Use not recommended in patients with impaired renal function (i.e. CrCl <50 mL/min).
Consider underlying risk of coronary heart disease and minimize modifiable risks (eg, hypertension, hyperlipidemia, diabetes mellitus, smoking).
Interrupt therapy if lactic acidosis or pronounced hepatotoxicity, which may include hepatomegaly and steatosis even in the absences of marked transaminase elevations, is suspected.
Emergence of lamivudine-resistant hepatitis B virus has been reported in HIV-1 infected patients coinfected with hepatitis B virus after treatment with lamivudine-containing antiretroviral regimens.