Duovir N Tablet

Duovir N Tablet (Lamivudine Zidovudine Nevirapine)

Duovir-N Tablets, DUOVIR-N is a combination of three drugs commonly used in the management of the Human Immunodeficiency Virus (HIV) infection. Both zidovudine and lamivudine belong to the nucleoside analogue class of antiretroviral drugs.

Composition

Each Film coated Tablet contains:

• Lamivudine 150 mg
• Zidovudine  300 mg
• Nevirapine  200 mg

Uses

• Lamivudine 150mg indicated as part of antiretroviral combination therapy for the treatment of Human Immunodeficiency Virus (HIV) infected adults and children and also used in the treatment of Hepatitis B virus infection.
• Zidovudine 300mg is used in combination with other antiretroviral (ART) medicines for the treatment of human immunodeficiency virus (HIV-1) infection. Zidovudine is also indicated for use in HIV-positive pregnant (over 14 weeks) women for prevention of maternal-fetal HIV transmission (passing of infection), and for primary preventive treatment of HIV infection in new-born infants.
• Nevarapine 200mg is used to treat and control Human Immunodeficiency Virus (HIV-1) infection for adults, adolescents, and children of any age. It must be used along with other HIV medicines.

How it works?

• Lamivudine 150mg belongs to a class of medication called nucleoside reverse transcriptase inhibitors. It decreases the amount of virus (HIV and hepatitis) in the blood. It also increases the number of infection fighting cells in the body (CD4 cells). It does not cure HIV completely but reduces the chances of getting acquired immunodeficiency syndrome (AIDS) and HIV related infections or cancer.
• Zidovudine 300mg belongs to a group of medications called nucleoside analogue reverse transcriptase inhibitors (NRTIs), also known as antiretrovirals. Zidovudine does not cure HIV infection; it reduces the amount of viruses in the body by inhibiting the enzyme (viral reverse transcriptase) which is essential for the virus to grow. Further, zidovudine also increases some white blood cells (CD4 cells) of the body that are important in fighting infections.
• Nevirapine 200mg belongs to a class of anti-HIV medicines called non-nucleoside reverse transcriptase inhibitors (NNRTIs). Reverse transcriptase is an enzyme that HIV needs in order to multiply. Nevirapine stops reverse transcriptase from working, and thus helps control HIV-1 infection.

Common side effects

Diarrhea and fever, Redistribution/accumulation of body fat, Acne-like rash, Depression, Arthralgia, Increase in blood urea or creatine phosphokinase, Dizziness, Insomnia, Cough, Fatigue and malaise, Abdominal cramps, Anorexia and stomatitis, Thrombocytopenia, Worsening of hepatitis b infection, Myalgia, Amylase, Peripheral neuropathy, Musculoskeletal pain, Chills, Neuropathy, Abdominal pain, Neutropenia, Dyspepsia, Pancreatitis, Andheadache

How should Duovir-N be taken?

You should take your Duovir-N, 1 tablet twice daily, with a glass of water, with or without food. Since each tablet of Duovir-N contains half of the commonly prescribed daily doses of each of the 3 constituent drug, zidovudine, lamivudine and nevirapine, you should not need to change the dose of Duovir-N. You should continue to take your Duovir-N for as long as recommended by your doctor, and you will be monitored carefully to ensure that you do not develop any serious side effects, in which case your doctor will probably recommend that you stop taking your Duovir-N.

How long should you take Duovir-N?

You should take your Duovir-N continually for as long as recommended by your doctor, and you will be monitored carefully to ensure that you do not develop any serious side effects, in which case your doctor will probably recommend that you stop taking your Duovir-N.

Missed dose of Duovir-N

If you miss a dose of Duovir-N take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.

How should Duovir-N be stored?

You keep your Duovir-N below 30?C in a cool dry place.

EXPERT ADVICE

• Consult your doctor if you have diabetes and are using insulin.
• Patients receiving this therapy are always at a risk for infections and hence should report any such cases to the doctor.
• Consult your doctor if you take any prescription medication; Inform your doctor if you take other medicine for treatment of HIV or hepatitis B infection, hairy cell leukemia [a type of blood cancer], or antibiotics for infection.
• Lamivudine may rarely cause a serious side effect like lactic acidosis with symptoms such as pain or weakness of muscle, numbness or feeling cold in arms or legs, stomach pain, nausea, vomiting, lack of breath, aberrant heart rate, dizziness, weak or tired feeling; hence, inform the doctor immediately if you experience any of these symptoms.
• It is possible to pass on HIV when on this medication and hence it is important to take necessary precautions to prevent HIV from spreading.
• Inform you doctor if you notice signs of change in the distribution of fat (lipodystrophy), erosion of bones (osteronecrosis), or inflammation of pancreas (pancreatitis).
• If you are on therapy it is important to use effective non hormonal method of contraception or condom so that a pregnancy can be avoided.
• Use with caution in pediatric patients with a history of pancreatitis or other significant risk factors for pancreatitis.

FAQs

Q: Is lamivudine safe during pregnancy?
A: Lamivudine can be taken during pregnancy if the benefit outweighs the risk.

Q: Is it safe to use lamivudine during breastfeeding?
A: HIV infected women should not breastfeed for the risk of passing the virus to the baby through the breast milk.

Q: Can lamivudine cure hepatitis B?
A: Lamivudine (Duovir-N) is used to treat hepatitis B but some patients may be resistant to this drug

Q: Can lamivudine cause anemia?
A: Lamivudine may cause anemia as a side effect in some patients. Kindly consult your doctor in case any side effects are observed.

Q: Is zidovudine safe during pregnancy?
A: Zidovudine may harm the baby. Zidovudine should only be given if there is no other alternative drug. Please follow your doctor?s advice regarding its use.

Q: Is it safe to use zidovudine during breastfeeding?
A: Zidovudine is not safe for the baby and should not be used by women who are breastfeeding.

Q: Is zidovudine a prodrug?
A: Yes, zidovudine is a prodrug and must be activated (by phosphorylation in lymphocytes) in the body to exert its antiviral action.

Q: Is zidovudine a protease inhibitor?
A: No, zidovudine is not a protease inhibitor; it is a nucleoside analogue reverse transcriptase inhibitor.

Q: Does zidovudine cross placenta?
A: Zidovudine crosses placenta and thereby reducing the HIV transmission from the mother to the fetus.

Q: How is zidovudine administered?
A: Zidovudine (Duovir-N) can be administered as tablets, syrups and suspension in combination with other antiretroviral medications.

Q: Does zidovudine cause muscle pain?
A: Yes, muscle pain is a known adverse effect of use zidovudine.

Q: Is nevirapine the same as Viramune?
A: Yes, Viramune is a brand name of nevirapine.

Q: Is nevirapine safe in pregnancy?
A: Experiences of drug use and evidence from studies in pregnant women have shown risk to fetus. This drug may be used in pregnant women if benefit outweighs the risk. Patients should follow the advice of the doctor regarding its use.

Q: Is nevirapine generic?
A: Nevirapine is a generic drug.