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Unplanned lamivudine therapy interruption may be necessary in specific situationssuch as serious drug toxicityintercurrent illness or surgery precluding oral intakesevere hyperemesis gravidarum unresponsive to antiemeticsor drug non-availabilityIf short-term treatment interruptioni.eless than 1 to 2 daysis necessaryin general it is recommended that all antiretroviral agents be discontinued simultaneouslyespecially if the interruption is because of serious toxicityHoweverif a short-term treatment interruption is anticipated in the case of elective surgerythe pharmacokinetic properties and food requirements of specific drugs should be consideredWhen the antiretroviral regimen contains drugs with differing half-livesstopping all drugs simultaneously may result in functional monotherapy of the drug with the longest half-lifeFor exampleafter discontinuationthe duration of detectable drug concentrations of efavirenz and nevirapine range from less than 1 week to more than 3 weeksSimultaneously stopping all drugs in a regimen containing these agents may result in functional monotherapy with the NNRTI and may increase the risk of NNRTI-resistant mutationsPlanned long-term treatment interruptions are not recommended due to the potential for HIV disease progressioni.edeclining CD4 countsviral reboundacute viral syndromedevelopment of minor HIV-associated manifestations or serious non-AIDS complicationsdevelopment of drug resistanceincreased risk of HIV transmissionand increased risk for opportunistic infectionsIf therapy must be discontinuedcounsel patient on the potential risks and closely monitor for any clinical or laboratory abnormalities.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effectsMany people using this medication do not have serious side effects.

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the formulation and dosage of lamivudine in epivir-hbv are not approved for patients co-infected with hbv and hiv.