Spectrum Of Activity
BW ≥30 kg: Zidovudine/Lamivudine 300/150 mg PO q12h
BW <30 kg: Avoid
Combivir (TN) 1 tab = Zidovudine 300 mg + Lamivudine 150 mg
Safety and efficacy in pediatric patients <30 kg of BW have not been established
HIV infection BW ≥30 kg: Zidovudine/Lamivudine 300/150 mg PO q12h
Hepatic impairment Avoid
CrCl ≥50CrCl <50No dose adjustmentAvoid
Treatment of HIV infection. Prevention of perinatal HIV transmission.
Black Box Warning: Severe acute exacerbations of hepatitis B have been reported in patients who are co-infected with hepatitis B virus (HBV) and HIV-1 and have discontinued lamivudine. Hepatic function should be monitored closely with both clinical and laboratory follow-up for at least several months. If appropriate, initiation of anti-hepatitis B therapy may be warranted. Discontinue lamivudine/zidovudine if clinical or laboratory findings suggestive of lactic acidosis or pronounced hepatotoxicity occur. Zidovudine has been associated with hematologic toxicity, particularly in patients with advanced HIV-1 disease. Prolonged use of zidovudine has been associated with symptomatic myopathy.
Monitor viral load prior to initiation or modification of treatment.
Monitor CD4 cell counts prior to initiation or with modification of ARV treatment and every 3-6 months; thereafter during at least the first 2 years of treatment.
Monitor hepatitis B screening at baseline and with modification of ARV treatment.
Perform hepatitis C antibody testing prior to initiation or modification of ARV treatment.
Monitor ALT,AST, and total bilirubin at baseline and with modification of ARV treatment.
Monitor CBC with differential, fasting blood glucose or HbA1c, urinalysis, symptoms of hepatic dysfunction, signs of lipoatrophy.
Loss of appetite
Steatosis of liver
Antimicrobial class: Antiretroviral agent, Nucleotide reverse transcriptase inhibitor
Pregnancy category: C
Average serum half life: 0.5-3 hours (Zamivudine), 5-7 hours (Lamivudine)
Precautions: Monitoring recommended, use of caution required with granulocyte count <1000 cells/mm(3) or Hb <9.5 g/dL, and treatment interruption may be necessary.
Discontinue use if pancreatitis is supsected.
Suspend treatment if lactic acidosis is suspected.
Lipoatrophy has been reported and is related to cumulative exposure; monitoring recommended and use of an alternative regimen may be warranted.
Breastfeeding: Breastfeeding is not recommended in the setting of HIV infection.