Drug Interaction Report

Lamivudine and Sorbitol: Interaction Details

A pharmacist-reviewed analysis of the Lamivudine and Sorbitol interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Lamivudine

Epivir Epivir-HBV® Epivir®
+

Sorbitol

No brand names on record
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 8 documented Lamivudine interactions, 7 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
probable
Severity
Major

What happens

Reduced lamivudine exposure, reduced efficacy of lamivudine and loss of virological control

Interaction Deep Dive

Concomitant use of lamivudine and sorbitol has resulted in a sorbitol dose-dependent reduction in lamivudine exposure. In a study in healthy adult subjects (N=16), coadministration resulted in decreases in lamivudine AUC and Cmax12. Avoid use of sorbitol-containing medicines with lamivudine 34. If coadministration cannot be avoided, consider more frequent monitoring of hepatitis B or HIV viral load 12.

Why it happens (mechanism)

Unknown

Literature reports

1 report — tap to read

a) Coadministration of a single 300 mg dose of lamivudine oral solution with a single dose of sorbitol in solution 3.2 grams, 10.2 grams, or 13.4 grams resulted in dose-dependent decreases of 20%, 39%, and 44% in the lamivudine AUC(0 to 24), 14%, 32%, and 36% decreases in the lamivudine AUC(infinity), and 28%, 52%, and 55% decreases in the Cmax of lamivudine in a randomized study in healthy adult subjects (N=16) 234.

Common questions

Can I take Lamivudine and Sorbitol together?

Reduced lamivudine exposure, reduced efficacy of lamivudine and loss of virological control Always confirm with your pharmacist or prescriber before making any change.

How serious is the Lamivudine and Sorbitol interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

Questions for your pharmacist

  • Does my dose of Lamivudine or Sorbitol need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (4)

  1. Product Information: EPIVIR(R) oral tablets, oral solution, lamivudine oral tablets, oral solution. ViiV Healthcare (per manufacturer), Research Triangle Park, NC, 2018. DailyMed
  2. Product Information: EPIVIR-HBV(R) oral tablets, oral solution, lamivudine oral tablets, oral solution. GlaxoSmithKline (per FDA), Research Triangle Park, NC, 2017.
  3. Product Information: TRIUMEQ oral tablets, abacavir, dolutegravir, lamivudine oral tablets. ViiV Healthcare (per FDA), Durham, NC, 2023. DailyMed
  4. Product Information: TRIUMEQ PD oral tablets for suspension, abacavir, dolutegravir, lamivudine oral tablets. ViiV Healthcare (per FDA), Durham, NC, 2023. DailyMed
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Lamivudine

Keep reading about Lamivudine

All Lamivudine interactions (8) Lamivudine drug information
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Sorbitol

Keep reading about Sorbitol

All Sorbitol interactions (1)
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Lamivudine + Activated Charcoal Coffee Charcoal European Mandrake Glucomannan Guar Gum Gum Arabic Horsetail Slippery Elm + 10 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.