Combivir
Generic Name:
Lamivudine and zidovudine
Brand Names:
Combivir
Combivir Description:
Combivir is a medication distributed by Glaxo-Smith-Kline Beecham Corporation that is prescribed to patients for treatment of the human immunodeficiency virus (HIV-1). Combivir contains lamivudine (Epivir) and zidovudine, which are synthetic nucleoside analogues that are protection agents against HIV-1.
Combivir Uses:
Combivir is used in the treatment of HIV-1. Combivir is a medication with two separate nucleoside analogues that help treat and prevent the spread of HIV-1. It is normally administered with other antiretrovirals. Combivir is not a cure for IV-related illnesses and does not prevent the spread of HIV to other people.
Combivir Interactions:
Studies have shown that Combivir should not be used with the following drugs because of known interactions with either lamivudine or zidovudine:
- Antiretroviral Agents like zalcitabine, stavudine, ribavirin
- Anthracycline antibiotics like Doxorubicin
- Hematologic, bone marrow suppressive and cytotoxic agents like ganciclovir, interferon alfa, ribavirin, and others
Combivir Dosage Information:
Typical Dosage Recommendations
Adults typically take one single Combivir tablet that contains 150 mg of lamivudine and 300 mg of zidovudine twice a day.
Children also take one Combivir tablet twice a day. However, before a pediatric patient is prescribed Combivir in the tablet form, it is necessary for the patient to be thoroughly assessed by a physician in order to determine whether or not the child is able to consume a tablet medication. In the event that a child would be unable to consume the tablet, the physician will order the child to consume the liquid form of the two active ingredients in Combivir. The doctor will prescribe the oral solution form of Epivir which is the lamivudine and a syrup form of Retrovir which is zidovudine.
Missing a Dose
Do not take a double dose of Combivir to regain your regular dosing schedule. Take the missed dose immediately, or if it is close to the time of your next dose, simply skip the missed dose and resume your regular dosing schedule.
Overdosing
If you experience an overdose, contacting a doctor immediately is advised.
Lamivudine Toxicity
There is no known antidote for Combivir. One study found that an adult patient receiving Combivir medication consumed six grams of lamivudine. The patient received multiple hematologic tests and the test results showed normal readings. However, the patient did have an amount of the lamivudine removed through a four hour hemodialysis (kidney replacement therapy).
Zidovudine Toxicity
Acute overdose scenarios have been reported in both pediatric and adult patients receiving Combivir treatment. However, with these situations, the overdoses involved consumption of almost 50 grams of zidovudine. With these levels of consumption, nausea and vomiting are the only consistent symptoms noted. In other cases, it has been recorded that the patient had symptoms of dizziness, headache, drowsiness, confusion, and increased tiredness. One scenario noted a case of a grand mal seizure. All of these patients did recover from the overdose situation.
Combivir FDA Approval:
September 26, 1997
Combivir Recall/Black Box Warning Information:
Blood Disorders
Combivir may be connected to blood related (hematologic) toxicity and stop the body from producing adequate amounts of white and red blood cells. The hematologic toxicity types include abnormally low white blood cell counts (neutropenia) and red blood cell counts (anemia). This is especially true for patients with an advanced type of HIV-1.
Muscle Disease
A patient who is consuming zidovudine for an extended amount of time may also have symptoms of a muscle disease (symptomatic myopathy). Tell your doctor immediately if you develop muscle pain or weakness.
Lactic Acidosis
There have been fatalities recorded in patients from lactic acidosis (a condition where lactic acid builds up in the bloodstream faster than it can be removed) and hepatomegaly with steatosis (an enlarged liver with an abnormal accumulation of fatty acids). This is typical of nucleoside analogues. This can occur alone, mixed with lamivudine and/or zidovudine, and/or other types of antiretrovirals.
Other Warnings
There have been cases of acute exacerbations of hepatitis B recorded from patients who are also infected with the hepatitis B virus who have discontinued the consumption of lamivudine.
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