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Lamivudine + Nevirapine + Zidovudine is a combination of antiretrovirals medicines. It is prescribed to treat HIV (human immunodeficiency virus) infection. It boosts up the immunity to fight against HIV to manage or treat AIDS (acquired immunodeficiency syndrome). Lamivudine + Nevirapine + Zidovudine restricts the growth of HIV in the body and reduces the risk of getting HIV-related complications to improve the lifespan of an individual. The medicine can be taken with or without food. Taking these medicines regularly at the same time increases their effectiveness. A dose of this medicine should not be missed as it can affect your recovery. It is important to complete the full course of the treatment until your doctor advises you to stop it. Sudden discontinuation of the treatment may affect the potency of the medicine. The most common side effects of this medicine are headaches, nasal congestion, diarrhea, nausea, weakness and tiredness, cough, and rash. These side effects are generally temporary, but if they persist or become serious inform your doctor. This medicine can also make you feel lazy or weak, so it is advised to avoid driving. Drinking plenty of fluid can help you to cope up with the side effects, so stay hydrated. Before starting with the treatment, you should consult your doctor if you are pregnant or breastfeeding, or have any health condition. Your doctor may suggest regular blood tests to check your blood counts, kidney and liver functions, and other health conditions. If you are HIV positive, you should not breastfeed or share personal belongings like razors or toothbrushes. Consult your doctor to know about safe sex methods in order to prevent transmission of HIV during intercourse. Lamivudine + Nevirapine + Zidovudine is a combination of three antiviral medicines: Lamivudine, Zidovudine and Nevirapine. They work by preventing HIV (virus) from multiplying, thereby reducing the amount of virus in your body. They also increase the CD4 cell (white blood cells that protect against infection) count in your blood.

• HIV infection

Synergistically reduce viral resistance and inhibit reverse transcriptase via DNA chain termination. Lamivudine: NRTI; following phosphorylation, inhibits HIV reverse transcriptase by viral DNA chain termination; cytosine analog. Zidovudine: NRTI; interferes with HIV viral RNA-dependent DNA polymerase (inhibits viral replication); thymidine analog. Nevirapine: Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI); activity against HIV-1 by binding to reverse transcriptase, and thereby blocking RNA- and DNA-dependent DNA polymerase actions including HIV-1 replication. Does not require intracellular phosphorylation for activity.

Adult Dose: Adult: PO: One tablet twice daily. Renal Dose: Renal impairment: CrCl (ml/min) <50 Avoid

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Lamivudine + Nevirapine + Zidovudine may be taken with or without food, but it is better to take it at a fixed time.

Common: • Nausea • Vomiting • Diarrhea • Headache • Tiredness • Insomnia (difficulty in sleeping) • Rash • Muscle damage • Anemia (low number of red blood cells) • Decreased white blood cell count (neutrophils)

[UNSAFE] Lamivudine + Nevirapine + Zidovudine may cause side effects which could affect your ability to drive. You may experience fatigue while taking Lamivudine + Nevirapine + Zidovudine and this may affect your ability to drive. Lamivudine + Nevirapine + Zidovudine is a combination of three medicines which slows down or stops the progression of HIV infections. Take it on an empty stomach, preferably at bedtime, to reduce side effects. Skipping doses increases the risk of treatment failure. Make sure that you take all your doses at the correct time. Lamivudine + Nevirapine + Zidovudine may cause dizziness or sleepiness. Don't drive or do anything requiring concentration until you know how it affects you. Lamivudine + Nevirapine + Zidovudine can cause birth defects. Use effective contraception while taking Lamivudine + Nevirapine + Zidovudine and 12 weeks after stopping it. It may cause weakening of your bones. Exercise regularly and take calcium and vitamin D supplements as suggested by your doctor. Your doctor may monitor your kidney and liver functions regularly. Inform your doctor if you develop symptoms such as abdominal pain, loss of appetite, darkened urine or yellowing of the eyes or skin. Do not stop taking Lamivudine + Nevirapine + Zidovudine without your doctor's advice.

Neutrophil count <0.75 x 109/l; haemoglobin levels <7.5 g/dl or 4.65 mmol/l. Lactation.

Zidovudine: acyclovir and valacyclovir may increase CNS depression. Increased risk of haematologic toxicity with ganciclovir, valganciclovir, dapsone, doxorubicin, vincristine and vinblastine. Doxorubicin may reduce phophorylation; fluconazole may increase levels/effects; increased risk of hepatic decompensation or haematologic toxicities with interferon-? and ribavirin (also increases risk of pancreatitis and lactic acidosis). Methadone may increase effects/levels. Increased risk of myalgia, malaise and/or fever, maculopapular rash and effects/levels with probenecid. Stavudine may decrease antiviral activity; valproic acid may increase plasma levels (AUC increased by 80%). Lamivudine: Increased risk of hepatic decompensation or haematologic toxicities with interferon-? and ribavirin (also increases risk of mitochondrial toxicity, pancreatitis and lactic acidosis). Ganciclovir and valganciclovir may increase effects and toxicity; sulfamethoxazole/trimethoprim may increase AUC and decrease clearance (increasing levels and effects).

[CAUTION] Caution is advised when consuming alcohol with Lamivudine + Nevirapine + Zidovudine. Please consult your doctor.

[CONSULT YOUR DOCTOR] Lamivudine + Nevirapine + Zidovudine may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.

[SAFE IF PRESCRIBED] Lamivudine + Nevirapine + Zidovudine is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.

[CAUTION] Lamivudine + Nevirapine + Zidovudine should be used with caution in patients with kidney disease. Dose adjustment of Lamivudine + Nevirapine + Zidovudine may be needed. Please consult your doctor. [CAUTION] Lamivudine + Nevirapine + Zidovudine should be used with caution in patients with liver disease. Dose adjustment of Lamivudine + Nevirapine + Zidovudine may be needed. Please consult your doctor. Use of Lamivudine + Nevirapine + Zidovudine is not recommended in patients with moderate to severe liver disease. Regular monitoring of liver function tests is advised while you are taking this medicine.

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