Generic
Lamivudine + Nevirapine + Zidovudine
1 brands available in the market
At a glance
Lamivudine + Nevirapine + Zidovudine is a combination of three antiretroviral medicines used for HIV infection. It prevents virus multiplication and boosts immunity.
Description
Lamivudine, Zidovudine and Nevirapine synergistically reduce viral resistance and inhibit reverse transcriptase via DNA chain termination. Lamivudine and Zidovudine are nucleoside reverse transcriptase inhibitors (NRTIs) and Nevirapine is a non-nucleoside reverse transcriptase inhibitor (NNRTI). This combination is convenient for HIV-1 infected patients and ensures higher compliance.
Indications
- HIV-1 infection (in combination with other antiretrovirals)
Therapeutic class
Antiretroviral
Pharmacological class
NRTI + NNRTI Combination
Pharmacology
Lamivudine and Zidovudine are nucleoside analogues that are phosphorylated to active triphosphate metabolites and inhibit reverse transcription via DNA chain termination. Nevirapine binds directly to reverse transcriptase and disrupts the enzyme's catalytic site.
Mechanism of action
Prevents HIV-1 replication through viral DNA chain termination and reverse transcriptase inhibition.
Dosage
Adult Dose (Oral):
- 1 tablet twice daily
- Only for patients who have tolerated the initial 200 mg once daily Nevirapine dose for 2 weeks
Renal Impairment: CrCl <50 mL/min: Avoid use
Administration
- Swallow tablet whole; do not chew, crush or break
- Can be taken with or without food, but a fixed time is preferable
- Taking on an empty stomach (preferably at bedtime) may reduce side effects
Missed dose
Not generally applicable (regular dosing required); consult doctor if needed.
Side effects
Common Side Effects:
- Nausea
- Vomiting
- Diarrhea
- Headache
- Fatigue
- Insomnia
- Skin rash
- Muscle damage
- Anemia (low red blood cell count)
- Decreased white blood cell count (neutrophils)
Precautions & warnings
- Monitor liver and kidney function regularly
- Avoid driving or activities requiring concentration (may cause fatigue and dizziness)
- Use effective contraception (medicine may cause birth defects)
- Avoid alcohol
- Do not stop suddenly
- Inform your doctor if you experience abdominal pain, loss of appetite, dark urine, or yellowing of eyes/skin
Contraindications
- Neutrophil count <0.75 x 10^9/L
- Hemoglobin levels <7.5 g/dL
- Lactation
- Moderate to severe liver disease
Drug interactions
- Acyclovir and valacyclovir may increase CNS depression
- Increased risk of hematologic toxicity with ganciclovir, dapsone, doxorubicin
- Increased risk of hepatic decompensation with interferon and ribavirin
- Methadone may increase levels/effects
Food interactions
Caution is advised when consuming alcohol with this combination; consult your doctor.
Use in pregnancy
Use in Pregnancy: May be unsafe during pregnancy. Animal studies have shown harmful effects on the fetus. Consult your doctor.
Use in lactation
Use in Lactation: Probably safe during breastfeeding. Limited human data suggests no significant risk to the baby.
Pediatric use
This fixed-dose combination is not recommended for pediatric patients (weighing less than 30 kg).
Geriatric use
Use with caution in elderly; no special dose adjustment may be needed.
Renal / hepatic impairment
Renal Impairment: Use with caution; avoid if CrCl <50 mL/min.
Hepatic Impairment: Use with caution; not recommended in moderate to severe liver disease.
Overdose effects
No specific overdose information available; excessive doses may increase side effects.
Storage conditions
Store in a cool and dry place; keep out of reach of children.
Chemical structure
Lamivudine + Nevirapine + Zidovudine