Children

3TC (lamivudine, Epivir) is approved for use by children aged over three months at a dose of 4mg/kg twice daily, to a maximum dose of 300mg per day. It is available as a solution or tablet.

In the US 3TC can be used in infants under 30 days of age, dosed twice daily at 2mg/kg.

It was licensed for children following demonstration that adding 3TC to AZT (zidovudine, Retrovir), ddI (didanosine, Videx) or a combination of AZT and ddI resulted in CD4 cell count increases and reductions in viral load, and a lowered risk of disease progression and death.^[1][2] Once-daily 3TC dosing may also be possible in children, although this is not an approved dosing regimen.^[3]

3TC should be used with caution in children with a history or risk of pancreatitis. It should not be used in combination with emtricitabine. Any patient with creatinine clearance of less than 50ml/minute or impaired hepatic function should not use Combivir, Trizivir, or Kivexa. Other side-effects are similar to those found in adults.

Combivir and Kivexa are only approved for use in children over 12 years of age, while Trizivir is not approved for use in people younger than 18 years of age.

The formulation of EPIVIR HBV is not sufficient for children who are HIV-infected, unless the child requires a 100mg 3TC dose.