BNF for Children 2011-2012

BNFC 2011–2012 5.3.1 HIV infection 313Emtriva c (Gilead) ACapsules, white/blue, emtricitabine 200 mg, net price30-cap pack = £163.50DoseHIV infection in combination with other antiretroviraldrugs. By mouthChild body-weight over 33 kg 200 mg once dailyOral solution, orange, emtricitabine 10 mg/mL, netprice 170-mL pack (candy-flavoured) = £46.50Electrolytes Na + 460 micromol/mLDoseHIV infection in combination with other antiretroviraldrugs. By mouthChild 4 months–18 yearsBody-weight under 33 kg 6 mg/kg once dailyBody-weight over 33 kg 240 mg once dailyNote 240 mg oral solution : 200 mg capsule; where appropriatethe capsule may be used instead of the oral solutionWith tenofovirSee under TenofovirWith efavirenz and tenofovirSee under TenofovirLAMIVUDINE(3TC)Cautions see notes above; interactions: Appendix 1(lamivudine)Chronic hepatitis B Recurrent hepatitis in patients withchronic hepatitis B may occur on discontinuation of lamivudine.When treating chronic hepatitis B with lamivudine,monitor liver function tests every 3 months, and viral andserological markers of hepatitis B every 3–6 months, morefrequently in patients with advanced liver disease or followingtransplantation (monitoring to continue for at least 1 yearafter discontinuation)Hepatic impairment see notes above and CautionsaboveRenal impairment reduce dose if estimated glomerularfiltration rate less than 50 mL/minute/1.73 m 2 ;consult product literaturePregnancy see p. 310Breast-feeding can be used with caution in womeninfected with chronic hepatitis B alone, providingadequate measures are taken to prevent hepatitis Binfection in infants; for women infected with HIV, seep. 310Side-effects see notes above; also peripheral neuropathy,muscle disorders including rhabdomyolysis,nasal symptoms, alopeciaLicensed use Epivir c not licensed for use in childrenunder 3 months; Zeffix c not licensed for use inchildrenIndication and doseSee preparationsEpivir c (ViiV) ATablets, f/c, lamivudine 150 mg (scored, white), netprice 60-tab pack = £143.32; 300 mg (grey), 30-tabpack = £157.51Oral solution, banana- and strawberry-flavoured,lamivudine 50 mg/5 mL, net price 240-mL pack =£39.01Excipients include sucrose 1 g/5 mLDoseHIV infection in combination with other antiretroviraldrugs. By mouthChild 1–3 months 4 mg/kg twice dailyChild 3 months–12 years 4 mg/kg (max. 150 mg) twicedaily or 8 mg/kg (max. 300 mg) once dailyorBody-weight 14–21 kg 75 mg twice daily or 150 mgonce dailyBody-weight 21–30 kg 75 mg in the morning and150 mg in the evening or 225 mg once dailyBody-weight over 30 kg 150 mg twice daily or 300 mgonce dailyChild 12–18 years 150 mg twice daily or 300 mg oncedailyZeffix c (ViiV) ATablets, brown, f/c, lamivudine 100 mg, net price 28-tab pack = £78.09DoseChronic hepatitis B infection either with compensatedliver disease (with evidence of viral replicationand histology of active liver inflammation or fibrosis)when first-line treatments cannot be used, or (incombination with another antiviral drug withoutcross-resistance to lamivudine) with decompensatedliver disease. By mouthChild 2–12 years 3 mg/kg (max. 100 mg) once dailyChild 12–18 years 100 mg once dailyNote Children receiving lamivudine for concomitant HIVinfection should continue to receive lamivudine in a doseappropriate for HIV infectionWith abacavirSee under AbacavirWith zidovudineSee under ZidovudineWith abacavir and zidovudineSee under AbacavirSTAVUDINE(d4T)Cautions see notes above; also history of peripheralneuropathy, excessive alcohol intake, concomitantuse of isoniazid—risk of peripheral neuropathy (seeunder Side-effects); history of pancreatitis or concomitantuse with other drugs associated with pancreatitis;interactions: Appendix 1 (stavudine)Hepatic impairment see notes aboveRenal impairment risk of peripheral neuropathy;reduce dose to 50% if estimated glomerular filtrationrate 25–50 mL/minute/1.73 m 2 ; reduce dose to 25%if estimated glomerular filtration rate less than 25 mL/minute/1.73 m 2Pregnancy manufacturer advises use only if potentialbenefit outweighs riskBreast-feeding see p. 3105 Infections