • ≥4 weeks to < 3 months:
      • 4 mg/kg/dose (max 150mg/dose) oral solution twice daily
    • ≥ 3 months to < 3 years:
      • 5 mg/kg/dose (max 150mg/dose) oral solution twice daily
    • ≥ 3 years
      • 5 mg/kg/dose (max 150mg/dose) oral solution twice daily OR 10 mg/kg once daily of the oral solution (maximum 300 mg per dose)
  • Pediatric dosing for scored 150-mg tablet (weight ≥14 kg):
    • 14 to < 20 kg: 75 mg PO twice daily
    • ≥20 to < 25 kg: 75 mg AM/150 mg PM
    • ≥25 kg: 150 mg twice daily or 300 mg once daily
  • Child and adolescent weighing ≥25 kg and adult:
    • 150 mg PO twice daily or 300 mg PO once daily.
  • Weight-based dosing:
    • 3 kg to < 6kg: 3 mL oral solution twice daily
    • 6 kg to < 10 kg: 4 mL oral solution twice daily
    • 10 kg to < 14kg: 6mL oral solution twice daily
  • For weight-based dosing and how to dose combination pills containing lamivudine: see the 3TC page in the Guidelines for the use of Antivirals in Pediatric HIV.
  • For HBV:
    • Children ≥2 years and Adolescents: 3 mg/kg/dose (max 100 mg/dose) once daily

PEDIATRIC RENAL DOSING

  • Infants/Children: Requires renal dosage adjustment. Insufficient data exist to recommend specific dosing; however, the following has been suggested (Aronoff 2007):
    • CrCl 30-50 mL/min: 4 mg/kg/dose once daily
    • CrCl 10-29 mL/min: 2 mg/kg/dose once daily
    • CrCl < 10 mL/min: 1 mg/kg/dose once daily
    • HD: 1 mg/kg/dose once daily; dose after HD on HD days
  • Children and Adolescents ≥30 kg:
    • CrCl ≥50 mL/min: usual dose
    • CrCl 30-49 mL/min: 150 mg once daily
    • CrCl 15-29 mL/min: 150 mg x 1, then 100 mg once daily
    • CrCl 5-14 mL/min: 150 mg x 1, then 50 mg once daily
    • CrCl < 5 mL/min: 50 mg x 1, then 25 mg once daily
    • HD: 50 mg x 1, then 25 mg once daily; dose after HD on HD days

ADVERSE DRUG REACTIONS

GENERAL

  • One of the best-tolerated NRTIs, with a side-effect profile comparable to placebo in hepatitis trials.

COMMON

  • Headache
  • Nausea

OCCASIONAL

  • GI: diarrhea, abdominal pain
  • Insomnia (association unclear; may be due to coadministered ARVs)
  • Hepatitis flare or fulminant hepatitis (in HBV co-infected pts if 3TC withdrawn or with the development of 3TC-resistant HBV)

RARE

  • Lactic acidosis: listed as an NRTI class effect, but unlikely to be caused by 3TC.
    • In vitro, 3TC, TDF, FTC, and ABC are not associated with mitochondrial toxicity.
  • Pancreatitis (reported in pediatric pts)

DRUG INTERACTIONS

  • Lamivudine itself has few CYP-mediated interactions because it is not a CYP substrate, inhibitor, or inducer.
  • However, clinically relevant issues include reduced lamivudine exposure with sorbitol-containing products.
Drug-to-Drug Interactions

Drug

Effect of Interaction

Recommendations/Comments

Abacavir

3TC AUC decreased by 15%; Cmax decreased by 35%.

Not clinically significant. Use standard dose.

Methadone

No reported interaction. Methadone: No change.

Not clinically significant. Use standard dose.

Sorbitol

Sorbitol decreases lamivudine exposure in a dose-dependent manner.

Avoid chronic coadministration when possible.

Trimethoprim/Sulfamethoxazole

3TC AUC increased by 44%.

TMP-SMX increases lamivudine AUC by ~44%; usually no dose adjustment unless renal function warrants a lamivudine dose adjustment

  • Also, duplicate therapy with other lamivudine- or emtricitabine-containing products, renal-function constraints with fixed-dose combinations, and interactions driven by coformulated agents such as dolutegravir, doravirine, abacavir, zidovudine, efavirenz, or TDF may occur unintentionally.
    • Note on coformulations: also see specific drug module used in any coformulation.

      • Duplicate 3TC/FTC

        Do not coadminister with other lamivudine-containing products or emtricitabine-containing products.

      • Dovato/Triumeq

        Note DTG-driven interactions: dofetilide is contraindicated; rifampin or carbamazepine require additional dolutegravir dosing; avoid oxcarbazepine, phenytoin, phenobarbital, and St. John’s wort; separate polyvalent cations unless taken with food as allowed; monitor metformin/dalfampridine interactions.

      • Delstrigo

        DOR is a CYP3A substrate; strong CYP3A inducers are contraindicated because they can substantially reduce doravirine exposure. If rifabutin is coadministered, add doravirine 100 mg approximately 12 hours after Delstrigo.

SPECTRUM

HIV and HBV

RESISTANCE

HIV resistance:

  • M184V/I causes high-level 3TC/FTC resistance; M184V reduces HIV replication capacity (viral fitness) and increases susceptibility to AZT and TDF. K65R reduces 3TC susceptibility approximately 5–10-fold.
  • T69 insertion and Q151M complexes may also reduce susceptibility. TAMs alone do not confer high-level 3TC resistance.

HBV resistance:

  • YMDD-region mutations, particularly rtM204V/I, often with rtL180M.

PHARMACOLOGY

MECHANISM

Intracellular phosphorylation to active lamivudine triphosphate, which inhibits HIV reverse transcriptase and HBV polymerase/reverse transcriptase.

PHARMACOKINETIC PARAMETERS

Absorption

Oral bioavailability ~86%

Metabolism and Excretion

Renal clearance accounts for about 71% of total lamivudine clearance.

Protein Binding

<36%

T1/2

Serum: 5-7 hrs; intracellular:12 hrs.

Distribution

Widely distributed. Vd = 1.3 L/kg.

DOSING FOR DECREASED HEPATIC FUNCTION

Usual dose.

PREGNANCY RISK

  • No dose adjustment is required during pregnancy. First-trimester exposure has not been associated with increased congenital anomalies.
    • 3TC has high placental transfer and has not been associated with adverse maternal, obstetric, or infant outcomes.

BREASTFEEDING COMPATIBILITY

Lamivudine is excreted into human breast milk. Formula or pasteurized donor milk eliminates postnatal HIV transmission risk; sustained viral suppression on ART during breastfeeding reduces transmission risk to < 1%, but not zero. People with HIV who choose breastfeeding should be supported with close monitoring.

COMMENTS

  • Lamivudine (3TC) has appeared in more unique fixed-dose combinations than almost any other nucleoside analog, reflecting its favorable safety profile, long clinical experience, and compatibility with multiple antiretroviral classes.
  • If treating HIV/HBV co-infected patients:
    • Select 3TC formulations with the higher 3TC dose for HIV infection (e.g., 300 mg/day).
    • High rate of HBV resistance with prolonged lamivudine monotherapy.
      • In HIV/HBV coinfection: use 3TC with TAF or TDF as part of fully suppressive ART
    • When modifying ART in HIV/HBV coinfection, maintain HBV-active therapy with TAF or TDF plus 3TC/FTC, or initiate entecavir with fully suppressive ART when tenofovir cannot be used.
      • Withdrawal of HBV-active therapy is not recommended; if unavoidable, monitor closely for HBV reactivation/hepatitis flare.
  • Pros: very well tolerated; also active (at a lower dose than needed for HIV) against HBV.
    • Convenient coformulations available; once-daily dosing with low pill burden (1 tab once daily).
    • Resistance (184V mutation) increases susceptibility to AZT and TDF and delays the accumulation of thymidine analogue mutations (TAMs).
    • 3TC or FTC remains a common NRTI component in most initial oral ART regimens.
      • DTG/3TC is also a recommended two-drug initial regimen for selected patients, but not for those with HIV RNA >500,000 copies/mL, HBV coinfection, or when ART must begin before reverse-transcriptase genotype and HBV testing are available, or after CAB-LA PrEP unless INSTI susceptibility has been documented.
    • Decreased fitness with the 184V mutation, which may reduce antiviral activity.
  • Cons: high-level resistance with a single point mutation (184V).
    • Risk of hepatitis flare or fulminant hepatitis if 3TC is withdrawn or if resistance develops in co-infected patients.
    • Shorter intracellular half-life compared to FTC.
    • More frequent emergence of 184V with AZT/3TC than TDF/FTC in the GS934 study.

Basis for recommendation

  1. Ghany MG, Pan CQ, Lok AS, et al. AASLD ISDA Practice Guideline on treatment of chronic hepatitis B. Hepatology. 2026;83(4):974-997.  [PMID:41186418]

    Comment: Current AASLD/IDSA evidence-based guideline for chronic HBV treatment, including selection of high-barrier nucleos(t)ide analogues and considerations for antiviral discontinuation.

  2. Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children. Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. https://clinicalinfo.hiv.gov/en/guidelines/pediatric-arv/lamivudine (accessed 9/17/2026, last updated June 2026)

    Comment: Current U.S. pediatric lamivudine dosing and formulation guidance, including age- and weight-based dosing and pediatric fixed-dose combinations.

  3. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV. Department of Health and Human Services. Year. Available at https://clinicalinfo.hiv.gov/en/guidelines/adult-and-adolescent-arv. Updated August 24, 2026. Accessed September 16, 2026.

    Comment: Current U.S. adult/adolescent ART guideline supporting lamivudine-containing initial regimens, DTG/3TC eligibility restrictions, management of HIV/HBV coinfection, renal dosing, and use of lamivudine-containing fixed-dose combinations.

References

  1. Figueroa MI, Brites C, Cecchini D, et al. Efficacy and Safety of Dual Therapy With Dolutegravir/Lamivudine in Treatment-naive Persons With CD4 Counts <200/mm3: 48-Week Results of the DOLCE Study. Clin Infect Dis. 2026;82(1):122-131.  [PMID:40874763]

    Comment: Randomized multicenter 48-week trial evaluating DTG/3TC in ART-naïve patients with CD4 ≤200 cells/mm³ and provides reassuring efficacy and safety data in a population underrepresented in GEMINI.

  2. Cordova E, Hernandez Rendon J, Mingrone V, et al. Efficacy of dolutegravir plus lamivudine in treatment-naive people living with HIV without baseline drug-resistance testing available (D2ARLING): 48-week results of a phase 4, randomised, open-label, non-inferiority trial. Lancet HIV. 2025;12(2):e95-e104.  [PMID:39826566]

    Comment: Phase 4 randomized trial demonstrating efficacy of DTG/3TC when baseline resistance results were unavailable. The relevance to current U.S. guidance is that it still recommends genotype and HBV results before initiating DTG/3TC.

  3. Brooks KM, Kiser JJ, Ziemba L, et al. Pharmacokinetics, safety, and tolerability of dispersible and immediate-release abacavir, dolutegravir, and lamivudine tablets in children with HIV (IMPAACT 2019): week 24 results of an open-label, multicentre, phase 1-2 dose-confirmation study. Lancet HIV. 2023;10(8):e506-e517.  [PMID:37541705]

    Comment: Phase 1/2 pediatric PK, safety, and dose-confirmation study supporting dispersible and immediate-release ABC/DTG/3TC formulations in children with HIV

  4. Jeng WJ, Papatheodoridis GV, Lok ASF. Hepatitis B. Lancet. 2023;401(10381):1039-1052.  [PMID:36774930]

    Comment: Review of chronic HBV management; discusses lamivudine’s low genetic barrier to resistance and preference for entecavir, TDF, or TAF.

  5. Llibre JM, Brites C, Cheng CY, et al. Efficacy and Safety of Switching to the 2-Drug Regimen Dolutegravir/Lamivudine Versus Continuing a 3- or 4-Drug Regimen for Maintaining Virologic Suppression in Adults Living With Human Immunodeficiency Virus 1 (HIV-1): Week 48 Results From the Phase 3, Noninferiority SALSA Randomized Trial. Clin Infect Dis. 2023;76(4):720-729.  [PMID:35235656]

    Comment: Phase 3 switch RCT: switching suppressed adults to DTG/3TC was noninferior to continuing a 3- or 4-drug regimen at week 48, with no observed treatment-emergent resistance.

  6. Osiyemi O, De Wit S, Ajana F, et al. Efficacy and Safety of Switching to Dolutegravir/Lamivudine Versus Continuing a Tenofovir Alafenamide-Based 3- or 4-Drug Regimen for Maintenance of Virologic Suppression in Adults Living With Human Immunodeficiency Virus Type 1: Results Through Week 144 From the Phase 3, Noninferiority TANGO Randomized Trial. Clin Infect Dis. 2022;75(6):975-986.  [PMID:35079789]

    Comment: Phase 3 randomized switch trial demonstrating durable noninferiority of DTG/3TC versus continued TAF-based 3- or 4-drug ART through week 144.

  7. Cahn P, Sierra Madero J, Arribas JR, et al. Three-year durable efficacy of dolutegravir plus lamivudine in antiretroviral therapy - naive adults with HIV-1 infection. AIDS. 2022;36(1):39-48.  [PMID:34534138]

    Comment: Three-year follow-up of GEMINI-1/2 demonstrating durable virologic efficacy of DTG/3TC in treatment-naïve adults

  8. Cahn P, Madero JS, Arribas JR, et al. Dolutegravir plus lamivudine versus dolutegravir plus tenofovir disoproxil fumarate and emtricitabine in antiretroviral-naive adults with HIV-1 infection (GEMINI-1 and GEMINI-2): week 48 results from two multicentre, double-blind, randomised, non-inferiority, phase 3 trials. Lancet. 2019;393(10167):143-155.  [PMID:30420123]

    Comment: Pivotal phase 3 GEMINI-1/2 trials demonstrating noninferiority of DTG/3TC to DTG + TDF/FTC at week 48 in selected ART-naïve adults.

  9. Quercia R, Perno CF, Koteff J, et al. Twenty-Five Years of Lamivudine: Current and Future Use for the Treatment of HIV-1 Infection. J Acquir Immune Defic Syndr. 2018;78(2):125-135.  [PMID:29474268]

    Comment: Narrative review of 25 years of lamivudine use in HIV, including pharmacology, antiviral activity, safety, M184V-mediated resistance and viral-fitness effects, and its role in contemporary combination and two-drug ART; several authors were affiliated with ViiV Healthcare.

  10. Margot NA, Enejosa J, Cheng AK, et al. Development of HIV-1 drug resistance through 144 weeks in antiretroviral-naïve subjects on emtricitabine, tenofovir disoproxil fumarate, and efavirenz compared with lamivudine/zidovudine and efavirenz in study GS-01-934. J Acquir Immune Defic Syndr. 2009;52(2):209-21.  [PMID:19644384]

    Comment: Resistance analysis from GS-01-934; M184V/I emerged significantly less often after virologic failure with FTC/TDF/EFV than with 3TC/ZDV/EFV

  11. Castagna A, Danise A, Menzo S, et al. Lamivudine monotherapy in HIV-1-infected patients harbouring a lamivudine-resistant virus: a randomized pilot study (E-184V study). AIDS. 2006;20(6):795-803.  [PMID:16549962]

    Comment: A historical randomized pilot study suggests that continued 3TC in the presence of M184V may preserve some virologic/immunologic benefit compared with complete treatment interruption. These data support the fitness cost of M184V, but this is not a current treatment strategy.

  12. Dienstag JL, Schiff ER, Wright TL, et al. Lamivudine as initial treatment for chronic hepatitis B in the United States. N Engl J Med. 1999;341(17):1256-63.  [PMID:10528035]

    Comment: Landmark placebo-controlled U.S. trial: 143 patients randomized and 137 included in the efficacy analysis. At 52 weeks of lamivudine, findings included improved histologic, virologic, biochemical, and HBeAg outcomes versus placebo.

  13. Aronoff GR, Bennett WM, Berns JS, et al. Drug Prescribing in Renal Failure: Dosing Guidelines for Adults and Children. 5th ed. Philadelphia, PA: American College of Physicians; 2007. ISBN 978-1-930513-76-1

    Comment: Reference source for renal dose adjustment of lamivudine in adults and children, including suggested pediatric dosing in renal impairment and dialysis when primary pediatric pharmacokinetic data are limited.



  14. NIH Perinatal Guidelines, Appendix B: Lamivudine (Epivir, 3TC)—Safety and Toxicity in Pregnancy. Updated March 31, 2026. Accessed 9/17/2026.

    Comment: Current pregnancy and lactation data for 3TC: no pregnancy dose adjustment, no increased congenital anomaly signal with first-trimester exposure, high placental transfer, and documented passage into human breast milk.



  15. ViiV Healthcare Company. EPIVIR- lamivudine tablet, film coated. [revised 8/2024; accessed 9/16/26]

    Comment: Current U.S. EPIVIR prescribing information; primary source for HIV-1 indication, formulations, adult and pediatric dosing, renal adjustment, warnings, adverse effects, drug interactions, and pharmacokinetic data.

  16. Strides Pharma Science Limited. LAMIVUDINE tablet. [revised 1/2026; accessed 9/15/26]

    Comment: Current PI.


Last updated: October 11, 2026