Informational only — Not medical advice. Always consult a licensed healthcare provider.

Shasthya স্বাস্থ্য · Health, made simple
বাং
Community data Updated 1 day ago

Lamivudine + Zidovudine + Nevirapine

Drugs for HIV / Anti-retroviral drugs Prescription
Check interactions
🌐 বাংলায় দেখুন

Indications

A fixed dose combination of Lamivudine, Zidovudine and Nevirapine is recommended for people with HIV-1 infection who can tolerate maintenance therapy with Nevirapine 200 mg twice daily. All three medicines are taken twice daily, and each tablet holds half of the daily dose of every component. Because the three drugs come together in a single tablet taken twice a day, it's easier for patients to manage, and more of them are likely to keep taking it as prescribed.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

Lamivudine, Zidovudine and Nevirapine work together to reduce viral resistance, and they inhibit reverse transcriptase through DNA chain termination.

Lamivudine: Intracellularly, Lamivudine is phosphorylated to its active 5'-triphosphate metabolite, Lamivudine triphosphate (L-TP). L-TP mainly works by inhibiting reverse transcription (RT). Once the nucleoside analogue is incorporated, the DNA chain is terminated. After an oral dose, Lamivudine is absorbed quickly and distributed widely. Binding to plasma protein is low.

Zidovudine: Intracellularly, Zidovudine is phosphorylated to its active 5'-triphosphate metabolite, Zidovudine triphosphate (ZDV-TP). ZDV-TP mainly works by inhibiting RT through DNA chain termination, which happens after the nucleoside analogue is incorporated. After an oral dose, Zidovudine is absorbed quickly and distributed widely. Binding to plasma protein is low. Zidovudine is eliminated mainly by hepatic metabolism.

Nevirapine: Nevirapine binds directly to reverse transcriptase (RT). It blocks the RNA-dependent and DNA-dependent DNA polymerase activities by disrupting the catalytic site of the enzyme. Its activity does not compete with template or nucleoside triphosphates.

Pregnancy & Breastfeeding

Lamivudine + Zidovudine + Nevirapine is a Pregnancy Category C medicine. Studies in animals have shown a harmful effect on the fetus, and there are no adequate, well-controlled studies in humans. Even so, the possible benefits may justify using it in a pregnant woman despite the possible risks.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.

Adults: The adult dose of Lamivudine + Zidovudine + Nevirapine is one tablet twice daily. This fixed dose combination is not recommended for patients who have not first taken the lower dose of Nevirapine, 200 mg once daily, for 2 weeks, and/or who have not tolerated that dose. After two weeks of successful therapy on the low dose, patients can be switched to 200 mg twice daily, provided they showed no hypersensitivity reaction (rash, abnormal liver function tests) during their first exposure to Nevirapine. Liver function tests and similar checks are desirable before Nevirapine is started, and they should be repeated at frequent intervals while the patient continues on the fixed dose combination. Dosage adjustment Lamivudine: for patients with low body weight (<50 kg), where a dose adjustment may be needed, it is preferable not to use this fixed dose combination. Zidovudine: this is a fixed dose combination, so it should not be prescribed for patients who need a dose adjustment. That includes patients with reduced renal function (creatinine clearance 50 ml/min) and those who have dose limiting adverse events. Nevirapine: some patients get a severe rash, or a rash with constitutional complaints, during the first 14 days on Nevirapine 200 mg once daily. In these patients the dose should not be raised to twice daily, and they should not receive the triple fixed dose combination, until the rash has resolved. In the same way, if liver function tests are abnormal, Nevirapine should be stopped until liver function returns to normal, and a careful restart is advisable only after extended observation. If the problem recurs, Nevirapine cannot be restarted. Where Nevirapine has to be restarted after an interruption, 200 mg daily should be given for 14 days, followed by the twice daily dose if there is no hypersensitivity reaction. No studies have been documented that suggest a Nevirapine dose for patients with hepatic dysfunction, renal insufficiency or those on dialysis.

Side Effects & Interactions

Side Effects

No side-effect data recorded yet.