Lamivudine-13C15N2D2

Lamivudine-[13C,15N2,d2], an isotope of Lamivudine, serves as a crucial reverse transcriptase inhibitor pivotal in HIV/AIDS treatment [1]. Pharmacokinetic studies highlight its rapid absorption post-oral administration, achieving peak serum concentrations within 0.5 to 1.5 hours, with high bioavailability in adults (82%) and children (68%) [1]. It undergoes intracellular phosphorylation to lamivudine 5'-triphosphate, inhibiting HIV-1 and HBV replication by competing with viral reverse transcriptase [1]. The drug is widely distributed across body fluids, freely crossing the placenta and appearing in breast milk postpartum [1]. Metabolism primarily occurs in the kidneys, necessitating dosage adjustment in renal impairment, while hepatic function minimally impacts clearance [1]. Dolutegravir/lamivudine (Dovato®), a potent single-tablet regimen combining an integrase inhibitor with lamivudine, demonstrates efficacy comparable to standard ART regimens in maintaining sustained viral suppression without resistance mutations, making it a preferred treatment option for HIV-1 patients [2]. Adefovir, a nucleotide analog, represents a significant advance in hepatitis B treatment, effectively suppressing lamivudine-resistant strains with minimal resistance development and improving clinical outcomes [3]. These references underscore Lamivudine's diverse clinical applications and its pivotal role in antiretroviral and hepatitis treatment paradigms.