Duovir® is a combined medication that together with other anti-retrovirals treats HIV-1 infection. Taking this antiviral drug), a patient can keep the infection at the low level and maintain immunity to fight HIV related infections. Duovir® is not a cure for HIV-1 infection. Not for use in patients weighing less than 30 kg and over 65 years of age.
Active Ingredient
Description
Duovir® manufacturer is Cipla. Its active chemical compounds are Lamivudine and Zidovudine that belong to the drug class called synthetic guanosine nucleoside reverse transcriptase inhibitors (NRTIs).
Indications:
- treatment of human immunodeficiency virus (HIV-1) infection in combination with other anti-retrovirals.
MOA (mechanism of action):
Zidovudine is a structural analog of thymidine, a prodrug that must be phosphorylated to its active 5′-triphosphate metabolite, zidovudine triphosphate (ZDV-TP). It inhibits the activity of HIV-1 reverse transcriptase (RT) by terminating DNA chain after incorporation of the nucleotide analogue. It competes with the natural substrate dGTP and incorporates itself into viral DNA. Intracellularly Lamivudine is phosphorylated to its active 5′-triphosphate metabolite, lamivudine triphosphate (3TC-TP). Thus, lamivudine triphosphate inhibits RT via DNA chain termination after incorporation of the nucleotide analogue. ZDV-TP and 3TC-TP are weak inhibitors of cellular DNA polymerase.
Dosage
The recommended oral dose is 1 tablet (Lamivudine 150 mg and Zidovudine 300 mg) twice daily.
Some people who take Duovir® may experience:
- Hematologic toxicity, including neutropenia and severe anemia* (low red blood cell count) and neutropenia/leucopenia (low white blood cell count), which is associated with Zidovudine.
- Lactic acidosis (a build-up of lactic acid in the body), together with an enlarged liver. Symptoms are deep, rapid breathing, drowsiness, and non-specific symptoms such as nausea, vomiting and stomach pain.
- Immune Reconstitution Syndrome (immune response to fight infections that may have been hidden in the body).
- Severe acute exacerbations of hepatitis B have been reported in patients who are co-infected with hepatitis b virus (HBV) and HIV-1 and have discontinued Lamivudine.
- Prolonged use of Zidovudine has been associated with symptomatic myopathy.
Precautions:
HIV-1 infection can be passed by sexual contact with someone who is infected, or by transfer of infected blood (when sharing injection needles). Patient can still pass HIV-1 when taking Duovir®, although the risk is lowered by therapy. That is why it is important to discuss with doctor the precautions needed to avoid infecting other people.
Women who are HIV-1-positive must not breastfeed because HIV-1 infection can be passed on to the baby in breast milk.
Take special care if you have moderate or severe liver disease, you have ever had liver disease, including hepatitis B or C, you are seriously overweight (especially if you are a woman), you have severe kidney disease.
Consult doctor before taking if you are taking phenytoin (for treating epilepsy), methadone (as a heroin substitute). Zidovudine speeds up the removal of methadone from the body. If you are taking methadone, you will be checked for any withdrawal symptoms. Your methadone dose may need to be re-elevated.
Women who are HIV-1-positive must not breastfeed because HIV-1 infection can be passed on to the baby in breast milk.
Missing a dose
If you miss a dose you should take it as soon as you remember about your missing. If it is the time for the next dose you should continue your regular dosing schedule. Do not take a double dose of Duovir® to compensate the missed dose.
Overdose
If an overdose occurs and you are not feeling well, stop taking the medication immediately. You should seek emergency medical attention or contact your healthcare provider immediately.
Storage
Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) and away from excess moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.
