lamivudine and zidovudine

Pronunciation:	lah MIH vue deen and zye DOE vue deen
Brand:	Combivir

What is the most important information I should know about lamivudine and zidovudine?

The combination of lamivudine and zidovudine (Combivir) should not be taken together with any other medications that contain either of these two drugs. This includes Epivir, Retrovir, Epzicom (abacavir and lamivudine), and Trizivir (abacavir, lamivudine, zidovudine).

Before taking this medication, tell your doctor if you have kidney disease, liver disease, a pancreas disorder, bone marrow suppression, or problems with your muscles.

Lamivudine and zidovudine can lower the blood cells in your body that help you fight infections. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. It is important that you not miss any scheduled visits to your doctor.

If you have hepatitis B you may develop liver symptoms after you stop taking lamivudine and zidovudine, even months after stopping. Your doctor may want to check your liver function on a regular basis for several months after you stop using this medication. Do not miss any scheduled visits.

This medication may cause lactic acidosis (the build up of lactic acid in the body). Lactic acidosis symptoms can start slowly and gradually get worse. Symptoms include unusual muscle pain and weakness, trouble breathing, fast or uneven heart rate, nausea, vomiting, stomach pain, and numbness or cold feeling in your arms or legs. Call your doctor at once if you have any of these symptoms, even if they are only mild. Early signs of lactic acidosis generally get worse over time and this condition can be fatal.

What is lamivudine and zidovudine?

Lamivudine and zidovudine are antiviral medications. They are in a group of human immunodeficiency virus (HIV) medicines called reverse transcriptase inhibitors. This medication helps keep the HIV virus from reproducing in the body.

The combination of lamivudine and zidovudine is used to treat HIV, which causes the acquired immunodeficiency syndrome (AIDS). This medication is not a cure for HIV or AIDS.

Lamivudine and zidovudine may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking lamivudine and zidovudine?

Do not use this medication if you are allergic to lamivudine or zidovudine. The combination of lamivudine and zidovudine (Combivir) should not be taken together with any other medications that contain either of the two drugs. This includes Epivir, Retrovir, Epzicom (abacavir and lamivudine), and Trizivir (abacavir, lamivudine, zidovudine).

Before taking lamivudine and zidovudine, tell your doctor if you are allergic to any drugs, or if you have:

kidney disease;
liver disease;
pancreatitis;
bone marrow suppression; or
problems with your muscles.

If you have any of the conditions listed above, you may not be able to use lamivudine and zidovudine or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. HIV can be passed to the baby if the mother is not properly treated during pregnancy. Take all of your HIV medicines as directed to control your infection while you are pregnant.

Your name may need to be listed on an antiviral pregnancy registry when you start using this medication.

You should not breast-feed while you are using lamivudine and zidovudine. Women with HIV or AIDS should not breast-feed at all. Even if your baby is born without HIV, you may still pass the virus to the baby in your breast milk.

Do not give this medication to a child younger than 12 years old.

How should I take lamivudine and zidovudine?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Lamivudine and zidovudine can be taken with or without food.

HIV/AIDS is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Be sure to read the medication guide or patient instructions provided with each of your medications. Do not change your doses or medication schedule without advice from your doctor. Every person with HIV or AIDS should remain under the care of a doctor.

If you have hepatitis B you may develop liver symptoms after you stop taking this medication, even months after stopping. Your doctor may want to check your liver function at regular visits for several months after you stop using lamivudine and zidovudine. Do not miss any scheduled visits.

Store lamivudine and zidovudine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Symptoms of a lamivudine and zidovudine overdose may include nausea, vomiting, headache, dizziness, drowsiness, confusion, and seizure (convulsions).

What should I avoid while taking lamivudine and zidovudine?

Avoid contact with people who have colds, the flu, or other contagious illnesses. Contact your doctor immediately if you develop signs of infection.

Avoid having unprotected sex or sharing needles, razors, or toothbrushes. Taking this medication will not prevent you from passing HIV to other people. Talk with your doctor about safe methods of preventing HIV transmission during sex, such as using a condom and spermicide. Sharing drug or medicine needles is never safe, even for a healthy person.

Avoid drinking alcohol while taking lamivudine and zidovudine. Alcohol may increase the risk of damage to the pancreas and/or liver.

What are the possible side effects of lamivudine and zidovudine?

Stop using this medication and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

muscle pain and weakness, trouble breathing, fast or uneven heart rate, nausea, vomiting, stomach pain, numbness or cold feeling;
fever, chills, body aches, flu symptoms;
easy bruising or bleeding, unusual weakness, pale skin;
nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
sudden and severe stomach pain with nausea, vomiting, fever, chills, and rapid pulse; or
white patches or sores inside your mouth or on your lips.

Less serious side effects may be more likely to occur, such as:

changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and trunk);
nausea, vomiting, diarrhea, loss of appetite;
sleep problems (insomnia), strange dreams;
headache, dizziness; or
cough, runny or stuffy nose.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect lamivudine and zidovudine?

Before taking this medication, tell your doctor if you are using any of the following drugs:

cancer treatments;
stavudine (Zerit);
doxorubicin (Adriamycin);
zalcitabine (Hivid);
ganciclovir (Cytovene);
interferon-alfa (Roferon, Intron, Rebetron);
trimethoprim (Bactrim, Proloprim, Septra, Trimpex); or
ribavirin (Rebetol, Ribasphere, Copegus Virazole).

There may be other drugs not listed that can affect lamivudine and zidovudine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist has information about lamivudine and zidovudine written for health professionals that you may read.

What does my medication look like?

Lamivudine and zidovudine is available with a prescription under the brand name Combivir. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

Combivir 150 mg lamivudine/300 mg zidovudine-white, film-coated, capsule-shaped tablets.

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.

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