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lamivudine vs emtricitabine
Sep 7, 2013

hello doctor, frequently i have heard these two molecules have completely same profile regarding many important things like drug resistance profile, side effects, pharmacokinetics etc. so, can one choose any of them in their first regimen? which one would you prefer, a (tenofovir/lamivudine/efavirenz) or (tenofovir/emtricitabine/efavirenz)? I n one article i found emergence of drug resistance is more with lamivudine (M184V). for ur info, lamivudine based regimens cost $12/month less than emtricitabine based ART in my country. Regards.

Response from Dr. Young

Hello and thanks for posting.

Lamivudine (3TC, Epivir) and emtricitabine (FTC, Emtriva) are very similar molecules indeed- both often used in combination with other NRTIs, and available in coformulated pills.

Overall, the medications are very similar in potency and tolerability. There are some studies that suggest that there might be less drug resistance with FTC and FTC has a somewhat longer half life, but the absolute differences are small; in my opinion, these differences are easily outweighed by making sure that one remains as adherent as possible to their medications and medical plan.

In national and international treatment guidelines, including the 2013 World Health Organization and US DHHS Guidelines, the two are recommended interchangeably (other than for the preference of using medications in fixed-dose combinations).

So, if cost differences are significant, I'd have no reservation about using 3TC over the more expensive FTC.

I hope that's helpful, BY

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