Generic Name: Lamivudine + Zidovudine Brand Name(s): .

Uses

What is Lamivudine + Zidovudine used for?

This product contains 2 drugs: lamivudine and zidovudine. It is used with other HIV medications to help control HIV infection. It helps to decrease the amount of HIV in your body so your immune system can work better. This lowers your chance of getting HIV complications (such as new infections, cancer) and improves your quality of life. Both lamivudine and zidovudine belong to a class of drugs known as nucleoside reverse transcriptase inhibitors (NRTIs).

Lamivudine/zidovudine is not a cure for HIV infection. To decrease your risk of spreading HIV disease to others, do all of the following: (1) continue to take all HIV medications exactly as prescribed by your doctor, (2) always use an effective barrier method (latex or polyurethane condoms/dental dams) during all sexual activity, and (3) do not share personal items (such as needles/syringes, toothbrushes, and razors) that may have contacted blood or other body fluids. Consult your doctor or pharmacist for more details.

How should I take Lamivudine + Zidovudine?

Take this medication by mouth with or without food, usually 2 times daily or as directed by your doctor. Take this medication with a full glass of water (8 ounces/240 milliliters) unless your doctor directs you otherwise.

Because this combination product has fixed doses of lamivudine and zidovudine, it should only be used if your doctor has determined that the doses of both medications in this product are right for you. This product is not to be used in children weighing less than 30 kilograms (66 pounds).

It is very important to continue taking this medication (and other HIV medications) exactly as prescribed by your doctor. Do not skip any doses. Do not increase your dose, take this drug more often than prescribed, or stop taking it (or other HIV medicines) even for a short time unless directed to do so by your doctor. Skipping or changing your dose without approval from your doctor may cause the amount of virus to increase, make the infection more difficult to treat (resistant), or worsen side effects.

This medication works best when the amount of drug in your body is kept at a constant level. Therefore, take this drug at evenly spaced intervals. To help you remember, take it at the same times each day.

How do I store Lamivudine + Zidovudine?

Lamivudine + Zidovudine is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Lamivudine + Zidovudine in the bathroom or the freezer. There may be different brands of Lamivudine + Zidovudine that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Lamivudine + Zidovudine down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Lamivudine + Zidovudine?

Before taking lamivudine/zidovudine, tell your doctor or pharmacist if you are allergic to either drug; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, liver problems (such as hepatitis B or C, cirrhosis), disease of the pancreas (pancreatitis), alcohol use, low red/white blood cell counts.

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

Also limit alcohol because it can increase the risk of liver problems and pancreatitis.

Children may be more sensitive to the side effects of this drug, especially pancreatitis.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Tell your doctor if you are pregnant before using this medication. Treatment can lower the risk of passing HIV infection to your baby. Discuss the risks and benefits with your doctor.

Lamivudine and zidovudine pass into breast milk. Because breast milk can transmit HIV, do not breast-feed.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Lamivudine + Zidovudine during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Lamivudine + Zidovudine. Lamivudine + Zidovudine is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Lamivudine + Zidovudine?

Headache, tiredness, loss of appetite, nausea, vomiting, diarrhea, trouble sleeping, dizziness, or stuffy nose may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

As your immune system gets stronger, it can begin to fight off infections you already had, possibly causing disease symptoms to come back. You could also have symptoms if your immune system becomes overactive. This reaction may happen at any time (soon after starting HIV treatment or many months later). Get medical help right away if you have any serious symptoms, including: unexplained weight loss, severe tiredness, muscle aches/weakness that doesn’t go away, headaches that are severe or don’t go away, joint pain, numbness/tingling of the hands/feet/arms/legs, vision changes, signs of infection (such as fever, chills, swollen lymph nodes, trouble breathing, cough, non-healing skin sores), signs of an overactive thyroid (such as irritability, nervousness, heat intolerance, fast/pounding/irregular heartbeat, bulging eyes, unusual growth in the neck/thyroid known as a goiter), signs of a certain nerve problem known as Guillain-Barre syndrome (such as trouble breathing/swallowing/moving your eyes, drooping face, paralysis, trouble speaking).

Tell your doctor right away if any of these unlikely but serious side effects occur: mental/mood changes (such as depression), signs of pancreatitis (such as nausea, vomiting, stomach/abdominal/back pain, fever), easy bruising/bleeding, skin/nail color changes.

Changes in body fat may occur while you are taking this medication (such as increased fat in the upper back and stomach areas, decreased fat in the arms and legs). The cause and long-term effects of these changes are unknown. Discuss the risks and benefits of treatment with your doctor, as well as the possible use of exercise to reduce this side effect.

This medication can commonly cause a rash that is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of a severe reaction. Therefore, seek immediate medical attention if you develop any rash.

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Lamivudine + Zidovudine?

Some products that may interact with this drug include: orlistat, probenecid, ribavirin, stavudine, drugs that may decrease bone marrow function or lower blood cell counts (such as ganciclovir, trimethoprim, cancer chemotherapy including doxorubicin), drugs that may affect the kidneys (including NSAIDs such as ibuprofen or naproxen).

Other medications can affect the removal of zidovudine from your body, which may affect how lamivudine/zidovudine works. Examples include rifampin, valproic acid, among others.

If you are also taking clarithromycin, take this medication at least 2 hours apart from your clarithromycin dose.

Do not take other products that contain either lamivudine or zidovudine with this medication.

Emtricitabine is similar to lamivudine and should not be taken with this medication.

Lamivudine + Zidovudine may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Lamivudine + Zidovudine?

Lamivudine + Zidovudine may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Lamivudine + Zidovudine?

Lamivudine + Zidovudine may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Lamivudine + Zidovudine.

What is the dose of Lamivudine + Zidovudine for an adult?

Usual Adult Dose for HIV Infection

1 tablet orally twice a day

Use: In combination with other antiretrovirals, for the treatment of HIV-1 infection

Usual Adult Dose for Nonoccupational Exposure

US CDC recommendations: 1 tablet orally every twice a day

Duration of therapy: 28 days

Comments:

-Recommended as part of a preferred NNRTI-based or protease inhibitor-based regimen for nonoccupational postexposure prophylaxis of HIV infection; also recommended as part of alternative regimens (NNRTI-based, protease inhibitor-based, or triple NRTI)

-Prophylaxis should be started as soon as possible, within 72 hours of exposure.

-Current guidelines should be consulted for additional information.

Usual Adult Dose for Occupational Exposure

US Public Health Service working group recommendations: 1 tablet orally twice a day

Duration of therapy: 28 days, if tolerated

Comments:

-Recommended as part of alternative regimens for HIV postexposure prophylaxis

-Prophylaxis should be started as soon as possible, preferably within hours after exposure.

-The optimal duration of prophylaxis is unknown and may differ based on the institution protocol.

-Current guidelines should be consulted for additional information.

Renal Dose Adjustments

CrCl less than 50 mL/min: Not recommended; individual components should be used.

Comments:

-The individual components should be used if dose reduction of either component required for patients with renal dysfunction.

Liver Dose Adjustments

Not recommended; individual components should be used.

Comments:

-Zidovudine levels increased in patients with liver dysfunction, which may increase risk of hematologic toxicity; hematologic toxicities should be monitored frequently.

Other Comments

Administration advice:

-Use in combination with other antiretroviral agents.

-May administer without regard to food

-If a patient is unable to reliably swallow a tablet, use the oral liquid formulations of each component.

-Do not use this drug in patients experiencing dose-limiting side effects; use the individual components.

-Consult the manufacturer product information regarding missed doses.

Storage requirements:

-Store between 2C and 30C (36F and 86F).

Monitoring:

-Hematologic: Blood counts (frequently in patients with advanced HIV-1 disease; periodically in other HIV-1-infected patients)

-Hepatic: Hepatic function of HIV-1/HBV-coinfected patients with clinical and laboratory follow-up (for at least several months after stopping therapy)

What is the dose of Lamivudine + Zidovudine for a child?

Usual Pediatric Dose for HIV Infection

At least 30 kg: 1 tablet orally twice a day

Comments:

-Use of the individual components is recommended for patients less than 30 kg; the manufacturer product information for lamivudine and zidovudine should be consulted.

Use: In combination with other antiretrovirals, for the treatment of HIV-1 infection

Precautions

This drug is not recommended for use in pediatric patients weighing less than 30 kg.

How is Lamivudine + Zidovudine available?

Lamivudine + Zidovudine is available in the following dosage forms and strengths:

  • Oral Tablet

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Lamivudine + Zidovudine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Sources

Review Date: March 12, 2018 | Last Modified: March 12, 2018

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