Do not take Lamivudine/Zidovudine Teva
- if you are allergic (hypersensitive) to lamivudine or zidovudine or any of the other ingredients of Lamivudine/Zidovudine Teva.
- if you have very low red blood cell count (severe anaemia) or very low white blood cell count (neutropenia).
If you are not sure please ask your doctor.
Take special care with Lamivudine/Zidovudine Teva
Discuss the use of Lamivudine/Zidovudine Teva with your doctor if you have kidney or liver disease to ensure the doses of the active substances in Lamivudine/Zidovudine Teva are suitable for you.
It is important that your doctor knows about all your symptoms even if you think they are not related to HIV infection. Your doctor may decide to prescribe lamivudine or zidovudine as separate medicines instead of Lamivudine/Zidovudine Teva.
Anaemia (low red blood cell count) and neutropenia/leucopenia (low white blood cell count) may occur within 4-6 weeks due to treatment with zidovudine, one of the active substances in Lamivudine/Zidovudine Teva. If severe, your physician may stop treatment with
Lamivudine/Zidovudine Teva. This has occurred more commonly in patients with advanced HIV disease and with higher doses of zidovudine than the dose in Lamivudine/Zidovudine Teva. Regular blood tests will be arranged to check whether there is a problem with your white and red blood cell count. This adverse reaction is infrequent in patients with early HIV disease and blood tests may be performed less frequently.
If you take ribavirin and zidovudine together it may cause or worsen anaemia. Please contact your doctor if you notice symptoms of anaemia (such as tiredness and shortness of breath). Your doctor will advise you whether you should stop taking Lamivudine/Zidovudine Teva.
The class of medicines to which Combivir belongs (NRTIs) can cause a condition called lactic acidosis, together with an enlarged liver. Lactic acidosis, if it occurs, usually develops after a few months of treatment. Deep, rapid breathing, drowsiness, and non specific symptoms such as nausea, vomiting and stomach pain, might indicate the development of lactic acidosis. This rare, but serious side effect occurs more often in women, particularly if very overweight. If you have liver disease you may also be more at risk of getting this condition. While you are being treated with Lamivudine/Zidovudine Teva, your doctor will monitor you closely for any signs that you may be developing lactic acidosis.
Redistribution, accumulation or loss of body fat may occur in patients receiving combination antiretroviral therapy. Contact your doctor if you notice changes in body fat.
In some patients with advanced HIV infection (AIDS) and a history of opportunistic infection, signs and symptoms of inflammation from previous infections may occur soon after anti-HIV treatment is started. It is believed that these symptoms are due to an improvement in the body?s immune response, enabling the body to fight infections that may have been present with no obvious symptoms. If you notice any symptoms of infection, please inform your doctor immediately.
Please speak with your doctor if you have a history of liver disease. Patients with chronic hepatitis B or C and treated with antiretroviral agents are at increased risk of severe and potentially fatal liver adverse events and may require blood tests for monitoring of liver function.
If you have a chronic hepatitis B infection, you should not stop your treatment without instructions from your doctor, as you may have a recurrence of your hepatitis. This recurrence may be more severe if you have serious liver disease.
You will need to take Lamivudine/Zidovudine Teva every day. This medicine helps to control your condition and delay disease progression, but it is not a cure for HIV infection. You may continue to develop other infections and other illnesses associated with HIV disease. You should keep in regular contact with your doctor. Do not stop taking your medicine without first talking to your doctor.
Treatment with Lamivudine/Zidovudine Teva has not been shown to reduce the risk of passing HIV infection on to others by unprotected sexual contact or by blood transfer (for example, blood transfusions or sharing needles). You should continue to use appropriate precautions to prevent this.
Bone problems
Some patients taking combination antiretroviral therapy may develop a bone disease called osteonecrosis (death of bone tissue caused by loss of blood supply to the bone). The length of combination antiretroviral therapy, corticosteroid use, alcohol consumption, severe immunosuppression, higher body mass index, among others, may be some of the many risk factors for developing this disease. Signs of osteonecrosis are joint stiffness, aches and pains (especially of the hip, knee and shoulder) and difficulty in movement. If you notice any of these symptoms please inform your doctor.
Taking other medicines
It is important that you tell your doctor about all the medicines you are taking including those you have bought yourself. These may affect the action of Lamivudine/Zidovudine Teva, or Lamivudine/Zidovudine Teva may affect their action. Lamivudine/Zidovudine Teva should not be taken with high doses of co-trimoxazole, or injections of ganciclovir or foscarnet, as lamivudine, one of the active substances in Lamivudine/Zidovudine Teva may interact with these. Lamivudine/Zidovudine Teva should also not be taken with stavudine, as zidovudine the other active substance in Lamivudine/Zidovudine Teva may reduce the action of this medicinal product.
Zidovudine, may also interact with the following medicines and may make any side effects worse: Phenytoin, probenecid, rifampicin, atovaquone, valproic acid, methadone, dapsone, pentamidine, pyrimethamine, co-trimoxazole, fluconazole, amphotericin, flucytosine, ganciclovir, interferon, clarithromycin, vincristine, vinblastine and doxorubicin.
Pregnancy and breast-feeding
If you become pregnant, or are planning to become pregnant, you must contact your doctor to discuss the potential adverse effects and the benefits and risks of your antiretroviral therapy to you and your child.
If you have taken Lamivudine/Zidovudine Teva during your pregnancy, your doctor may request regular visits to monitor the development of your child. Such visits may include blood tests and other diagnostic tests.
In children whose mothers took nucleoside and nucleotide analogues during pregnancy, the benefit from the reduced chance of being infected with HIV is greater than the risk of suffering from side effects.
If you are breast-feeding please inform your doctor before taking any medicines.
Lamivudine/Zidovudine Teva is not recommended if you are breast-feeding. It is recommended that HIV infected women do not breast-feed their infants under any circumstances in order to avoid transmission of HIV.
Ask your doctor or pharmacist for advice before taking any medicine.
