Combivir

Pronunciation

Generic Name: lamivudine and zidovudine (la MIV ue deen and zye DOE vue deen)
Brand Names: Combivir

What is Combivir?

Combivir is an antiviral medication containing a combination of lamivudine and zidovudine. These medicines belong to a group of human immunodeficiency virus (HIV) medicines called reverse transcriptase inhibitors. Combivir helps keep the HIV virus from reproducing in the body.

Combivir is used to treat HIV, which causes the acquired immunodeficiency syndrome (AIDS). This medication is not a cure for HIV or AIDS.

Important information

Do not take Combivir if you have ever had an allergic reaction to Combivir or any medicine that contains lamivudine, zidovudine, or emtricitabine, including: Atripla, Complera, Emtriva, Epivir, Epzicom, Retrovir, Trizivir, or Truvada.

Zidovudine can weaken your immune system and cause signs of infection (fever, mouth sores, skin sores, flu symptoms, pale skin). Your blood will need to be tested often. Long-term use of zidovudine can cause muscle weakness, or loss of muscle tissue similar to "wasting syndrome" caused by HIV.

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Some people develop lactic acidosis while taking Combivir. Early symptoms may get worse over time and this condition can be fatal. Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, slow or uneven heart rate, dizziness, or feeling very weak or tired.

This medicine may cause a serious condition called lactic acidosis. Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, fast or uneven heart rate, dizziness, or feeling very weak or tired.

Combivir can also cause severe or life-threatening effects on your liver. Call your doctor at once if you have any of these symptoms while taking Combivir: pain in your upper stomach, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes). Your doctor may want to check your liver function for several months after you stop using the medication. Visit your doctor regularly.

Before taking this medicine

Do not take Combivir if you have ever had an allergic reaction to any medicine that contains lamivudine, zidovudine, or emtricitabine. This includes Atripla, Combivir, Complera, Emtriva, Epivir, Epzicom, Retrovir, Stribild, Trizivir, and Truvada.

Some people develop a life-threatening condition called lactic acidosis while taking Combivir. You may be more likely to develop lactic acidosis if you are overweight or have liver disease, if you are a woman, or if you have taken HIV or AIDS medications for a long time. Talk with your doctor about your individual risk.

Combivir can also cause severe or fatal liver problems. Tell your doctor if you have liver disease, especially hepatitis B.

Do not take Combivir with any other medicine that contains lamivudine, zidovudine, or emtricitabine. This includes Atripla, Combivir, Complera, Emtriva, Epivir, Epzicom, Retrovir, Stribild, Trizivir, and Truvada.

To make sure you can safely take Combivir, tell your doctor if you have any of these other conditions:

  • kidney disease;

  • pancreas disorder (especially in a child taking this medicine); or

  • if you take ribavirin to treat hepatitis C.

FDA pregnancy category C. It is not known whether Combivir will harm an unborn baby. HIV can be passed to your baby if you are not properly treated during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Take all of your HIV medicines as directed to control your infection.

See also: Pregnancy and breastfeeding warnings (in more detail)

If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of Combivir on the baby.

Women with HIV or AIDS should not breast-feed a baby. Even if your baby is born without HIV, the virus may be passed to the baby in your breast milk.

Combivir should not be used to treat HIV in adolescents weighing less than 66 pounds.

How should I take Combivir?

Take Combivir exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Combivir can be taken with or without food.

HIV/AIDS is usually treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice. Every person with HIV or AIDS should remain under the care of a doctor.

Combivir can lower blood cells that help your body fight infections and help your blood to clot. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. Your blood may need to be tested often.

If you have hepatitis B you may develop liver symptoms after you stop taking medicine that contains lamivudine. Your doctor may want to check your liver function for several months after you stop using Combivir.

Store at room temperature away from moisture and heat.

Combivir dosing information

Usual Adult Dose for HIV Infection:

1 tablet orally twice a day

Usual Adult Dose for Nonoccupational Exposure:

(Not approved by FDA)

Centers for Disease Control and Prevention (CDC) recommendations: 1 tablet orally every 12 hours plus efavirenz or lopinavir-ritonavir
Duration: 28 days

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

Usual Adult Dose for Occupational Exposure:

(Not approved by FDA)

CDC recommendations:
Basic regimen for HIV postexposure prophylaxis: 1 tablet orally every 12 hours
Duration: Generally 28 days; however, the exact duration of therapy may differ based on the institution's protocol.

Therapy should begin promptly, preferably within 1 to 2 hours postexposure.

Usual Pediatric Dose for HIV Infection:

30 kg or more: 1 tablet orally twice a day

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Combivir?

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection. Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Taking this medicine will not prevent you from passing HIV to other people. Do not have unprotected sex or share razors or toothbrushes. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

Combivir side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Combivir: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Early symptoms of lactic acidosis may get worse over time and this condition can be fatal. Get emergency medical help if you have even mild symptoms: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, fast or uneven heart rate, dizziness, or feeling very weak or tired.

Call your doctor at once if you have:

  • low white blood cell counts - fever, swollen gums, painful mouth sores, pain when swallowing, skin sores, cold or flu symptoms, cough, trouble breathing;

  • low red blood cells (anemia) - pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or

  • liver problems - nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Combivir may increase your risk of certain infections or autoimmune disorders by changing the way your immune system works. Symptoms may occur weeks or months after you start treatment with Combivir. Tell your doctor if you have:

  • signs of a new infection - fever, night sweats, swollen glands, mouth sores, diarrhea, stomach pain, weight loss;

  • chest pain (especially when you breathe), dry cough, wheezing, feeling short of breath;

  • cold sores, sores on your genital or anal area;

  • rapid heart rate, feeling anxious or irritable, weakness or prickly feeling, problems with balance or eye movement;

  • trouble speaking or swallowing, severe lower back pain, loss of bladder or bowel control; or

  • swelling in your neck or throat (enlarged thyroid), menstrual changes, impotence, loss of interest in sex.

Common Combivir side effects may include:

  • headache;

  • nausea, diarrhea;

  • tiredness, general ill feeling;

  • cold symptoms such as stuffy nose, sneezing, sinus pain, cough; or

  • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and trunk).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Combivir?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Combivir, especially:

  • doxorubicin;

  • ganciclovir;

  • interferon alfa (Alferon A, Infergen, Intron A, Rebetron);

  • ribavirin;

  • stavudine; or

  • zalcitabine.

This list is not complete. Other drugs may interact with lamivudine and zidovudine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about Combivir.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2014 Cerner Multum, Inc. Version: 10.03. Revision Date: 2014-09-17, 9:55:37 PM.

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