Combivir

Please read this factsheet together with the patient information leaflet carefully before taking your medicine. Please speak to your clinic doctor or pharmacist if you would like more information about how these drugs work.

Combivir is a preparation that contains both zidovudine and lamivudine in one tablet. Zidovudine and lamivudine both belong to a class of drugs called nucleoside analogues or nucleoside reverse transcriptase inhibitors (NRTIs). NRTIs are used for the treatment of HIV infection, in combination with other anti-HIV drugs If you would like more information about how these drugs work in the body, a leaflet is available. Please ask the pharmacist for details.

Before taking Combivir
Tell your doctor about:

* All other drugs that you are taking, including any that you buy over the counter in a community pharmacy and herbal medicines;
* Any previous allergy to any other medicines;
* If you have ever had any liver disease;
* If you have ever had any kidney disease;

Taking your Combivir:

* Combivir is available as a white tablet, containing 300mg of zidovudine and 150mg of lamivudine.
* The usual dose is one tablet twice each day.
* If you need to take a lower dose of zidovudine or lamivudine eg if you have reduced kidney function, Combivir is not suitable for you. Your doctor will prescribe zidovudine and lamivudine separately.
* The doses should be divided equally throughout the day: try to take the doses as close as possible to twelve hours apart, and at the same times each day.
* There is no effect of food upon absorption, therefore you can take the tablets before, with or after food. Taking doses after food may help prevent nausea - this is usually due to zidovudine and may occur when you first start taking Combivir
* Combivir works best if there is a constant amount in your bloodstream. It is therefore very important to take the tablets regularly. If you forget a dose, take it as soon as you remember.

Do not run out of Combivir if you are going on holiday and need additional supplies - tell your doctor.
Your pharmacist will check that you have enough to last until your next appointment.

Side effects
Combivir, like all other medicines, has some side effects. The most important ones are:

Some of these side effects may occur when you first start taking Combivir and frequently disappear after 4 or 5 weeks of treatment. If you experience any of these side effects or any other symptoms after you start Combivir tell your doctor who will advise you what to do. If you decide to stop taking Combivir it is important that you tell your doctor so that he or she can discuss other treatment options with you.

Combination antiretroviral therapy and zidovudine in particular has been associated with redistribution of body fat (lipodystrophy) in HIV patients including the loss of peripheral and facial subcutaneous fat and increased intra-abdominal and visceral fat.

Lactic acidosis has been reported with the use of nucleoside analogues. Your doctor will be monitoring your lactate levels, but if you experience the following symptoms, inform your doctor:

* nausea and vomiting;
* abdominal pain;
* loss of appetite;
* weight loss;
* rapid, deep breathing or muscle
weakness;

Admission to hospital
If you are admitted to hospital please bring all your medicines with you. This is especially important for anti-HIV medication as it has to be taken regularly. Thomas Macaulay Ward now operates a self medication programme. Some patients are able to self administer their medicines to enable them to stick to the routine they have been used to at home.

Storing your Combivir
Combivir tablets should be stored at room temperature.