Precautions and warnings

**Patients with kidney or liver problems, or poor bone marrow function, should be assessed carefully before starting treatment. There is a higher risk of serious infections in these patients. Extra caution is needed for people—especially overweight women—who have risk factors for, or already have, liver disease. People with low body weight should not use the combined lamivudine/zidovudine tablet. Do not take separate tablets of lamivudine or zidovudine at the same time as the combined tablet. If dose adjustments are needed for either drug, use the separate formulations instead.**

**Monitor blood counts regularly: every 2 weeks for the first 3 months in patients with advanced disease, then monthly; for those with early disease, every 1–3 months. Also check liver function (LFTs), mean cell volume, creatine kinase, viral load, CD4 counts, and blood lactate levels. Patients should report symptoms like sore throat, nausea, vomiting, unexplained bruising, or bleeding. Drink plenty of fluids (2–3 liters per day) unless you have a fluid restriction.**

**Stop the treatment if serious side effects like severe lactic acidosis, worsening liver enlargement, or quickly increasing liver enzyme levels occur. Cases of lactic acidosis and fatty liver (hepatic steatosis) have been reported in pregnant women. During the third trimester of pregnancy, monitor liver enzymes and electrolytes regularly.**

Drug Interactions

**Zidovudine:**
- Taking acyclovir or valacyclovir with zidovudine can cause more drowsiness and confusion affecting the brain.
- The risk of blood problems increases if zidovudine is taken with ganciclovir, valganciclovir, dapsone, doxorubicin, vincristine, or vinblastine.
- Doxorubicin can reduce how well zidovudine is activated in the body.
- Fluconazole can raise zidovudine levels and effects.
- Using zidovudine with interferon or ribavirin raises the risk of liver failure and blood problems, and ribavirin also increases the risk of pancreatitis (inflammation of the pancreas) and lactic acidosis (a dangerous buildup of lactic acid).
- Methadone can increase the effects and levels of zidovudine.
- Probenecid can increase the chances of muscle pain, tiredness, fever, and skin rash, as well as higher levels and effects of zidovudine.
- Stavudine may make zidovudine less effective against viruses.
- Valproic acid can raise zidovudine levels in the blood by about 80%.

**Lamivudine:**
- Interferon or ribavirin can increase the risk of serious liver and blood problems if used with lamivudine, and ribavirin may also increase the risk of mitochondrial damage, pancreatitis, and lactic acidosis.
- Ganciclovir and valganciclovir can make lamivudine’s effects and side effects stronger.
- Taking lamivudine with sulfamethoxazole/trimethoprim can increase its levels in the body and reduce how quickly it is cleared out, resulting in increased effects and possible side effects.

Mode of actions

These drugs work together to lower the chance of the virus becoming resistant and to stop reverse transcriptase, an enzyme the virus needs to make new copies of itself. They do this by preventing the virus from building its DNA.

Lamivudine is a type of drug called an NRTI (nucleoside reverse transcriptase inhibitor) and is similar to the building block cytosine. After it is changed (phosphorylated) inside the cell, it blocks HIV reverse transcriptase and stops the virus from making DNA.

Zidovudine is also an NRTI, and looks like the building block thymidine. It prevents the virus from copying its genetic material by blocking the enzyme it needs.

Nevirapine is a different type of reverse transcriptase inhibitor called an NNRTI (non-nucleoside reverse transcriptase inhibitor). It works against HIV-1 by attaching directly to the reverse transcriptase enzyme and blocking its activity, so the virus can’t make new genetic material. Nevirapine does **not** need to be changed inside the cell to work.

Dosage & Administration

Adult: PO: One tablet twice daily.

Renal impairment:
CrCl (ml/min)

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required despite potential risks.

Mothers with a newborn baby who have used this drug during the last 3 months of pregnancy may seldom create symptoms including drowsiness, muscle stiffness or shakiness, feeding or breathing troubles, constant crying. If you notice any of these symptoms of your baby's particularly during their first month, tell the doctor immediately.

This medicine passes into breast milk. Talk to your doctor before breastfeeding.

Pack Size & Price