Generic Name: lamivudine/zidovudine (la-MIV-ue-deen/zye-DOE-vue-deen)
Brand Name: Combivir
One of the 2 active ingredients in lamivudine/zidovudine, zidovudine, has been associated with certain blood disorders (eg, low white blood cell levels, severe anemia), especially in patients with advanced HIV disease, and muscle pain and inflammation, when it is used for long periods of time. High levels of lactic acid in the blood and severe liver problems, which may be life-threatening, have been reported with the use of lamivudine/zidovudine.
Some patients with both HIV and hepatitis B infection who were taking lamivudine have developed severe worsening of their hepatitis B after they stopped taking lamivudine. Patients who have both HIV and hepatitis B infection and who stop using lamivudine/zidovudine should have their liver function closely checked for at least several months after their last dose.
Lamivudine/zidovudine is used for:
Treating HIV infection in combination with other medicines.
Lamivudine/zidovudine is an antiviral combination. Lamivudine and zidovudine are both nucleoside analogues that work together to slow the growth of HIV by blocking an enzyme needed by the virus to reproduce.
Do NOT use lamivudine/zidovudine if:
- you are allergic to any ingredient in lamivudine/zidovudine
- you are also taking stavudine, zalcitabine, or other medicines containing lamivudine or zidovudine
- you have severe kidney problems, decreased liver function, abnormal liver function tests, or high levels of lactic acid in the blood (lactic acidosis)
Contact your doctor or health care provider right away if any of these apply to you.
Before using lamivudine/zidovudine:
Some medical conditions may interact with lamivudine/zidovudine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you weigh less than 66 lbs (30 kg)
- if you have a history of liver problems (eg, abnormal liver function tests, hepatitis B infection) or lactic acidosis
- if you have a history of kidney problems, a bone marrow disorder, pancreas problems, abnormal blood cell counts, or nerve or muscle problems
- if you are significantly overweight
Some MEDICINES MAY INTERACT with lamivudine/zidovudine. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Interferon alfa or ribavirin because serious liver problems may occur
- Stavudine because its effectiveness may be decreased by lamivudine/zidovudine
- Clarithromycin, doxorubicin, rifampin, or zalcitabine because they may decrease lamivudine/zidovudine's effectiveness
- Acetaminophen, ganciclovir, ibuprofen, methadone, probenecid, trimethoprim/sulfamethoxazole, valproic acid, vancomycin, or zalcitabine because they may increase the risk of lamivudine/zidovudine's side effects or toxic effects
This may not be a complete list of all interactions that may occur. Ask your health care provider if lamivudine/zidovudine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use lamivudine/zidovudine:
Use lamivudine/zidovudine as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Take lamivudine/zidovudine by mouth with or without food.
- Continue to use lamivudine/zidovudine even if you feel well. Do not miss any doses.
- Taking lamivudine/zidovudine at the same time each day will help you remember to take it.
- If you miss a dose of lamivudine/zidovudine, take it as soon as possible. If it is within 2 hours of your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use lamivudine/zidovudine.
Important safety information:
- Lamivudine/zidovudine may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use lamivudine/zidovudine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- The risk of side effects may be greater and additional benefits may not be obtained if you take lamivudine/zidovudine in high doses. Do NOT take more than the recommended dose without checking with your doctor.
- Lamivudine/zidovudine is not a cure for HIV infection. Patients may still get illnesses and infections associated with HIV. Remain under the care of your doctor.
- Lamivudine/zidovudine does not stop the spread of HIV to others through blood or sexual contact. Use barrier methods of birth control (eg, condoms) if you have HIV infection. Do not share needles, injection supplies, or items like toothbrushes or razors.
- When your medicine supply is low, get more from your doctor or pharmacist as soon as you can. Do not stop taking lamivudine/zidovudine, even for a short period of time. If you do, the virus may grow resistant to the medicine and become harder to treat.
- Do not stop taking lamivudine/zidovudine without first checking with your doctor. Some conditions, including hepatitis B, may become worse if lamivudine/zidovudine is suddenly stopped.
- Changes in body fat (eg, an increased amount of fat in the upper back, neck, breast, and trunk, and loss of fat from the legs, arms, and face) may occur in some patients taking lamivudine/zidovudine. The cause and long-term effects of these changes are unknown. Discuss any concerns with your doctor.
- Lab tests, including blood cell counts and liver and kidney function tests, may be performed while you use lamivudine/zidovudine. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Lamivudine/zidovudine should not be used in CHILDREN weighing less than 66 lbs (30 kg); safety and effectiveness in these children have not been confirmed. Caution is advised when using lamivudine/zidovudine in CHILDREN with a history of pancreatitis, or children who have taken other medicines for HIV infection.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using lamivudine/zidovudine while you are pregnant. Lamivudine/zidovudine is found in breast milk. Do not breast-feed while taking lamivudine/zidovudine. Mothers infected with HIV should not breast-feed. There is a risk of passing the HIV infection or lamivudine/zidovudine to the baby.
Possible side effects of lamivudine/zidovudine:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Appetite loss; changes in body fat; cough; diarrhea; dizziness; fatigue; headache; indigestion; nasal problems; sleeplessness or other sleep problems; tiredness; weakness.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); dark urine; depression; fast or irregular heartbeat; infection (fever, chills, sore throat); inflammation of the pancreas (severe stomach pain, nausea, vomiting); joint pain; mental or mood changes; muscle pain; nausea; numbness, tingling, or weakness in arms or legs; seizures; shortness of breath; stomach tenderness or pain; swelling or soreness of the mouth or tongue; unusual bleeding or bruising; unusual tiredness; unusual weakness or exhaustion; vomiting; yellowing of the skin or eyes.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include confusion; dizziness; drowsiness; headache; nausea; seizures; tiredness; vomiting.Proper storage of lamivudine/zidovudine:
Store lamivudine/zidovudine at room temperature or in the refrigerator, between 36 and 86 degrees F (2 and 30 degrees C). Store in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep lamivudine/zidovudine out of the reach of children and away from pets.
- If you have any questions about lamivudine/zidovudine, please talk with your doctor, pharmacist, or other health care provider.
- Lamivudine/zidovudine is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take lamivudine/zidovudine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about lamivudine/zidovudine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to lamivudine/zidovudine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using lamivudine/zidovudine.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.