Zidovudine 300 mg and Lamivudine 150 mg – 60 tablets
Manufacturer – Cipla India
Instructions for use
White, film-coated, biconvex tablets with the inscription “DVR” on one side. One tablet of Duovir contains lamivudine 150 mg and zidovudine 300 mg. Excipients – microcrystalline cellulose, sodium starch glycolate, magnesium stearate, silicon dioxide colloid, hydroxypropylmethylcellulose, titanium dioxide, talc, propylene glycol.
Duovir is a combined antiviral drug. Lamivudine and zidovudine, nucleoside analogues, are highly effective selective inhibitors of HIV-1 and HIV-2 replication. Lamivudine is a synergist of zidovudine relative to inhibition of HIV replication in cell culture. Active substances are sequentially metabolized by intracellular kinases to 5-mono-, di- and triphosphate. Lamivudine triphosphate and zidovudine triphosphate are substrates for HIV reverse transcriptase and competitive inhibitors of this enzyme.
Antiviral activity of drugs is due mainly to the inclusion of their monophosphate form to the chain of viral DNA, which leads to its rupture.
Lamivudine triphosphate and zidovudine triphosphate have a significantly lower affinity to DNA polymerases in human cells.
Clinical observation shows that combination therapy with lamivudine and zidovudine slows the development of resistance to zidovudine in patients who have not previously received antiretroviral therapy.
Lamivudine in combination with zidovudine reduces the amount of HIV-1 in the body and increases the number of CD4 + cells. Lamivudine in combination with zidovudine, as well as therapy that includes together with other drugs lamivudine and zidovudine, significantly reduce the risk of progression of the disease and the lethal end.
Data on the increase in toxicity with the simultaneous use of lamivudine and zidovudine are absent.
The drug is used inside. In adults and children over 12 years of age, Duovir is used 1 tablet 2 times a day. The drug can be used regardless of the meal. It is not recommended for patients who need dose adjustments, for example, if kidney function is impaired (creatinine clearance less than 50 ml/min), with a body weight of less than 50 kg.
When Duovir is used, headache, malaise, fatigue, nausea, vomiting, diarrhea, anorexia, chills and diarrhea, neuropathy, insomnia, dizziness, symptoms, and signs of nasal mucosa damage, cough, bone and muscle pain, neutropenia are possible.
Hypersensitivity to the drug components, severe neutropenia (neutrophil count less than 0.75×109 / L) or anemia (hemoglobin level less than 7.5 g / dl or 4.65 mmol / L), patients under 12 years of age, peripheral neuropathy, impaired kidney function (with creatinine clearance 50 ml / min and below), pregnancy, lactation period.
Features of use
When Duovir is used, patients may develop severe, unsafe for life, and sometimes fatal reactions. Among them were Stevens-Johnson syndrome, toxic necrosis of the epidermis and manifestations of hypersensitivity with skin rash and general manifestations, as well as a violation of internal organs. When patients develop signs or symptoms of severe skin reactions or hypersensitivity, including (the list is not exhaustive), severe skin rashes or rashes with diarrhea, vesicles, lesions of the oral mucosa, conjunctivitis, facial swelling, pain in muscles and joints, general malaise and / or expressed violations of the liver function of the drug should be immediately discontinued.
In patients with pancreatitis in history or in the presence of other significant risk factors for the development of pancreatitis, Duovir should be used very carefully and only in the absence of any alternative therapy. Use of Duovir should be discontinued immediately if there are clinical signs, symptoms or a change in laboratory indicators, indicating pancreatitis.
In patients with impaired bone marrow function (the number of granulocytes does not exceed 1000 cells per 1 mm3 or the hemoglobin level does not exceed 9.5 g / dl), Duovir is used under the constant supervision of a doctor.
Terms and conditions of storage
Store at a temperature not exceeding 30 ° C, out of the reach of children. Shelf life – 2 years.