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pEpivir-HBV is not appropriate for patients co-infected with HBV and HIV-1If a patient with unrecognized or untreated HIV-1 infection is prescribed Epivir-HBV for the treatment of HBVrapid emergence of HIV-1 resistance is likely to result because of the subtherapeutic dose and the inappropriate use of monotherapy for HIV-1 treatmentHIV counseling and testing should be offered to all patients before beginning treatment with Epivir-HBV and periodically during treatment because of the risk of rapid emergence of resistant HIV-1 and limitation of treatment options if Epivir-HBV is prescribed to treat chronic hepatitis B in a patient who has unrecognized or untreated HIV-1 infection or who acquires HIV-1 infection during treatment./ppPatients with Renal ImpairmentThe pharmacokinetic properties of lamivudine have been determined in healthy adults and in adults with impaired renal functionwith and without hemodialysisTable 5/ppLamivudine is predominantly eliminated in the urine by active organic cationic secretionThe possibility of interactions with other drugs administered concurrently should be consideredparticularly when their main route of elimination is active renal secretion via the organic cationic transport systeme.gtrimethoprimsee Clinical Pharmacology12.3No data are available regarding interactions with other drugs that have renal clearance mechanisms similar to that of lamivudine./ppEpivir-HBV is not appropriate for patients co-infected with HBV and HIV-1If a patient with unrecognized or untreated HIV-1 infection is prescribed Epivir-HBV for the treatment of HBVrapid emergence of HIV-1 resistance is likely to result because of the subtherapeutic dose and the inappropriate use of monotherapy for HIV-1 treatmentHIV counseling and testing should be offered to all patients before beginning treatment with Epivir-HBV and periodically during treatment because of the risk of rapid emergence of resistant HIV-1 and limitation of treatment options if Epivir-HBV is prescribed to treat chronic hepatitis B in a patient who has unrecognized or untreated HIV-1 infection or who acquires HIV-1 infection during treatment./p
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