Side-effects

3TC (lamivudine, Epivir) is generally a safe drug, with fewer side-effects than other nucleoside reverse transcriptase inhibitors (NRTIs). Its commonest side-effects are headache, fatigue, and nausea which generally subside over time. Other side-effects include decreased appetite, diarrhoea, skin rash, and abdominal pain. Nausea and diarrhoea can be controlled with other medicines, which can be prescribed before starting 3TC. 3TC’s side-effects are most likely to occur during the early weeks of treatment.

Discontinuation of 3TC may result in a flare-up of hepatitis B infection in people with HIV/HBV co-infection. Careful monitoring of these patients is advised.

Less common side-effects of 3TC are pancreatitis (usually in advanced disease) peripheral neuropathy, anaemia, decreased neutrophil count, increased liver enzymes, fat redistribution. neutropenia (low white blood cell counts) and rash. There have also been reports of hair loss, severe anaemia and lactic acidosis (a serious increase in levels of lactic acid in the blood) among people receiving 3TC, while pancreatitis has been reported in children.