Zeffix belongs to a group of medicines called antivirals. It is used for the treatment of hepatitis B virus infection. Hepatitis B is a virus which infects the liver, and leads to liver damage. Zeffix can be used in people whose liver is damaged but still functions ( compensated liver disease) and in people whose liver is damaged and does not function normally ( decompensated liver disease).
Zeffix is used to treat patients 18 years of age or over with long term (chronic) hepatitis B.
Treatment with Zeffix can reduce the amount of hepatitis B virus in your body. This should lead to a reduction in liver damage and an improvement in your liver function.
|Table of Contents|
|What do you have to consider before using it?|
|How is it used?|
|What are possible side effects?|
|How should it be stored?|
Do not take Zeffix:
- if you are allergic (hypersensitive) tolamivudine or to any of the other ingredients of Zeffix.
If you are not sure please consult your doctor
Take special care with Zeffix
Zeffix reduces the amount of hepatitis B virus in your body, and keeps the liver disease under control, therefore reducing health problems relating to your liver in the future. For effective treatment you will need to take Zeffix every day. Patients respond to the treatment differently, therefore it is not known for how long you will have to take this medicine.
Your doctor will be checking your response to treatment by taking regular blood samples. The results of these tests will help your doctor to decide when your treatment with Zeffix can be stopped.
Before treatment with Zeffix you should have discussed any additional medical problems that you have with your doctor. If you have kidney disease the dose of this medicine may have to be reduced, as it is your kidneys that are mainly responsible for getting rid of the medicine from your body. Your doctor will advise you on the correct dose of Zeffix to take if required.
Do not stop taking Zeffix without instruction from your doctor, as there is a small risk of your hepatitis getting worse. When you stop taking Zeffix your doctor will monitor you for at least the following four months to check for any problems. This will mean taking blood samples to check for any abnormal liver enzymes, indicating liver damage.
The active substance in Zeffix is lamivudine. If you are already taking this medicinal product for HIV infection, your doctor will continue to treat you with the higher dose, usually 150 mg twice a day, as the lower dose of 100 mg of lamivudine is insufficient to treat HIV infection.
Because your medicine helps to control your hepatitis B and it is not yet known whether it will cure it, you are still at risk of transmitting this virus to others through sexual contact or by blood transfer, and you should use appropriate precautions to prevent this. There is an effective vaccine available to protect those at risk from becoming infected with hepatitis B virus.
If you are a diabetic, please note that each dose of Zeffix (100 mg = 20 ml) contains 4 g sugar.
The class of medicines to which Zeffix belongs (NRTIs) can cause a condition called lactic acidosis (build up of lactic acid in the body), 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. As you have liver disease you may also be more at risk of getting this condition. While you are being treated with Zeffix your doctor will monitor you closely for any signs that you may be developing lactic acidosis.
Taking other medicinesSome medicines may affect the action of Zeffix. Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
Zeffix should not be taken with:
- zalcitabine or lamivudine (used to treat HIV infection)
- emtricitabine (used to treat HIV or hepatitis B infection)
Taking Zeffix with food and drink:
Zeffix can be taken with food or on an empty stomach.
PregnancyAsk your doctor or pharmacist for advice before taking any medicine.
Tell your doctor if you are pregnant, or are planning to become pregnant, or if you are breast-feeding. Your doctor will advise whether you should continue to take Zeffix while you are pregnant. Do not stop treatment with Zeffix without your doctor?s advice.
The ingredients in Zeffix can pass into breast-milk. If you are breast-feeding, you must check with your doctor before you take Zeffix.
Driving and using machines
No studies on the effect of Zeffix on the ability to drive and use machines have been performed.
Important information about ingredients of Zeffix oral solution
This medicine contains preservatives (propyl parahydroxybenzoate: E216 and methyl parahydroxybenzoate: E218) which may cause allergic reactions (possibly delayed). This medicinal product contains sucrose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product. Sucrose may be harmful to the teeth.
Always take Zeffix exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.
The recommended dose of Zeffix is 20 ml (100 mg lamivudine) once a day. It can be taken with food or on an empty stomach.
Your doctor will advise you on how long you will need to take the medicine for.
Your doctor may need to reduce your dose of Zeffix if you have kidney problems.
To measure your dose of medicine accurately use the oral dosing syringe supplied with the pack as follows:
1. Remove the bottle cap
2. Push the plastic adapter into the neck of the bottle, while holding the bottle firmly
3. Insert the syringe firmly into the adapter
4. Turn the bottle upside down
5. Pull out syringe plunger until the first portion of your full dose is withdrawn
6. Turn the bottle the correct way up and remove the syringe from the adapter
7. Administer the dose into the mouth by placing the tip of the syringe against the inside of the cheek. Slowly depress the plunger, allowing time to swallow. Forceful squirting to the back of the throat may cause choking.
8. Repeat steps 3 to 7 in the same way until you have taken the whole dose
9. After use the syringe must not be left in the bottle. Take off the syringe and adapter and wash them thoroughly in clean water. Let them dry completely before you use them again.
10. Replace and tighten the bottle cap
If you take more Zeffix than you should
Accidentally taking too much of your medicine is unlikely to cause any serious problems. However, you should tell your doctor or your pharmacist, or contact your nearest hospital emergency department for further advice.
If you forget to take ZeffixIf you forget to take your medicine, take it as soon as you remember and then continue to take it as instructed. Do not take a double dose to make up for forgotten individual doses.
If you stop taking Zeffix
You must not stop taking Zeffix without consulting your doctor (see section 2).
If you have any further questions on the use of this product, ask you doctor or pharmacist.
Like all medicines, Zeffix can cause side effects, although not everybody gets them. Side effects reported in Zeffix clinical trials were tiredness, respiratory tract infections, throat discomfort, headache, stomach discomfort and pain, nausea, vomiting and diarrhoea, increases in liver enzymes and enzymes produced in the muscles (see below).
Some people may be allergic to medicines. If you have any of the following symptoms soon after taking Zeffix STOP taking the medicine and tell your doctor immediately:
* Sudden wheeziness and chest pain or tightening.
* Swelling of eyelids, face or lips.
* Skin rash or ?hives? anywhere on the body.
Side effects thought to be caused by Zeffix are listed below:
Very common side effects
These may affect more than 1 in 10 people
- Increases in enzymes produced by the liver called transaminases
Common side effects
These may affect up to 1 in 10 people
- Increases in an enzyme called creatine phosphokinase produced in the muscles
- Cramps and muscle pains
Other side effects
Other side effectshave occurred in a very small number of people but their exact frequency is unknown
- Reductions in platelets, blood cells important for blood clotting. If you have a low platelet count you may notice you bruise more easily
- Breakdown of muscle
- Marked worsening of liver disease after Zeffix is stopped or during treatment if resistance develops. This can be fatal in some patients.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist
Keep out of the reach and sight of children.
Do not use Zeffix after the expiry date which is stated on the bottle and the carton.
Do not store above 25 °C.
Discard one month after first opening.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.
What Zeffix contains
The active substance is lamivudine. Each ml of oral solution contains 5 mg of lamivudine.
The other ingredients are:
Sucrose, methyl parahydroxybenzoate (E218), propyl parahydroxybenzoate (E216), citric acid, propylene glycol, sodium citrate, artificial strawberry flavour, artificial banana flavour, purified water.
What Zeffix looks like and contents of the pack
Zeffix oral solution is supplied in cartons containing a white polyethylene bottle, with a child resistant cap. The solution is clear, colourless to pale yellow in colour with strawberry/banana flavouring. The bottle contains 240 ml of lamivudine solution (5 mg/ml). The pack includes an oral dosing syringe and a syringe-adapter for the bottle.
Marketing Authorisation Holder and Manufacturer
Manufacturer Glaxo Wellcome GmbH Co. KG Industriestrasse 32-36 23843 Bad Oldesloe Germany Marketing Authorisation Holder Glaxo Group Ltd Greenford Road Greenford Middlesex UB6 0NN United Kingdom
For any information about this medicinal product, please contact the local representative of the Marketing Authorisation Holder:
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