Bephardine 100mg medicine for chronic hepatitis B (3 blisters x 10 tablets)

lamivudin is a reetrovirus resistant synthesis, belonging to the group of dideooxucleosides inhibiting the opposite code of the virus.

To have a lamivudine effect, it must be chemically and transformed into an active and metabolic substance 5 - Triphosphate.

This metabolic substance has a similar structure to Deoxyctidin Triphosphate, which is a natural substrate for reverse transcription enzymes.

Drugs with competitive activity with natural deoxyctidin triphosphate to merge the virus's DNA by the enzyme transcription, causing early end of the virus's DNA synthesis.

lamivudin has very low toxicity for cells.

Lamivudin has the activity of HIV Type 1 and 2 (HIV-2) and also has the effect of inhibiting the hepatitis B virus in chronic patients. Despite being well tolerated, but not used lamivudin is alone because of anti -drug.

This resistance is due to the mutation of the enzyme transcription, reducing sensitivity more than 100 times and losing antiviral effect on patients.

Lamivudin and zidovudin combination therapy in patients who have not been treated before, reduces about 10 times the virus density in plasma, lasts more than 1 year, despite the mutations of the backward enzyme.

pharmacokinetics

After drinking, Lamivudin absorbs rapidly with bioavailability of about 80%. The ratio is attached to low plasma proteins (

The average plasma sale time is 2.5 hours and about 70% of the dosage is eliminated without changing in the urine. The half -life of Lamivudin Triphosphate in the cell is prolonged, on average over 10 hours in lymphocytes in peripheral blood.

The total clearance is 0.37 ± 0.05 liters/hour/kg.

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Be cautious when using

to stop the drug in patients with abdominal pain, nausea or vomiting or abnormal biochemical results that suspect pancreatitis. Only use the drug when eliminated pancreas.

Must stop the drug in patients with aminotransferase levels increasing rapidly, liver gradually or acidosis.

Be cautious when used for people at risk of liver disease.

Patients with HIV and HIE B or C chronic hepatitis at the same time are treated with a combination of high -risk Retrovirus anti -Retrovirus drugs.

Hepatitis B is more likely to return to worse in people with chronic hepatitis B stop using lamivudine. Must monitor liver function in these people. Before using lamivudin to treat hepatitis B, the patient must not have HIV because of low -dose lamivudine to treat hepatitis will lead to Lamivudine -resistant HIV strains.

Must reduce the dose in patients with renal failure.

Must monitor closely when taking the drug, especially lamivudin in combination with zidovudin for children with a history of pancreatitis or a risk of pancreatitis. It is necessary to stop the drug as soon as the clinical signs or the test results suggest pancreatitis. Instructions for relatives or people looking after HIV infected with signs and symptoms of pancreatic inflammation.

Inform the patient that Lamivudin does not cure HIV infection, they continue to carry HIV virus, including opportunistic infections. Patients still have to be monitored and taken continuously. Clearly tell the patient that Lamivudin does not reduce the risk of HIV transmission and they have to use condoms to protect their partners.

The ability to drive and operate machinery

Drivers or machinery operate should be cautious when using the drug because the drug can cause headaches, discomfort, fatigue, dizziness.

Pregnancy

can use lamivudin for pregnant women, especially when the sewing muscle is protected from infection to the fetus. In case of using lamivudin combined oral (lamivudin and zidovudin), avoid for pregnant people.

Breastfeeding period

Whether it is not sure whether lamivudin has excreted in human milk or not, there is likely to occur unwanted effects due to lamivudin in young breastfed children. There is also a high risk of HIV infection due to breastfeeding. Instructions for mothers infected with HIV should not breastfeed.

Drug interaction

Zidovudine concentration in plasma increases significantly (about 39%) when used in combination with lamivudine.

trimethoprim/sulfamethoxazole increases lamivudin's bioavailability (44%) reflected in the measurement of the area under the concentration - time (AUC) curve, and reduces the clearance of the kidney (30%).

Although AUC is not much affected, the absorption of lamivudin is slowed down and the plasma peak concentration is lower than 40% when the patient takes the medicine when full compared to when taking the drug when hungry.