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Lamivudine/Zidovudine/Efavirenz

Lamivudine/Zidovudine/Efavirenz

DRUG SUMMARY

Zidovudine-lamivudine is a nucleoside reverse transcriptase inhibitor combination tablet that was used as the backbone component of combination antiretroviral therapy for years, but now is rarely used due to short-term and long-term toxicity. Lamivudine is usually well-tolerated. Zidovudine, however, frequently causes gastrointestinal side effects, headache, and malaise. Patients taking zidovudine for a prolonged period can develop neutropenia, anemia, myopathy, lactic acidosis, lipoatrophy, and hepatomegaly with steatosis. In addition, the zidovudine-lamivudine combination requires twice-daily dosing. Patients who currently take zidovudine-lamivudine should be strongly encouraged to change to a recommended agent.

Uses

This product contains 2 drugs: lamivudine and zidovudine. It is used with other HIV medications to help control HIV infection. It helps to decrease the amount of HIV in your body so your immune system can work better. This lowers your chance of getting HIV complications (such as new infections, cancer) and improves your quality of life. Both lamivudine and zidovudine belong to a class of drugs known as nucleoside reverse transcriptase inhibitors (NRTIs).

Lamivudine/zidovudine is not a cure for HIV infection. To decrease your risk of spreading HIV disease to others, do all of the following: (1) continue to take all HIV medications exactly as prescribed by your doctor, (2) always use an effective barrier method (latex or polyurethane condoms/dental dams) during all sexual activity, and (3) do not share personal items (such as needles/syringes, toothbrushes, and razors) that may have contacted blood or other body fluids. Consult your doctor or pharmacist for more details.

ADVERSE EFFECTS

Zidovudine commonly causes gastrointestinal side effects, such as nausea, vomiting, and loss of appetite. It can cause headache, weakness, dizziness, and other general symptoms, as well as peripheral neuropathy, bone marrow toxicity, including anemia and neutropenia, lipoatrophy, and lactic acidosis. Overall, lamivudine tends to be well tolerated. It may rarely cause side effects such as headache, diarrhea, nausea, or rash. It may be difficult to distinguish the cause of these side effects, since they are more commonly caused by zidovudine.

Lamivudine-Zidovudine Side Effects

Get emergency medical help if you have signs of an allergic reaction: 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).

Precautions

Before taking lamivudine/zidovudine, tell your doctor or pharmacist if you are allergic to either drug; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, liver problems (such as hepatitis B or C, cirrhosis), disease of the pancreas (pancreatitis), alcohol use, low red/white blood cell counts.

This drug may make you dizzy. Alcohol or marijuana can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

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