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Lamivudine and tenofovir (Oral)

la-MIV-ue-deen, ten-OF-oh-vir dye-soe-PROX-il FUE-ma-rate

Oral route(Tablet)

Warning: Post Treatment Acute Exacerbations of Hepatitis BSevere acute exacerbations of hepatitis B have been reported in patients who are co-infected with hepatitis B virus (HBV) and human immunodeficiency virus (HIV-1) and have discontinued lamivudine or tenofovir disoproxil fumarate. Monitor hepatic function closely with both clinical and laboratory follow-up for at least several months in patients who discontinue lamivudine/tenofovir disoproxil fumarate and are co-infected with HIV-1 and HBV . If appropriate, initiate anti-hepatitis B treatment .

Medically reviewed by Drugs.com. Last updated on Dec 31, 2019.

Commonly used brand name(s)

In the U.S.

  • Cimduo
  • Temixys

Available Dosage Forms:

  • Tablet

Therapeutic Class: Antiretroviral Agent

Pharmacologic Class: Nucleoside Reverse Transcriptase Inhibitor

Uses for lamivudine and tenofovir

Lamivudine and tenofovir combination is used together with other antiviral medicines to treat human immunodeficiency virus (HIV) infection. HIV is the virus that causes acquired immune deficiency syndrome (AIDS).

Lamivudine and tenofovir does not cure or prevent HIV or AIDS. It helps keep HIV from reproducing and appears to slow down the destruction of the immune system. This may help delay the development of problems that usually result from AIDS or HIV disease. It will not keep you from spreading HIV to other people. People who receive lamivudine and tenofovir may continue to have some of the problems usually related to AIDS or HIV disease.

Lamivudine and tenofovir is available only with your doctor's prescription.

Before using lamivudine and tenofovir

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For lamivudine and tenofovir, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to lamivudine and tenofovir or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of lamivudine and tenofovir combination in children weighing 35 kilograms (kg) or more. Safety and efficacy have been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of lamivudine and tenofovir combination in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution in patients receiving lamivudine and tenofovir combination.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking lamivudine and tenofovir, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using lamivudine and tenofovir with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Aceclofenac
  • Acemetacin
  • Amtolmetin Guacil
  • Aspirin
  • Atazanavir
  • Bromfenac
  • Bufexamac
  • Celecoxib
  • Choline Salicylate
  • Clonixin
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Didanosine
  • Diflunisal
  • Dipyrone
  • Droxicam
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Flufenamic Acid
  • Flurbiprofen
  • Horsetail
  • Ibuprofen
  • Indomethacin
  • Ketoprofen
  • Ketorolac
  • Ledipasvir
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Morniflumate
  • Nabumetone
  • Naproxen
  • Nepafenac
  • Niflumic Acid
  • Nimesulide
  • Nimesulide Beta Cyclodextrin
  • Orlistat
  • Oxaprozin
  • Oxyphenbutazone
  • Parecoxib
  • Phenylbutazone
  • Piketoprofen
  • Piroxicam
  • Pranoprofen
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Sodium Salicylate
  • Sorbitol
  • Sulindac
  • Tenoxicam
  • Tiaprofenic Acid
  • Tolfenamic Acid
  • Tolmetin
  • Valdecoxib

Using lamivudine and tenofovir with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Darunavir
  • Lopinavir
  • Ritonavir
  • Tipranavir

Interactions with food/tobacco/alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of lamivudine and tenofovir. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bone problems (eg, fractures, osteoporosis), history of or
  • Fanconi syndrome (kidney disease), history of or
  • Hepatitis B infection, history of or
  • Kidney failure, acute or
  • Liver disease or
  • Pancreatitis (swelling of the pancreas), history of—Use with caution. May make these conditions worse.
  • End-stage kidney disease or
  • Kidney disease, severe—Use is not recommended in patients with these conditions.

Proper use of lamivudine and tenofovir

Take lamivudine and tenofovir exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

Lamivudine and tenofovir comes with a patient information leaflet. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Do not stop using lamivudine and tenofovir without checking first with your doctor. When your supply of lamivudine and tenofovir is running low, contact your doctor or pharmacist ahead of time. Do not allow yourself to run out of lamivudine and tenofovir.

You may take lamivudine and tenofovir with or without food.

Keep taking lamivudine and tenofovir for the full time of treatment even if you begin to feel better. If you stop the medicine even briefly, the virus may become harder to treat.

Dosing

The dose of lamivudine and tenofovir will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of lamivudine and tenofovir. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For treatment of HIV infection:
      • Adults and children weighing 35 kilograms (kg) or more—1 tablet once a day. Lamivudine and tenofovir contains 300 mg lamivudine and 300 mg tenofovir disoproxil fumarate (equivalent to 245 mg tenofovir disoproxil).
      • Children weighing less than 35 kg—Use is not indicated in these patients.

Missed dose

If you miss a dose of lamivudine and tenofovir, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Store the medicine in its original bottle and keep it tightly closed.

Precautions while using lamivudine and tenofovir

It is very important that your doctor check you and your child's progress at regular visits, especially during the first few weeks that you take lamivudine and tenofovir. Blood and urine tests may be needed to check for any unwanted effects.

Do not take Temixys™ together with adefovir (Hepsera®).

Two rare but serious reactions to lamivudine and tenofovir are lactic acidosis (too much acid in the blood) and liver toxicity. Call your doctor right away if you or child have abdominal or stomach discomfort, cramping, nausea, vomiting, diarrhea, or a decreased appetite, muscle cramping or pain, unusual tiredness or weakness, trouble breathing, or yellow skin or eyes.

Lamivudine and tenofovir may cause a hepatitis B infection to worsen if you stop using it. Your doctor may check for the presence of hepatitis B before and during treatment with lamivudine and tenofovir and for at least several months after your last dose.

Lamivudine and tenofovir may increase the risk of kidney problems. To lower this risk, avoid other medicines that can be harmful to the kidneys such as aminoglycoside antibiotics, certain other antiviral medicines, and NSAID pain medicines.

Check with your doctor right away if you or your child have loss of appetite, nausea, or pains in the stomach, side, or abdomen, possibly radiating to the back. These could be symptoms of pancreatitis (swelling of the pancreas).

Lamivudine and tenofovir may also increase your or your child's risk of developing fractures (broken bones). Ask your doctor about this if you have any concerns.

Your immune system may get stronger when you start using HIV medicines. Tell your doctor right away if you notice any changes in your health. Sometimes the immune system will start to fight infections that were hidden in your body, such as pneumonia, herpes, or tuberculosis. Autoimmune disorders (eg, Graves' disease, polymyositis, and Guillain-Barré syndrome) may also occur.

Lamivudine and tenofovir may cause you to have excess body fat. Tell your doctor if you notice changes in your body shape, such as an increased amount of fat in the upper back and neck, or around the chest and stomach area. You might also lose fat from the legs, arms, and face.

Lamivudine and tenofovir does not decrease the risk of transmitting the HIV infection to others through sexual contact or by contaminated blood. Make sure you understand and practice safe sex, even if your partner also has HIV. Avoid sharing needles with anyone.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (St. John's wort) or vitamin supplements.

Lamivudine and tenofovir side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  • Fever
  • pain
  • stomach pain

Less common

  • Chest pain
  • chills
  • cough
  • difficulty in moving
  • joint pain or swelling
  • muscle ache, cramp, pain, or stiffness
  • sneezing
  • sore throat
  • tightness in the chest
  • troubled breathing

Incidence not known

  • Bloating
  • bloody urine
  • blurred vision
  • bone fractures, especially of the femur
  • bone pain
  • cloudy urine
  • constipation
  • dark urine
  • decreased appetite
  • decreased frequency or amount of urine
  • diarrhea
  • difficulty swallowing
  • dizziness
  • dry mouth
  • fast heartbeat
  • fast, shallow breathing
  • flushed, dry skin
  • frequent urination
  • fruit-like breath odor
  • general feeling of discomfort
  • hives, itching, skin rash
  • increased blood pressure
  • increased hunger
  • increased thirst
  • increased urination
  • increased volume of pale, dilute urine
  • indigestion
  • irregular heartbeat
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
  • light-colored stools
  • loss of appetite
  • lower back or side pain
  • mood changes
  • muscle weakness
  • nausea
  • numbness or tingling in the hands, feet, or lips
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • pale skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • seizures
  • sleepiness
  • stomach discomfort
  • sweating
  • swelling of the face, fingers, or lower legs
  • troubled breathing with exertion
  • unexplained weight loss
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • upper right abdominal or stomach pain
  • vomiting
  • weight gain
  • yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Anxiety
  • back pain
  • belching
  • burning, numbness, tingling, or painful sensations
  • discouragement
  • feeling sad or empty
  • headache
  • heartburn
  • indigestion
  • irritability
  • lack or loss of strength
  • loss of interest or pleasure
  • redistribution or accumulation of body fat
  • stomach upset
  • tiredness
  • trouble concentrating
  • trouble sleeping
  • unsteadiness or awkwardness
  • weakness in the arms, hands, legs, or feet

Incidence not known

  • Hair loss or thinning of hair

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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