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Generic name: Lamivudine, Zidovudine
Brand names: Combivir

Why is Combivir prescribed?

Combivir is used to fight the human immunodeficiency virus (HIV) that causes AIDS. It is a combination product containing the two AIDS drugs, lamivudine (Epivir) and zidovudine (Retrovir). It is intended for use with additional AIDS drugs.

HIV does its damage by slowly destroying the immune system, eventually leaving the body defenseless against infections. The drugs in Combivir interfere with the virus's ability to reproduce, thus staving off the decline of the immune system and preserving better health.

Most important fact about Combivir

Combivir is not a cure for HIV infection or AIDS. It does not completely eliminate HIV from the body or totally restore the immune system. There is still a danger of serious infections, so you should be sure to see your doctor regularly for monitoring and tests.

How should you take Combivir?

It's important to keep adequate levels of Combivir in your bloodstream at all times, so you need to take it regularly, exactly as prescribed, even when you're feeling better. Doses can be taken with or without food.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

--Storage instructions...

Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Combivir.

• More common side effects may include:
  Abdominal pain, abdominal cramps, allergic reactions, blisters, blood disorders, bone pain, breast enlargement, chills, cough, depression, diarrhea, dizziness, fat redistribution, fatigue, fever, flu-like symptoms, hair loss, headache, heart weakness, high blood sugar, indigestion, inflamed blood vessels, insomnia, joint pain, liver disorders, loss of appetite, mouth discoloration, mouth sores, muscle aches or weakness, nasal symptoms, nausea, nerve disorders, pancreatitis, seizures, skin rash, sleep disorders, vomiting, weakness, wheezing

Why should Combivir not be prescribed?

You should not take Combivir if either component, Epivir or Retrovir, has ever given you an allergic reaction.

Special warnings about Combivir

Remember that Combivir does not totally eliminate HIV from the body. The infection can still be passed on to others through sexual contact or blood contamination.

Combivir can upset the body's acid balance. It can also cause low blood cell counts (anemia), which can adversely affect your health. It should be used with extreme caution by anyone with an existing shortage of blood cells or a disease of the bone marrow (where blood cells are produced). It is very important to have your blood tested regularly, especially if you have an advanced case of HIV.

Combivir is known to occasionally cause serious liver problems.

If you have the chronic liver disease hepatitis B, the virus that causes it may become resistant to the Epivir component of Combivir. Your hepatitis may get worse when Combivir treatment is stopped.

Combivir can cause muscle pain and inflammation. Report these symptoms to your doctor.

If you weigh less than 110 pounds, you should not take Combivir. The Epivir component of Combivir is not recommended in people with low body weight.

Because Combivir contains fixed doses of Epivir and Retrovir, it cannot be used by people who might require a decrease or adjustment in the dosage of either drug, such as children and those with poor kidney or liver function.

Inflammation of the pancreas (pancreatitis) can be caused by the Epivir component of Combivir. If any signs of a pancreas problem develop such as severe abdominal pain that goes on for days, accompanied by nausea and vomiting, stop taking Combivir and call your doctor immediately.

Another side effect seen in some people receiving drugs for HIV is a redistribution of body fat, leading to extra fat around the middle, a "buffalo hump" on the back, and wasting in the arms, legs, and face. Researchers don't know whether this represents a long-term health problem or not.

Possible food and drug interactions when taking Combivir

If Combivir is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Combivir with the following:

Chemotherapy drugs
Doxorubicin (Doxil, Adriamycin)
Ganciclovir (Cytovene)
Interferon (Intron A, Roferon-A)
Ribavirin (Virazole)
Stavudine (Zerit)
Trimethoprim/Sulfamethoxazole (Bactrim, Septra)
Zalcitabine (Hivid)

Special information if you are pregnant or breastfeeding

The effects of Combivir during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, notify your doctor immediately.

Since HIV infection can be passed to your baby through breast milk, you should not breastfeed your infant.

Recommended dosage

ADULTS

For adults and adolescents 12 and over, the recommended dose is one tablet (containing 150 milligrams of Epivir and 300 milligrams of Retrovir) twice a day.

CHILDREN

Combivir should not be taken by children under 12 years of age.

Overdosage

The symptoms of Combivir overdose are unknown at this time. However, any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

• Symptoms of overdose with the Retrovir component may include:
  Confusion, dizziness, drowsiness, headache, lack of energy, nausea, seizure, vomiting