Combivir - an antiviral agent active against HIV.
Release form and composition
Combivir is available in the form of oval tablets white or almost white, film-coated, engraved with "GXFC3" on one side.
One tablet contains 150 mg of lamivudine on one side and 300 mg zidovudine other. Auxiliary components: magnesium stearate, colloidal anhydrous silica, microcrystalline cellulose, sodium starch glycolate type A.
Antiviral combination drug, the active substance is zidovudine and lamivudine is highly effective affects selective inhibitors of HIV-1 and HIV-2.
Lamivudine is a synergist zidovudine regards suppression of HIV replication in cell culture. The active ingredients of the drug is metabolized by intracellular kinases consistently to 5M'-triphosphate (TP).
Zidovudine triphosphate lamivudine triphosphate and - the substrates for the reverse transcriptase of HIV and competitive inhibitors of this enzyme. Advantageously, the antiviral activity of zidovudine and lamivudine caused addition to their monophosphate forms of viral DNA chain, leading to chain rupture.
According to the instructions Combivir is indicated for the treatment of HIV infection for children over 12 and adults with advanced immunosuppression (CD4 + cell counts below 500 cells / mm).
A method for receiving Combivir and dosages
Combivir for instructions intended for ingestion. The dosage for children over 12 years of age and adults is one tablet twice a day. Take Combivir without food.
Treatment should be under the supervision of the attending physician. In cases where it is necessary to reduce the dose or cancel a component of Combivir (zidovudine or lamivudine), you can go to certain drugs zidovudine and lamivudine.
Instructions for taking Combivir is contraindicated in case of hypersensitivity to zidovudine or lamivudine.
Zidovudine is contraindicated in severe anemia (hemoglobin levels below 4.65 mmol / l or 7.5 g / dl) or neutropenia (neutrophil count less than 0.75x109 / L).
In the opinion of Combivir it causes side effects that are typical of zidovudine and lamivudine.
Zidovudine Review of Combivir can cause such side effects:
- Hemopoietic system: often anemia (requiring transfusions), neutropenia and leucopenia; sometimes there is pancytopenia (with bone marrow hypoplasia) and thrombocytopenia; rarely - aplastic anemia Essential; in rare cases - aplastic anemia. In the opinion of Combivir, neutropenia and leucopenia often occur when taking high doses of zidovudine in patients with advanced HIV infection.
- Peripheral and central nervous system: often a headache and dizziness; rarely - increased drowsiness or insomnia, paresthesia, convulsions, anxiety, depression, decreased mental alertness.
- Respiratory system: rarely - asthma, shortness of breath, cough.
- The system of metabolism: rarely anorexia, lactic acidosis in the absence of hypoxia. Sometimes there is accumulation or fat redistribution.
- Cardiovascular system: perhaps a rare occurrence cardiomyopathy.
- Digestive system: frequently occur vomiting, nausea, diarrhea, abdominal pain, increased levels of bilirubin and liver enzymes; rarely - bloating, change in taste, pigmentation of the mucous membranes of the mouth, liver disease, pancreatitis, indigestion.
- The urinary system: frequent urination possible.
- Reproductive System: gynecomastia may occur rarely.
- Dermatological reactions: often have urticaria, pigmentation of the skin and nails, sweating; rarely - itching, rash.
- Musculoskeletal system: the case of the occurrence of myalgia, myopathy.
- Other adverse reactions: often malaise, generalized pain, fever; in rare cases - flu-like symptoms, chest pain, chills.
Lamivudine Review of Combivir may cause the following side effects:
- Hematopoietic system: the case of rare occurrence of neutropenia, thrombocytopenia and anemia; very rarely may aplastic anemia Essential.
- Peripheral and central nervous system: often a headache; rarely - paresthesia. There were reviews of Combivir the occurrence of peripheral neuropathy, but not clarified its relationship with lamivudine therapy.
- Metabolic: may accumulation or redistribution of fat tissue.
- Digestive system: often vomiting, nausea, diarrhea, epigastric pain; rarely - pancreatitis, transient increase in liver enzymes (ALT, AST), increased serum amylase.
- Dermatological reactions: alopecia may occur, rash.
- Musculoskeletal system: muscle lesions often occur, arthralgia; rarely - rhabdomyolysis.
- Other side effects: often - malaise, state of fatigue, fever.
The use of Combivir during pregnancy and lactation
According to the instructions Combivir should not be taken during the first trimester of pregnancy, or taking a ratio of risk to mother and fetus.
Reviews of Combivir suggest that zidovudine treatment of pregnant women and newborns administration of the drug reduces the incidence of HIV transmission from mother to child.
Women taking Combivir for instruction is not recommended for breast-feeding.