Lamivudine Sandoz 300 Mg Film Coated Tablets
Package leaflet: Information for the user SZ00000LT000
Lamivudine 150 mg Film-coated Tablets Lamivudine 300 mg Film-coated Tablets
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
• Keep this leaflet, you may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
What is in this leaflet:
1. What Lamivudine is and what it is used for
2. What you need to know before you take Lamivudine
3. How to take Lamivudine
4. Possible side effects
5. How to store Lamivudine
6. Contents of the pack and other information
Lamivudine is used to treat HIV (human immunodeficiency virus) infection in adults and children.
The active ingredient in Lamivudine is lamivudine. Lamivudine is a type of medicine known as an anti-retroviral. It belongs to a group of medicines called nucleoside analogue reverse transcriptase inhibitors (NRTIs).
Lamivudine does not completely cure HIV infection; it reduces the amount of virus in your body, and keeps it at a low level. It also increases the CD4 cell count in your blood. CD4 cells are a type of white blood cells that are important in helping your body to fight infection.
Not everyone responds to treatment with Lamivudine in the same way. Your doctor will monitor the effectiveness of your treatment.
Lamivudine and similar medicines may cause side effects in unborn babies. If you become pregnant while you’re taking Lamivudine, your baby may be given extra check-ups (including blood tests) to make sure it is developing normally.
Children whose mothers took NRTIs (medicines like Lamivudine) during pregnancy had a reduced risk of being infected with HIV. This benefit is greater than the risk of having side effects.
Breast-feeding
Women who are HIV-positive must not breast-feed, because HIV infection can be passed on to the baby in breast milk.
If you’re breast-feeding, or thinking about breast-feeding:
Talk to your doctor immediately.
Driving and using machines
Lamivudine is unlikely to affect your ability to drive or use machines.
Lamivudine contains Isomalt
If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.
Do not take Lamivudine:
• if you’re allergic (hypersensitive) to lamivudine or any of the other ingredients of this medicine (listed in Section 6).
Check with your doctor if you think this applies to you.
Take special care with Lamivudine
Some people taking Lamivudine or other combination treatments for HIV are more at risk of serious side effects. You need to be aware of the extra risks:
• if you have ever had liver disease, including hepatitis B or C (if you have hepatitis B infection, don’t stop Lamivudine without your doctor’s advice, as your hepatitis may come back).
• if you’re seriously overweight (especially if you’re a woman).
• if you’re diabetic and using insulin.
• if you or your child has a kidney problem, your dose may be altered.
Talk to your doctor if any of these apply to you. You may need extra check-ups, including blood tests, while you’re taking your medicine. See Section 4 for more information.
Look out for important symptoms
Some people taking medicines for HIV infection develop other conditions, which can be serious. You need to know about important signs and symptoms to look out for while you’re taking Lamivudine.
Read the information ‘Other possible side effects of combination therapy for HIV’ in Section 4 of this leaflet.
Protect other people
HIV infection is spread by sexual contact with someone who has the infection, or by transfer of infected blood (for example, by sharing injection needles). Lamivudine will not stop you passing HIV infection on to other people. To protect other people from becoming infected with HIV:
• Use a condom when you have oral or penetrative sex.
• Don’t risk blood transfer — for example, don’t share needles.
Other medicines and Lamivudine
Tell your doctor or pharmacist if you’re taking any other medicines, or if
you’ve taken any recently, including herbal medicines or other medicines you bought without a prescription.
Remember to tell your doctor or pharmacist if you begin taking a new medicine while you’re taking Lamivudine.
These medicines should not be used with Lamivudine:
• other medicines containing lamivudine, (used to treat HIV infection or hepatitis B infection)
• emtricitabine (used to treat HIV infection)
• high doses of co-trimoxazole, an antibiotic
• cladribine, used to treat hairy cell leukaemia.
Tell your doctor if you’re being treated with any of these.
Pregnancy
If you are pregnant, if you become pregnant, or are planning to become pregnant, talk to your doctor about the risks and benefits to you and your baby of taking Lamivudine.
Always take this medicine exactly as your doctor has told you to. Check with your doctor or pharmacist if you are not sure.
Swallow the tablets, with some water. Lamivudine can be taken with or without food.
If you cannot swallow the tablets whole, you may crush and combine them with a small amount of food or drink, and take all the dose immediately.
Stay in regular contact with your doctor
Lamivudine helps to control your condition. You need to keep taking it every day to stop your illness getting worse. You may still develop other infections and illnesses linked to HIV infection.
Keep in touch with your doctor, and don’t stop taking Lamivudine without your doctor’s advice.
How much to take
Adults and children who weigh at least 30 kg:
The usual dose of Lamivudine is 300 mg a day to be taken as:
• Either one 150 mg tablet twice a day, approximately 12 hours apart, or
• one 300 mg tablet once a day.
Children weighing 21 - 30 kg
• one half (%) of an Lamivudine tablet (75 mg) in the morning, and
• one whole Lamivudine tablet (150 mg) in the evening.
Children weighing 14 - 21 kg
• one half (%) of an Lamivudine tablet (75 mg) in the morning, and
• one half (%) of an Lamivudine tablet (75 mg) in the evening.
Tablets containing less lamivudine and an oral solution are available for the treatment of children over 3 months of age, or for people who need a lower dose than usual, or who can’t take tablets.
If you or your child has a kidney problem, your dose may be altered.
Talk to your doctor if this applies to you or your child.
If you take too much Lamivudine
Accidentally taking too much Lamivudine is unlikely to cause any serious problems. If you take too much, tell your doctor or your pharmacist, or contact your nearest hospital emergency department for further advice.
If you forget to take Lamivudine
If you forget to take a dose, take it as soon as you remember. Then continue your treatment as before. Don’t take a double dose to make up for a missed dose.
Like all medicines, Lamivudine can cause side effects, although not everybody gets them.
When you’re being treated for HIV, it can be hard to tell whether a symptom is a side effect of Lamivudine or other medicines you are taking, or an effect of the HIV disease itself. So it is very important to talk to your doctor about any changes in your health.
As well as the side effects listed below for Lamivudine, other conditions can develop during combination therapy for HIV.
Lactic acidosis is more likely to develop in people who have liver disease, or in obese (very overweight) people, especially women. Signs of lactic acidosis include:
• deep, rapid, difficult breathing
• drowsiness
• numbness or weakness in the limbs
• feeling sick (nausea), being sick (vomiting)
• stomach pain.
During your treatment, your doctor will monitor you for signs of lactic acidosis. If you have any of the symptoms listed above, or any other symptoms that worry you:
See your doctor as soon as possible.
It is important to read the information later in this section under ‘Other possible side effects of combination therapy for HIV’.
Common side effects
These may affect up to 1 in 10 people:
• headache
• feeling sick (nausea)
• being sick (vomiting)
• diarrhoea
• stomach pains
• tiredness, lack of energy
• fever (high temperature)
• general feeling of being unwell
• muscle pain and discomfort
• joint pain
• difficulty in sleeping (insomnia)
• cough
• irritated or runny nose
• rash
• hair loss (alopecia).
Uncommon side effects
These may affect up to 1 in 100 people:
Uncommon side effects that may show up in blood tests are:
• a decrease in the number of cells involved in blood clotting (thrombocytopenia)
• a low red blood cell count (anaemia) or low white blood cell count (neutropenia)
• an increase in the level of liver enzymes.
Rare side effects
These may affect up to 1 in 1,000 people:
• serious allergic reaction causing swelling of the face, tongue or throat which may cause difficulty in swallowing or breathing
• lactic acidosis (see the next section, ‘Other possible side effects of combination therapy for HIV’)
• inflammation of the pancreas (pancreatitis)
• breakdown of muscle tissue
• liver disorders, such as jaundice, enlarged liver or fatty liver, inflammation (hepatitis).
A rare side effect that may show up in blood tests is:
• an increase in an enzyme called amylase.
Very rare side effects
These may affect up to 1 in 10,000 people:
• tingling or numbness of the arms, legs, hands or feet.
Avery rare side effect that may show up in blood tests is:
• a failure of the bone marrow to produce new red blood cells (pure red cell aplasia).
If you get side effects
Tell your doctor or pharmacist if any of the side effects gets severe or troublesome, or if you notice any side effects not listed in this leaflet.
You may have problems with your bones
Some people taking combination therapy for HIV develop a condition called osteonecrosis. With this condition, parts of the bone tissue die because of reduced blood supply to the bone. People may be more likely to get this condition:
• if they have been taking combination therapy for a long time
• if they are also taking anti-inflammatory medicines called corticosteroids
• if they drink alcohol
• if their immune systems are very weak
• if they are overweight.
Signs of osteonecrosis include:
• stiffness in the joints
• aches and pains (especially in the hip, knee or shoulder)
• difficulty moving.
If you notice any of these symptoms:
Tell your doctor.
Other effects may show up in blood tests
Combination therapy for HIV can also cause:
• increased levels of lactic acid in the blood, which on rare occasions can lead to lactic acidosis
• increased levels of sugar and fats (triglycerides and cholesterol) in the blood
• resistance to insulin (so if you’re diabetic, you may have to change your insulin dose to control your blood sugar).
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme (www.mhra.gov.uk/yellowcard). By reporting side effects you can help provide more information on the safety of this medicine.
Keep this medicine out of the sight and reach of children
Do not use this medicine after the expiry date which is stated on the label and carton after EXP (month, year).
The expiry date refers to the last day of that month.
This medicinal product does not require any special storage conditions.
In use shelf life for bottle: After first opening: 3 months.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
Other possible side effects of combination therapy for HIV
Combination therapy including Lamivudine may cause other conditions to develop during HIV treatment.
What Lamivudine contains
The active substance is lamivudine.
Each Lamivudine 150 mg Film-coated Tablet contains 150 mg of lamivudine. Each Lamivudine 300 mg Film-coated Tablet contains 300 mg of lamivudine.
Old infections may flare up
People with advanced HIV infection (AIDS) have weak immune systems, and are more likely to develop serious infections (opportunistic infections). When these people start treatment, they may find that old, hidden infections flare up, causing signs and symptoms of inflammation. These symptoms are probably caused by the body’s immune system becoming stronger, so that the body starts to fight these infections.
If you get any symptoms of infection while you’re taking Lamivudine:
Tell your doctor immediately. Don’t take other medicines for the infection without your doctor’s advice.
The other ingredients are:
isomalt (E953), crospovidone Type A, magnesium stearate (E572), hypromellose 3cp (E464), hypromellose 6cp (E464), titanium dioxide (E171), macrogol 400, polysorbate 80 (E433).
What Lamivudine looks like and the contents of the pack
Lamivudine 150 mg Film-coated Tablets:
White capsule shaped, biconvex scored film coated tablets with a dimension of 15 x 6.5 mm, debossed with J on one side and 16 on the other side, 1 and 6 separated by a score line.
The tablet can be divided into equal doses.
Your body shape may change
People taking combination therapy for HIV may find that their body shape changes, because of changes in fat distribution:
• Fat may be lost from the legs, arms or face
• Extra fat may build up around the tummy (abdomen), or on the breasts or internal organs
• Fatty lumps (sometimes called buffalo hump) may appear on the back of the neck.
It is not yet known what causes these changes, or whether they have any long-term effects on your health. If you notice changes in your body shape:
Tell your doctor.
Lamivudine 300 mg Film-coated Tablets:
White capsule shaped, biconvex film coated tablets with a dimension of 19.1 x 8.9 mm, debossed with 17 on one side and J on the other side.
Alu-Alu blister pack: 14, 28, 30, 56, 60, 84, 90 and 120 film-coated tablets. HDPE container with child resistant polypropylene cap: 30, 60, 90 film-coated tablets.
Not all pack sizes may be marketed.
Marketing Authorisation Holder and Manufacturer
Lactic acidosis is a rare but serious side effect
Some people taking Lamivudine, or other medicines like it (NRTIs), develop a condition called lactic acidosis, together with an enlarged liver.
Lactic acidosis is caused by a build-up of lactic acid in the body. It is rare; if it happens, it usually develops after a few months of treatment. It can be life-threatening, causing failure of internal organs.
Marketing Authorisation Holder Sandoz Ltd,
Frimley Business Park, Frimley, Camberley, Surrey, GU16 7SR, UK. Manufacturer
Lek Pharmaceuticals d.d., Verovskova 57, 1526 Ljubljana, Slovenia Or Lek S.A., ul. Podlipie 16, 95-010 Strykow, Poland Or Salutas Pharma GmbH, Otto-von-Guericke-Allee 1,39179 Barleben, Germany Or S.C. Sandoz, S.R.L., Str. Livezeni nr. 7A, RO-540472 Targu-Mures, Romania
SZ00000LT000