Zidovudine and Lamivudine act by terminating the growth of the DNA chain and inhibiting the reverse transcriptase of HIV, where as Nevirapine is a non-nucleoside reverse transcriptase inhibtor.
How to use
Each film coated tablet contains :
Lamivudine 150mg
Zidovudine 300mg
Nevirapine 200mg
This medicine is not intended for use in paediatric patients.
This combination is indicated for treatment of HIV infection,once patients have been stabilised on the maintainence regimen of NEVIRAPINE 200mg bd, and have demonstrated adequate tolerability to the same.
1 tablet twice daily is the usual dosage for this combination, contact your health care professional for more information.
This medication should not be adminstered to patients who have just initiated therapy with Nevirapine. An initial lead in dosing of 200mg of Nevirapine once daily for 2 weeks is recommended and also to observe if the patient is reporting any adverse reactions to the same such as rashes, liver abnormalities.
As this is a fixed dose combination, this medication should not be taken by anyone requiring a dosage adjustment and it should be discontinued if the patient experiences severe rash during thier lead in dosing of Nevirapine until the rash has resolved, the patient should not use this combination for treatment if they do not demonstrate adequate tolerability to Nevirapine.
Side Effects
Zidovudine : Zidovudine has been associated with Haematologic Toxicity including Neutropenia and severe anaemia,prolonged use of Zidovudine has been associated with symptomatic myopathy.
Nevirapine : Severe life threatening skin reactions including fatal cases have occured in patient treated with Nevirapine. Patients developing signs or symptoms of severe skin reactions or hypersensitivity reactions must discontinue Nevirapine as soon as possible. Some other side effects of Nevirapine are Toxic Epidermal Necrolysis, Stevens-Johnsons Syndrome, Hypersensitivity reactions, Organ Dysfunction.
Lactic Acidosis and severe hepatomegaly with steatosis including fatal cases, have been reported with the use if Nucleoside Analogues alone or in combination, including Lamivudine, Zidovudine and other Antiretrovirals.
Consult your Doctor for more information.
Drug Interaction
This Combination is contra indicated in patients with clinically significant hypersensitvity to any of the components contained in the formula. This combination is also contra indicated in patients who are just initiating therapy with Nevirapine. Inform your doctor if you have any allergies and if you are taking any medication for any ther condition of any nature.
Over Dose
Lamivudine : There is no known antidote for lamivudine overdose. If overdose occurs the patient should be monitored and standard supportive treatment applied as required.
Zidovudine : No specific symptoms or signs have been identified following acute over dosage with Zidovudine apart from those mentioned earlier. Haemodialysis and peritoneal dialysis appear to have to have effect on the removal of Zidovudine while elimination of its primary metabolite, GZDV is enhanced.
Nevirapine : There is no known antidote for Nevirapine over dosage.
Contact your doctor immediately and seek emergency medical attention.
Notes
The duration of clinical benefit from antiretroviral therapy maybe limited. Patients receiving Nevirapine or any other retroviral therapy may continue to develop opportunistic infections and other complications of HIV infection, and therefore should remain under close clinical observation by physicians experienced in the treatment of patients associated with HIV.
If clinical hepatitis occurs, use of this medication should be permanently discontinued and not restarted after recovery. In some cases, hepatitic injury progresses despite discontinuation of treatment.
This medication should only be used during pregnancy if the potential benefits outweigh the potential risk. Consult your doctor if your are pregnant or planning to concieve.
Missed Dose
Do not double dose to make up for the missed dose. Consult your doctor for dosages and take exactly as directed.
Uses
This combination is used in the management of the HIV infection. since all 3 of these drugs are to be administered twice daily, a fixed dose combination is created, with each tablet containing half the commonly prescribed doses of Lamivudine, Zidovudine and Nevirapine.
Storage
Store in a cool dry place.
Precaution
This medicine is not intended for use in patients who are just initiating therapy with Nevirapine. This medicine should be administered only to patients who have received Zidovudine+Lamivudine(Standard Doses) + Nevirapine (200 MG OD) for 2 weeks and have demonstrated adequate tolerability to Nevirapine.
As this is a fixed dose combination this medication should not be prescribed for patients requiring dosage adjustment and also for patients with low body weight (<50kgs).
It is recommended that HIV infected mothers do not breast feed thier infants to avoid risking potential transmission of HIV Infection. It is not known whether Lamivudine is excreted in breast milk, Nevirapine and Zidovudine are present in breast milk.
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