LAMIVUDINE,ZIDOVUDINE

Background and Date of Approval

Lamivudine and Zidovudine is a combination medication containing the active ingredients lamivudine and zidovudine. It is indicated for the treatment of HIV-1 infection in combination with other antiretroviral medicines. Human immunodeficiency virus (HIV-1) infects and destroys immune system cells; consequently, the body's ability to resist infections diminishes and, in advanced disease, may lead to death. Patients with neutropenia (reduced white blood cells) or anaemia (reduced red blood cells) should not receive zidovudine or lamivudine. Inform your doctor if you have liver disease, including hepatitis B or C, renal disease, or are obese. Lamivudine and zidovudine received separate approvals from the U.S. Food and Drug Administration (FDA). Lamivudine received FDA approval on November 17, 1995. Zidovudine received FDA approval on March 19, 1987.

Uses

lamivudine and Zidovudine are used in the treatment of HIV–1 infection.

How is it administered?

Lamivudine and Zidovudine capsules or tablets is taken orally. The medication is usually taken once a day, with or without food, as directed by your healthcare provider. Swallow the capsule or tablet whole without crushing or chewing it.

Side Effects

lamivudine and Zidovudine can cause side effects such as nausea, vomiting, headache, diarrhea, fatigue, muscle pain, insomnia, rash, loss of appetite, abdominal pain, and joint pain. Although less common, these medications can also lead to serious side effects, such as severe allergic reactions, lactic acidosis, hepatotoxicity, blood disorders, and pancreatitis.

Warnings

Lamivudine and zidovudine carry several important warnings. These include the risk of lactic acidosis and hepatomegaly with steatosis, hematologic toxicity, hepatotoxicity in individuals with pre-existing liver disease, immune reconstitution syndrome, potential drug interactions, pancreatitis, mitochondrial toxicity, immune system changes, hypersensitivity reactions, and considerations for use during pregnancy.

Precautions

Inform your healthcare provider about all medications, including over-the-counter drugs and herbal supplements, to avoid potential drug interactions. Additionally, follow your healthcare provider's instructions regarding dosage and monitoring. Regularly attend check-ups to assess your response to the medications and address any concerns promptly.

Word of Advice

Lamivudine and zidovudine require consultation with a healthcare provider before use. Inform your doctor of any unusual side effects experienced during treatment. Disclose any history of liver disease, including hepatitis B or C, kidney disease, or obesity. Women who are pregnant or breastfeeding must consult their doctor prior to use. Direct any health-related questions about this medication to your healthcare provider.

References

KD Tripathi, Essentials of Medical Pharmacology, Antiviral drugs, 7th edition, 2013, 806 - 811. Goodman & Gilman’s, The Pharmacological Basis of Therapeutics, Antiretroviral agenteatment of HIV infection, 12th edition, 2011, 1632-1634. Milpharm Limited, Electronic medicines compendium (EMC), [ Revised on September 2020] [ Accessed on 16th May 2023], https://www.medicines.org.uk/emc/files/pil.2998.pdf ViiV Healthcare, US Food and Drug Administration, [ Revised on September 2015] [ Accessed on 16th May 2023], https://www.accessdata.fda.gov/drugsatfda_docs/...

Frequently Asked Questions

Can lamivudine and Zidovudine be used as preventive measures against HIV?

Lamivudine and Zidovudine are primarily used as part of a combination antiretroviral therapy (ART) regimen to treat HIV infection, not as a preventive measure. If you are concerned about HIV prevention, speak to your healthcare provider about appropriate strategies, including PrEP.

Can lamivudine and Zidovudine be used to treat hepatitis B?

Lamivudine and Zidovudine have previously been used to treat hepatitis B (HBV) infection. However, using these medications alone for HBV treatment is not advised because of the risk of developing resistance.

Can lamivudine and Zidovudine be used in children?

Lamivudine and Zidovudine are approved for use in pediatric populations, including infants, children, and adolescents, to treat HIV infection. The dosages may vary based on the child's weight and age.

Can lamivudine and Zidovudine cause lipodystrophy or changes in body fat distribution?

Lipodystrophy refers to changes in body fat distribution that can occur in individuals ng certain antiretroviral medications. While lamivudine and Zidovudine have been associated with fat loss and redistribution, the risk is generally lower than other medications.

Can lamivudine and Zidovudine be stopped once the viral becomes undetectable?

No, it is generally not recommended to stop taking lamivudine and Zidovudine or any other antiretroviral medications once the viral load becomes undetectable. A person should continue taking the prescribed medications as directed by a healthcare provider.

Can lamivudine and Zidovudine be used in elderly individuals?

Lamivudine and Zidovudine can be used in elderly individuals who require antiretroviral therapy for HIV treatment. However, dosage adjustments and careful monitoring may be necessary due to age-related changes in kidney function.

Written By: Muskan Patel, M.Pharm

Reviewed By: Dr. Vishwa Patel, MBBS