Lamivudine and Zidovudine

(la mi' vyoo deen) (zye doe' vyoo deen)

Brand Name(s): Combivir^®¶; also available generically

Other Name(s): 3TC and ZDV, 3TC and AZT, 3TC and azidothymidine

IMPORTANT WARNING:

Zidovudine may decrease the number of certain blood cells. Tell your doctor if you have or have ever had a low number of any type of blood cells or any blood disorders. If you experience any of these symptoms, call your doctor immediately: unusual bleeding or bruising; shortness of breath; pale skin; fever, sore throat, chills, and other signs of infection; or unusual tiredness or weakness.

Zidovudine may cause muscle problems, especially when used for a long period of time. Tell your doctor if you have or have ever had any disease of the muscles or muscle weakness. If you experience muscle pain or muscle weakness, call your doctor immediately.

Lamivudine and zidovudine may cause life-threatening damage to the liver and a potentially life-threatening condition called lactic acidosis (buildup of lactic acid in the blood). Tell your doctor if you have or have ever had liver disease. If you have liver disease your doctor will probably tell you not to take lamivudine and zidovudine. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment: nausea, vomiting, pain in the upper right part of your stomach, loss of appetite, extreme tiredness, unusual bleeding or bruising, weakness, dizziness, lightheadedness, fast or irregular heartbeat, trouble breathing, dark yellow or brown urine, light-colored bowel movements, yellowing of the skin or eyes, feeling cold, especially in the arms or legs, or muscle pain that is different than any muscle pain you usually experience.

Tell your doctor if you have or think you may have hepatitis B virus infection (HBV; an ongoing liver infection). Your doctor may test you to see if you have HBV before you begin your treatment with lamivudine and zidovudine. If you have HBV and you take lamivudine and zidovudine, your condition may suddenly worsen when you stop taking it. Your doctor will examine you and order lab tests regularly for several months after you stop taking lamivudine.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests during and after your treatment to check your body's response to lamivudine and zidovudine.

WHY is this medicine prescribed?

The combination of lamivudine and zidovudine is used to treat human immunodeficiency virus (HIV) infection. Lamivudine and zidovudine are in a class of medications called nucleoside reverse transcriptase inhibitors (NRTIs). They work by decreasing the amount of HIV in the blood.

Although the combination of lamivudine and zidovudine will not cure HIV, it may decrease your chance of developing acquired immunodeficiency syndrome (AIDS) and HIV-related illnesses. Taking these medications and making other life-style changes may also decrease the risk of giving the HIV virus to other people.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

The combination of lamivudine and zidovudine comes as a tablet to take by mouth. Take twice a day with or without food. Take lamivudine and zidovudine at around the same times every day.

Take this medication exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Continue to take lamivudine and zidovudine even if you feel well. Do not stop taking lamivudine and zidovudine without talking to your doctor.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

What SPECIAL PRECAUTIONS should I follow?

Before taking lamivudine and zidovudine,

• tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any otherdrugs, foods or substances. Tell your doctor or pharmacist about the allergy and whatsymptoms you had.

• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking lamivudine and zidovudine. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• in addition to the conditions listed in the IMPORTANT WARNING section, tell your doctor if you have or have ever had pancreatitis (swelling of the pancreas that does not go away) or kidney disease.

• tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking lamivudine and zidovudine, call your doctor.

  tell your doctor if you are breastfeeding or plan to breastfeed. Some of the medication and HIV may be passed to your baby in your breast milk. Talk to your doctor about the risks of breastfeeding your baby if you are taking lamivudine and zidovudine.

• you should be aware that your body fat may increase or move to different areas of your body, such as your upper back, neck (''buffalo hump''), breasts, and around your stomach. You may notice a loss of body fat from your face, legs, and arms.

• you should know that while you are taking medications to treat HIV infection, your immune system may get stronger and begin to fight other infections that were already in your body. This may cause you to develop symptoms of those infections. If you have new or worsening symptoms at any time during your treatment with lamivudine and zidovudine, be sure to tell your doctor.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Lamivudine and zidovudine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• headache
• diarrhea
• heartburn
• difficulty falling asleep or staying asleep
• depression
• stuffy nose
• cough
• joint pain

Some side effects can be serious. The following side effects are uncommon, but if you experience any of them, or any of those listed in the IMPORTANT WARNING section, call your doctor immediately:

• hives, rash, itching, difficulty breathing or swallowing
• numbness, tingling, or burning in your fingers or toes
• fever

Lamivudine and zidovudine may cause other side effects. Call your doctor if you have any unusual problems while taking lamivudine and zidovudine.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store the tablets in the refrigerator or at room temperature but away from excess heat and moisture (not in the bathroom).

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What OTHER INFORMATION should I know?

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a supply of lamivudine and zidovudine on hand. Do not wait until you run out of medication to refill your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

^¶ This branded product is no longer on the market. Generic alternatives may be available.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2025. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: July 15, 2025.