What is COMBIVIR?

COMBIVIR is the brand name of a pill that combines lamivudine and zidovudine. These two drugs can be used with other medicines to treat HIV.

HIV is the human immunodeficiency virus. It causes AIDS.
COMBIVIR slows HIV from making more copies of itself. This can keep the virus from infecting new cells. It can lower the amount of HIV in your body. Your CD4 cell count can increase with the lowering of the HIV virus.

The two drugs together are stronger against the virus than either one alone. COMBIVIR should be taken with other HIV drugs.

COMBIVIR can Nasutra be part of many treatments now used to fight HIV.


How COMBIVIR Works
What can COMBIVIR do for you?

• Helps keep viral load DOWN • Helps keep CD4 cell count UP by lowering the viral load • Helps you to avoid certain infections and cancers often linked to HIV

Good things you should know about COMBIVIR:

• Makes your pill schedule simpler • Helps you stick to your schedule • May be taken with or without food • Helps keep your treatment options open • Works with many other HIV drugs, giving your doctor many treatment choices • Needs only one co-pay for two drugs

Possible Side Effects of COMBIVIR
It’s important to know that serious side effects can occur with COMBIVIR, such as a decrease in red and white blood cells and muscle damage. A buildup of lactic acid and an enlarged liver, including fatal cases, have been reported rarely with some HIV drugs, including nucleoside analogues.

For HIV-infected individuals, periodic blood tests are recommended. If certain changes occur in your laboratory results while you are taking COMBIVIR, particularly if you become anemic or if your white blood cell count falls too low, your medication may need to be adjusted; your doctor may prescribe EPIVIR plus RETROVIR separately in place of COMBIVIR.

Some patients infected with both hepatitis B virus (HBV) and HIV have worsening of hepatitis after stopping lamivudine (a component of COMBIVIR). Discuss any change in treatment with your doctor. If you have both HBV and HIV and stop treatment with COMBIVIR, you should be closely monitored by your doctor for at least several months.

Worsening of liver disease (sometimes resulting in death) has occurred in patients infected with both HIV and hepatitis C virus who are taking anti-HIV medicines and are also being treated for hepatitis C with interferon with or without ribavirin. If you are taking COMBIVIR as well as interferon with or without ribavirin and you experience side effects, be sure to tell your doctor.

When you start taking HIV medicines, your immune system may get stronger and could begin to fight infections that have been hidden in your body, such as pneumonia, herpes virus or tuberculosis. If you have new symptoms after starting your HIV medicines, be sure to talk with your doctor.

Changes in body fat may occur in some patients taking antiretroviral therapy. These changes may include an increased amount of fat in the upper back and neck (“buffalo hump”), breast, and around the trunk. Loss of fat from the legs, arms and face may also occur. The cause and long-term health effects of these conditions are not known at this time.

In clinical studies of lamivudine plus zidovudine, side effects occurring in 5% or more of patients included: headache, upset stomach, weakness and fatigue, and nasal symptoms.

Tell your doctor promptly about any side effects or other unusual symptoms you may experience. Although it may make you healthier, COMBIVIR does not cure HIV.

Will COMBIVIR work the same as EPIVIR and RETROVIR taken together?

Taking one COMBIVIR Tablet twice a day is the same as taking one EPIVIR 150 mg Tablet twice a day and either two RETROVIR 100 mg Capsules three times a day or one RETROVIR 300 mg Tablet twice a day.



What should I do if I miss a dose of COMBIVIR?

If you miss a dose by more than 4 hours, wait and then take the next dose at the regularly scheduled time. However, if you miss a dose by less than 4 hours, take your missed dose immediately. Then take your next dose at the regularly scheduled time. Do not take more or less than your prescribed dose of COMBIVIR at any one time.


Who should not take COMBIVIR?

You should not take COMBIVIR if you have had a serious allergic reaction to either lamivudine (also known as EPIVIR or 3TC) or zidovudine (also known as RETROVIR or ZDV).

Do not take COMBIVIR at the same time as EPIVIR or RETROVIR, or TRIZIVIR® (abacavir sulfate/lamivudine/zidovudine), because they also contain lamivudine and zidovudine. Individual dosing with EPIVIR plus RETROVIR, rather than COMBIVIR, should be considered for:

• A child under 12 years of age.
• Anyone who requires dosage adjustments due to drug side effects or poor kidney function.

If you are 65 years of age or over, consult your healthcare professional about the functioning of your liver, kidneys, and heart; about other illnesses you may suffer from, and about any other medications you may be taking. It is possible that the dosage may need to be modified.


Can COMBIVIR be taken with other medications?

Yes. COMBIVIR can be taken with most other medications, including most anti-HIV drugs. Be sure to tell your doctor about all medications, over-the-counter or prescription, that you are taking.


How should I store COMBIVIR Tablets?
COMBIVIR Tablets may be stored at room temperature and do not require refrigeration.

Combivir and Breastfeeding

Combivir and Breastfeeding: An Overview

Both of the components of Combivir^®(lamivudine/zidovudine) pass through breast milk. Women with HIV or AIDS in developed countries (such as the United States) are typically advised not to breastfeed in order to reduce the chance of Neogra transmitting the virus to their infants. Therefore, most women taking Combivir should avoid breastfeeding.

 

Combivir and Breastfeeding: What Does the Research Say?

Studies have shown that both lamivudineand zidovudine pass through breast milk. More importantly, the HIV virus also passes through breast milk. Any HIV-infected woman who can safely feed her baby formula should not breastfeed. There are some situations in which formula feeding is not safe, such as if no clean water supply is available to mix the formula or wash the bottles. In these situations, it is difficult to know whether breastfeeding or formula feeding is more dangerous. In general, using both breastfeeding and formula feeding is considered to be the most dangerous, as digestive systemirritation or infections from unclean water can allow HIV to pass into the body from the digestive tract more easily.

 

Talking With Your Healthcare Provider About Combivir and Breastfeeding

You should talk with your healthcare provider about Combivir and breastfeeding. Each woman's situation is different, and you and your healthcare provider understand your situation best. After considering what you want and expect, as well as your current health situation, the two of you can make a shared decision about Combivir and breastfeeding that is right for you.

An Introduction to Combivir Side Effects

As with any medicine, side effects are possible with Combivir^®(lamivudine/zidovudine); however, not everyone who takes the drug will experience side effects. In fact, most people tolerate it quite well. When side effects do occur, in most cases, they are minor and either require no treatment or are easily treated by you or your healthcare provider.

 

(This article covers many, but not all, of the possible side effects with Combivir. Your healthcare provider can discuss a more complete list with you.)

 

Common Side Effects of Combivir

The exact formulation of Combivir (the two different medications in the same tablet) has not been studied in clinical trials. However, the combination of zidovudine and lamivudine in two separate tablets or capsules has been studied thoroughly in clinical trials. In these studies, the most common side effects of the zidovudine/lamivudine combination included:

 

• Headaches -- in up to 35 percent of people
• Nausea -- up to 33 percent
• A general ill feeling (malaise) and fatigue -- up to 27 percent
• Nasal symptoms -- up to 20 percent
• Diarrhea -- up to 18 percent
• Cough -- up to 18 percent
• Nausea and vomiting -- up to 13 percent
• Muscle or bone pain -- up to 12 percent
• Nerve problems, including unusual sensations (such as burning or tingling) -- up to 12 percent
• Insomnia -- up to 11 percent (see Combivir and Insomnia).
   

Other common side effects (occurring in 5 to 10 percent of people) included:

 

• Fever or chills
• Loss of appetite
• Abdominal pain (stomach pain)
• Stomach cramps
• Indigestion or heartburn
• Dizziness
• Joint pain.

Combivir and Insomnia: An Introduction

Insomnia is a relatively common side effect of Combivir^® (lamivudine/zidovudine). In clinical trials, 11 percent of people who took the combination of lamivudine andzidovudine (the active ingredients in Combivir) experienced insomnia or other sleep disorders. However, it is difficult to say with certainty that Combivir causes insomnia, since these studies did not compare the medication to a placebo (a "sugar pill" with no active ingredients). Without knowing how commonly insomnia occurs in similar people not taking Combivir, it is not possible to evaluate if the drug actually increases this risk.

 

What Is Insomnia?

People with insomnia may have one or more of the following symptoms:

 

• Difficulty falling asleep
• Waking up often during the night and having trouble going back to sleep
• Waking up too early in the morning
• Non-refreshing sleep.
   

Combivir and Insomnia: Suggestions

If you are taking Combivir and insomnia occurs, the cure may lie in improving your sleep habits. Some tips for better sleep include the following:

 

• Sleep in a dark, quiet room with a comfortable temperature.
• Keep a regular sleep-wake cycle. Try to go to bed and wake up at the same time every day.
• Avoid caffeine, alcohol, and nicotine in the four to six hours before bedtime.
• Don't exercise within two hours of bedtime. Exercising five or six hours before bedtime, however, may help you sleep more soundly.
• Don't eat large meals within two hours of bedtime.
• Don't nap later than 3 p.m.
• If you can't fall asleep within 20 minutes, do a quiet activity somewhere else and return to bed when you're sleepy.
• Wind down in the 30 minutes before bedtime with a relaxing pre-sleep ritual, such as a warm bath, soft music, or reading.