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Last reviewed on RxList: 5/22/2017
Epivir-HBV Side Effects Center

Last reviewed on RxList 05/23/2017

Epivir-HBV (lamivudine) Tablets and Oral Solution is a synthetic nucleoside analogue used to treat chronic hepatitis B virus (HBV) infection associated with evidence of hepatitis B viral replication and active liver inflammation. The tablet form of Epivir-HBV is available in generic form. Common side effects of Epivir-HBV include:

  • ear/nose/throat infections
  • sore throat
  • diarrhea
  • nausea
  • vomiting
  • dizziness
  • headache, and
  • fatigue
Other side effects of Epivir-HBV may include:
  • low platelet counts (thrombocytopenia),
  • swollen tongue,
  • high blood sugar (hyperglycemia),
  • weakness,
  • anemia,
  • severe allergic reaction (anaphylaxis),
  • hives,
  • muscle cramps,
  • numbness and tingling,
  • wheezing,
  • hair loss,
  • itching, and
  • rash.

The recommended adult oral dosage of Epivir-HBV is 100 mg once daily. Epivir-HBV may interact with trimethoprim or other drugs. Tell your doctor all medications and supplements you use. During pregnancy, Epivir-HBV should be used only if prescribed. This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breastfeeding.

Our Epivir-HBV (lamivudine) Tablets and Oral Solution Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Epivir-HBV Professional Information


The following adverse reactions are discussed in greater detail in other sections of the labeling:

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Adverse Reactions In Clinical Trials Of Adults With Chronic Hepatitis B Virus Infection

Clinical adverse reactions (regardless of investigator’s causality assessment) reported in greater or equal to 10% of subjects who received EPIVIR-HBV and reported at a rate greater than placebo are listed in Table 2.

Table 2. Clinical Adverse Reactionsa Reported in Greater than or Equal to 10% of Subjects who Received EPIVIR-HBV for 52 to 68 Weeks and at an Incidence Greater than Placebo (Trials 1-3)

Adverse Event EPIVIR-HBV
(n = 332)
(n = 200)
Ear, Nose, and Throat    
Ear, nose, and throat infections 25% 21%
Sore throat 13% 8%
Diarrhea 14% 12%
a Includes adverse events regardless of severity and causality assessment.

Specified laboratory abnormalities reported in subjects who received EPIVIR-HBV and reported at a rate greater than in subjects who received placebo are listed in Table 3.

Table 3. Frequencies of Specified Laboratory Abnormalities Reported during Treatment at a Greater Frequency in Subjects Treated with EPIVIR-HBV than with Placebo (Trials 1-3)a

(Abnormal Level)
Subjects with Abnormality/Subjects with Observations
Serum Lipase ≥2.5 x ULNb 10% 7%
CPK ≥7 x baseline 9% 5%
Platelets <50,000/mm3 4% 3%
a Includes subjects treated for 52 to 68 weeks.
b Includes observations during and after treatment in the 2 placebo-controlled trials that collected this information.
ULN = Upper limit of normal.

In subjects followed for up to 16 weeks after discontinuation of treatment, posttreatment ALT elevations were observed more frequently in subjects who had received EPIVIR-HBV than in subjects who had received placebo. A comparison of ALT elevations between Weeks 52 and 68 in subjects who discontinued EPIVIR-HBV at Week 52 and subjects in the same trials who received placebo throughout the treatment course is shown in Table 4.

Table 4. Posttreatment ALT Elevations with No-Active-Treatment Follow-up (Trials 1 and 3)

Abnormal Value Subjects with ALT Elevation/ Subjects with Observationsa
EPIVIR-HBVb Placebob
ALT ≥2 x baseline value 27% 19%
ALT ≥3 x baseline valuec 21% 8%
ALT ≥2 x baseline value and absolute ALT >500 IU/L 15% 7%
ALT ≥2 x baseline value; and bilirubin >2 x ULN and ≥2 x baseline value 0.7% 0.9%
a Each subject may be represented in one or more category.
b During treatment phase.
c Comparable to a Grade 3 toxicity in accordance with modified WHO criteria.
ULN = Upper limit of normal.

Adverse Reactions In Clinical Trials Of Pediatric Subjects With Chronic Hepatitis B Virus Infection

Most commonly observed adverse reactions in the pediatric trials were similar to those in adult trials. Posttreatment transaminase elevations were observed in some subjects followed after cessation of EPIVIR-HBV.

Postmarketing Experience

In addition to adverse reactions reported from clinical trials, the following adverse reactions have been reported during postmarketing use of EPIVIR-HBV. Because these reactions are reported voluntarily from a population of unknown size, it is not always possible to reliably estimate the frequency or establish a causal relationship to drug exposure. These reactions have been chosen for inclusion due to a combination of their seriousness, frequency of reporting, or potential causal connection to lamivudine.

Blood and Lymphatic System Disorders

Anemia (including pure red cell aplasia and severe anemias progressing on therapy), lymphadenopathy, splenomegaly, thrombocytopenia.



Endocrine and Metabolic




Hepatic and Pancreatic

Lactic acidosis and steatosis, posttreatment exacerbation of hepatitis [see BOX WARNING], pancreatitis.


Anaphylaxis, urticaria.


Cramps, rhabdomyolysis.


Paresthesia, peripheral neuropathy.


Abnormal breath sounds/wheezing.


Alopecia, pruritus, rash.

Read the entire FDA prescribing information for Epivir-HBV (Lamivudine Tablets and Oral Solution)

Related Resources for Epivir-HBV

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© Epivir-HBV Patient Information is supplied by Cerner Multum, Inc. and Epivir-HBV Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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