# Lamivudine in Nigeria

Lamivudine has 9 active NAFDAC registrations in our October 2026 copy of the register, from 6 registration holders; 29 further listings have lapsed.

- Source: https://ogbogwu.com/drugs/lamivudine/
- Drug class: Nucleoside reverse transcriptase inhibitor (NRTI) (Anti-HIV/ARVs)
- Also known as: 3TC, Epivir
- Prescription required: yes
- On the WHO Model List of Essential Medicines
- Last updated: February 2026

## Price in Nigeria

Lamivudine-containing HIV treatment is supplied free of charge through Nigeria's public ART programme — patients at accredited treatment sites pay nothing for their antiretrovirals, which is why private retail listings are scarce and why we quote no price. If you are being charged for ART, ask for the nearest accredited treatment centre. Institutional and programme supply is handled by registered distributors.

## What is Lamivudine?

Lamivudine, also known as 3TC, is a nucleoside reverse transcriptase inhibitor (NRTI) that is one of the most widely used antiviral medicines in Nigeria and globally. It is unique among antiretroviral drugs because it is effective against both HIV (Human Immunodeficiency Virus) and Hepatitis B virus (HBV), making it particularly important in Nigeria where both infections are highly prevalent. Lamivudine works by blocking the reverse transcriptase enzyme that HIV and Hepatitis B virus need to replicate their genetic material inside human cells. By inhibiting this enzyme, lamivudine prevents the virus from multiplying, helping to reduce the viral load in the blood and allowing the immune system to recover. In Nigeria, lamivudine is most commonly encountered as a component of fixed-dose combination tablets such as TLD (Tenofovir/Lamivudine/Dolutegravir) and the older TLE (Tenofovir/Lamivudine/Efavirenz), which are the backbone of the national HIV treatment programme.

Important note on availability in Nigeria: standalone lamivudine tablets (pure lamivudine 150mg, 300mg, or 100mg) are not currently registered with NAFDAC as single-ingredient products in the NAFDAC Greenbook. This is because Nigeria's national HIV treatment programme — in line with WHO guidance — has standardised on fixed-dose combinations such as TLD (tenofovir/lamivudine/dolutegravir), which combine lamivudine with one or two other antiretrovirals in a single tablet taken once a day. Every NAFDAC-registered product in Nigeria that contains lamivudine is a combination product. Patients treated through public ART centres receive these combinations free of charge under the national programme. If you are researching lamivudine for HIV or Hepatitis B treatment in Nigeria, the most relevant page is our entry on Tenofovir/Lamivudine/Dolutegravir (TLD), which is the current first-line regimen.

Nigeria bears a significant dual burden of HIV and Hepatitis B. With approximately 1.9 million people living with HIV and an estimated 20 million people chronically infected with Hepatitis B — one of the highest HBV prevalence rates in the world — lamivudine plays a critical role in addressing both epidemics. For HIV treatment, lamivudine is always used in combination with other antiretroviral medicines, never alone, as monotherapy rapidly leads to drug resistance. The standard HIV dose is 150mg twice daily or 300mg once daily. For Hepatitis B, lamivudine can be used as a standalone treatment at a lower dose of 100mg once daily, although tenofovir is increasingly preferred as it has a higher barrier to resistance. Lamivudine is available at government ART treatment centres throughout Nigeria — from major teaching hospitals in Lagos, Abuja, Kano, and Port Harcourt to primary health centres in rural communities — where it is provided free of charge as part of the national HIV treatment programme supported by PEPFAR and the Global Fund.

An important clinical consideration with lamivudine is the risk of Hepatitis B flare upon discontinuation. Many HIV-positive patients in Nigeria are co-infected with Hepatitis B, and lamivudine (as part of their ARV regimen) provides dual coverage against both viruses. If lamivudine or the lamivudine-containing regimen is stopped abruptly — whether due to poor adherence, treatment switch, or stock-outs — the Hepatitis B virus can rebound dramatically, causing a severe hepatitis flare that can lead to liver failure and even death. This phenomenon is particularly dangerous because many patients may not know they are co-infected with Hepatitis B, as HBV is often asymptomatic for years. Healthcare providers at ART centres across Nigeria are trained to screen for Hepatitis B before starting or changing antiretroviral regimens. Patients should never stop taking their lamivudine-containing medication without medical supervision, and any changes to treatment should be managed carefully by a qualified healthcare provider.

## What is Lamivudine used for?

- Treatment of HIV-1 infection in adults and children as part of combination antiretroviral therapy (always used with at least two other ARVs)
- Treatment of chronic Hepatitis B virus (HBV) infection at a dose of 100mg daily
- Prevention of mother-to-child transmission (PMTCT) of HIV during pregnancy and delivery
- Post-exposure prophylaxis (PEP) following accidental needle-stick injuries or sexual exposure to HIV
- Component of pre-exposure prophylaxis (PrEP) regimens in some settings
- Dual coverage for HIV-Hepatitis B co-infected patients when used as part of TLD or other combination regimens

## Dosage

Always follow a doctor's or pharmacist's instructions; this is general reference information.

- Adults: For HIV treatment: 150mg twice daily (every 12 hours) or 300mg once daily as part of a combination antiretroviral regimen. For Hepatitis B treatment: 100mg once daily. The 100mg dose for Hepatitis B is NOT adequate for HIV treatment — patients co-infected with both HIV and HBV must receive the full HIV dose of 300mg daily (usually as part of a fixed-dose combination). Tablets should be swallowed whole with water and can be taken with or without food.
- Children: For HIV treatment in children: the dose is calculated based on body weight, typically 4mg per kg of body weight twice daily, up to a maximum of 150mg twice daily. Lamivudine oral solution (10mg/ml) is available for children who cannot swallow tablets. For children weighing over 25kg who can swallow tablets, the adult dose may be used. Always follow the dosing instructions provided by the prescribing clinician.
- Elderly: The standard adult dose is generally used for elderly patients with normal kidney function. However, since lamivudine is primarily excreted by the kidneys, dose reduction may be necessary in elderly patients with impaired renal function. Kidney function should be assessed before starting treatment and monitored periodically.

It is critically important to understand the different dosing for HIV versus Hepatitis B. Never use the 100mg Hepatitis B dose for an HIV-positive patient, as this will lead to suboptimal HIV treatment and drug resistance. If you are taking lamivudine for Hepatitis B and are subsequently diagnosed with HIV, your dose will need to be increased and additional ARVs added. Never stop lamivudine abruptly without medical supervision, especially if you have Hepatitis B co-infection. Store at room temperature, away from moisture and direct sunlight.

## Side effects

Common: Headache — one of the most frequently reported side effects, usually mild; Nausea and vomiting — typically occurs early in treatment and improves over time; Fatigue and malaise — generally mild and transient; Diarrhoea — usually self-limiting; Insomnia or sleep disturbances; Abdominal pain or discomfort.

Serious (seek medical help immediately): Lactic acidosis — a rare but potentially fatal condition associated with NRTI use. Symptoms include persistent nausea, vomiting, abdominal pain, rapid breathing, and extreme tiredness.; Hepatitis B flare — severe worsening of Hepatitis B can occur if lamivudine is discontinued in co-infected patients, potentially leading to liver failure; Pancreatitis — inflammation of the pancreas causing severe abdominal pain radiating to the back, particularly reported in children; Hepatic steatosis (fatty liver) — can occur with lactic acidosis as part of mitochondrial toxicity; Severe anaemia or neutropenia — particularly when used with zidovudine (AZT); Peripheral neuropathy — numbness, tingling, or pain in the hands and feet.

When to see a doctor: Seek immediate medical attention if you experience severe abdominal pain, persistent nausea and vomiting, rapid or difficult breathing, extreme fatigue, muscle pain, yellowing of the eyes or skin, dark urine, or unusual bleeding or bruising. These may be signs of serious complications such as lactic acidosis, pancreatitis, or liver problems. In Nigeria, visit your ART treatment centre or the nearest hospital emergency department. If you have Hepatitis B and your lamivudine supply is interrupted due to stock-outs or any other reason, contact your healthcare provider urgently — do not simply stop taking the medication.

## Warnings

Do not take if: Known hypersensitivity or allergy to lamivudine or any component of the formulation; Severe hepatic impairment — use with extreme caution and close monitoring; Should not be used as monotherapy for HIV — must always be combined with other antiretrovirals to prevent rapid development of resistance.

Interactions: Trimethoprim-sulfamethoxazole (Septrin/cotrimoxazole) — commonly used for opportunistic infection prophylaxis in HIV patients in Nigeria; increases lamivudine blood levels by about 40% but dose adjustment is not usually required at standard doses; Emtricitabine (FTC) — should not be used together with lamivudine as they are structurally similar and provide no additional benefit while increasing toxicity risk; Zalcitabine — co-administration is not recommended due to overlapping toxicity profiles; Sorbitol-containing medicines — can reduce lamivudine absorption; avoid co-administration where possible; High-dose cotrimoxazole (for PCP treatment) — may significantly increase lamivudine levels and require monitoring.

Pregnancy & breastfeeding: Lamivudine is considered safe for use during pregnancy and is a key component of antiretroviral regimens used for prevention of mother-to-child transmission (PMTCT) of HIV in Nigeria. It is included in TLD, which is now the recommended first-line regimen for pregnant women living with HIV. Lamivudine does cross the placenta and is excreted in breast milk, but the benefits of preventing HIV transmission to the baby far outweigh the risks. In Nigeria, where breastfeeding is culturally important and formula feeding may not be safe due to water quality concerns, the WHO and Nigerian guidelines recommend that HIV-positive mothers on effective ART (including lamivudine-containing regimens) should breastfeed for up to 12 months while maintaining excellent adherence to their medication.

## Brands in Nigeria

Full searchable brand list: https://ogbogwu.com/drugs/lamivudine/brands/

## How to verify it is genuine

1. Check for a valid NAFDAC registration number on the product packaging. All medicines legally sold in Nigeria must bear a NAFDAC number.
2. Use the NAFDAC Mobile Authentication Service (MAS): scratch the security panel on the packaging and send the unique code via SMS to 38353 to confirm the product is genuine.
3. Obtain lamivudine only from government ART treatment centres, NAFDAC-registered pharmacies, or accredited healthcare facilities. Avoid purchasing from open markets or unverified vendors.
4. Inspect the packaging for signs of tampering, including broken seals, faded printing, or mismatched batch numbers and expiry dates.
5. Compare the appearance of the tablets (colour, shape, size, markings) with what you have previously received. Report any differences to your pharmacist or healthcare provider.
6. If purchasing from a private pharmacy, ensure the pharmacy has a valid Pharmacists Council of Nigeria (PCN) licence displayed and that a registered pharmacist is present.

Verify any NAFDAC number free (no login): https://ogbogwu.com/nafdac-checker/

## FAQs

### What is the difference between lamivudine for HIV and lamivudine for Hepatitis B?

The key difference is the dose. For HIV treatment, lamivudine is used at 150mg twice daily or 300mg once daily as part of a combination antiretroviral regimen — it is never used alone for HIV. For Hepatitis B treatment, lamivudine is used at a lower dose of 100mg once daily and may be used as a single agent. It is critically important not to confuse these doses. If an HIV-positive patient takes only the 100mg Hepatitis B dose, the HIV will not be adequately treated and drug resistance will develop rapidly. In Nigeria, many patients are co-infected with both HIV and Hepatitis B, so the higher HIV dose (300mg, usually as part of TLD) is used, which provides coverage for both infections. If you are being treated for Hepatitis B alone, your doctor should first confirm that you are HIV-negative before prescribing the 100mg dose.

### Can I buy lamivudine without a prescription in Nigeria?

Lamivudine is classified as a prescription-only medicine in Nigeria. For HIV treatment, it is provided free of charge at government ART treatment centres and should be obtained through the formal healthcare system with proper medical supervision. For Hepatitis B treatment, it requires a doctor's prescription. In practice, some pharmacies in Nigeria may sell lamivudine without a prescription, but this is strongly discouraged. Self-medicating with lamivudine is dangerous because: it must be used in combination for HIV (never alone); the dose differs for HIV versus Hepatitis B; you need to be tested for both HIV and Hepatitis B before starting; and you require regular monitoring of liver function and viral load. Always consult a healthcare provider before starting lamivudine.

### Is lamivudine safe during pregnancy?

Yes, lamivudine is considered safe during pregnancy and is a well-established component of antiretroviral therapy for pregnant women living with HIV. It has been used extensively in PMTCT programmes in Nigeria and across Africa for over two decades, with a strong safety record. Lamivudine is included in TLD, the current recommended first-line regimen for pregnant women with HIV in Nigeria. While lamivudine does cross the placenta and is present in breast milk, the benefits of preventing HIV transmission to the baby are substantial. Studies have not shown an increased risk of birth defects with lamivudine use during pregnancy. If you are pregnant and living with HIV, it is essential to continue your lamivudine-containing regimen throughout pregnancy, delivery, and breastfeeding. Attend your antenatal clinic regularly and take your medication as prescribed.

### What happens if I stop taking lamivudine suddenly?

Stopping lamivudine suddenly can have serious consequences, particularly if you have Hepatitis B co-infection. When lamivudine is discontinued in a patient with Hepatitis B (even if they were primarily taking it for HIV), the Hepatitis B virus can rebound aggressively, causing a severe hepatitis flare with symptoms including jaundice (yellowing of the skin and eyes), severe abdominal pain, extreme fatigue, and in severe cases, liver failure that can be life-threatening. For HIV, stopping lamivudine and other ARVs allows the virus to multiply again, increasing the viral load, weakening the immune system, and creating an opportunity for drug resistance to develop. If you need to change your medication for any reason, this must be done under medical supervision. If you are experiencing stock-outs at your treatment centre — a situation that occasionally occurs in Nigeria — contact your healthcare provider immediately or visit another ART centre to avoid treatment interruption.

## Sources

- NAFDAC Greenbook (official register of approved products in Nigeria)
- WHO Model List of Essential Medicines
- British National Formulary (BNF)
- Nigerian Standard Treatment Guidelines (Federal Ministry of Health)