Monograph Details
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Infections & Infestations
> Viral infections
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COMBIVIR |
| Manufacturer |
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GlaxoSmithKline Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Nucleoside analogues (reverse transcriptase inhibitors). |
| Generic Name |
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Lamivudine 150mg, zidovudine 300mg; tabs. |
| Indications |
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HIV infection. |
| Children |
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Not recommended. |
| Adults |
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1 tab twice daily. Hepatic or renal dysfunction (CrCl <50mL/min): not recommended. |
| Precautions |
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Bone marrow depression. Anemia. Not for use with other lamivudine or zidovudine products. Hepatitis B (monitor for post-treatment exacerbation). Decompensated liver disease or risk factors for liver disease. Suspend if lactic acidosis or hepatotoxicity (e.g., hepatomegaly, steatosis) occurs. Women, obesity, prolonged nucleoside exposure: increased risk of toxicity. Monitor blood counts. Elderly. Pregnancy (Cat.C). Nursing mothers: not recommended. |
| Interactions |
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See literature. Avoid concomitant other forms of zalcitabine, stavudine, doxorubicin, ribavirin. Bone marrow suppression increased by ganciclovir, interferon-alpha, cytotoxic drugs. TMP/SMX, atovaquone, fluconazole, methadone, probenecid, valproic acid, possibly others may affect lamivudine or zidovudine blood levels (clinical significance unknown); monitor. Triple therapy (once daily regimen) with abacavir + tenofovir or with didanosine + tenofovir: high rate of early viral non-response (see literature). Monitor for treatment-associated toxicities with interferon-alpha with or without ribavirin. |
| Adverse Reactions |
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Headache, GI upset, malaise, fatigue, nasal symptoms, cough, musculoskeletal pain, neuropathy, insomnia, fever/chills, dizziness, depression, rash, myalgia, arthralgia, lab abnormalities (neutropenia, severe anemia, thrombocytopenia, elevated ALT/AST, bilirubin or amylase), hyperglycemia, seizures, lactic acidosis, severe hepatomegaly with steatosis, fat redistribution, myopathy; pancreatitis (rare). |
| Extra Text |
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Note: Register pregnant patients exposed to lamivudine by calling (800) 258-4263. |
| How Supplied |
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Tabs—60 |
| Additional Resources |
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• Related Prescribing Note |
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