Duovir general information

What is Duovir used for?

Duovir tablets are a combination treatment for Human Immunodeficiency Virus (HIV) infection in patients with or without acquired immunodeficiency syndrome or AIDS. HIV impairs the immune system by attacking specific immune cells called CD4 cells that are involved in fighting infection and this can lead to opportunistic life-threatening infection (infections that would not normally be harmful). Duovir tablets help prevent or slow down the ability of HIV to replicate, which keeps the amount virus down to a low level and this results in an increase in CD4 cell numbers, so that the immune system can recover reducing the risk of disease progression.

How does Duovir work?

Duovir tablets contain a combination of two antiretroviral drugs lamivudine and zidovudine, which both belong to class of drugs known as nucleoside analogue reverse transcriptase inhibitors (NRTI) that are only effective against retroviruses (RNA virus) like HIV. A nucleoside is a building block of DNA that is needed by the virus to replicate, and nucleoside analogues, like lamivudine and zidovudine in Duovir tablets, become incorporated into the DNA that is copied from the virus RNA by an enzyme called reverse transcriptase. This blocks the action of reverse transcriptase and terminates the viral DNA chain so that it cannot become integrated into the DNA of the infected immune cell, which means that no more HIV can be produced. Lamivudine is highly synergistic with zidovudine, which means that it increases the effectiveness of zidovudine so that the combination of these two antiretroviral drugs in Duovir tablets slow down the replication of HIV within your body but cannot prevent the spread of the infection to others.

What does Duovir contain?

Duovir tablets contain a combination the active ingredients lamivudine (150mg) and zidovudine (300mg), which are antiretroviral drugs that are used to treat HIV infection.

Treating HIV infection with Duovir

Duovir tablets contain a combination of two antiretroviral drugs lamivudine and zidovudine which are used to treat HIV infection in patients with or without acquired immunodeficiency syndrome or AIDS. HIV impairs the immune system by attacking specific immune cells called CD4 cells that are involved in fighting infection and this can lead to opportunistic life-threatening infection (infections that would not normally be harmful). Lamivudine and zidovudine in Duovir tablets are inhibitors of the enzyme reverse transcriptase which is needed by retroviruses (RNA viruses) like HIV to become incorporated into the DNA of infected immune cells so that they can replicate. Duovir tablets help prevent or slow down the ability of HIV to replicate, which keeps the amount virus down to a low level and this results in an increase in CD4 cell numbers, so that the immune system can recover, reducing the risk of disease progression.

What are the side effects of Duovir?

The most commonly reported side effects when taking Duovir include: headache, gastrointestinal upset, particularly nausea, also diarrhoea, constipation, stomach pain; dizziness, fatigue, difficulty sleeping, rash, hair loss, muscle and joints aches and pains. A more serious but less common side effect is damage to the liver and a condition called lactic acidosis, which may cause pancreatitis, liver failure, or renal failure.

When should Duovir not be used?

You should not use Duovir if you:

• are allergic to lamivudine or zidovudine or any ingredients in Duovir tablets
• are pregnant or are breastfeeding, without discussion with your doctor
• have abnormally low neutrophil counts (<0.75 x 109/l), or abnormally low haemoglobin levels (<7.5 g/dl or 4.65 mmol/l)
• have had any blood disorders such as anaemia or bone marrow problems
• have kidney or liver disease
• are taking medicines that interact with Duovir, including: the antibiotic trimethoprim, the antriretrovirals zalicitabine and stavudine, the antiinfective atovaquone, the anticonvulsant phenytoin, probenecid for gout, the antivirals ribavirin and ganciclovir, the antibiotic rifampicin, the narcotic analgesics codeine and morphine, methadone for treatment of narcotic withdrawal, the non-steroidal antiinflammatoires (NSAID) aspirin, indomethacin, ketoprofen and naproxen, oxazepam and lorazepam for anxiety and sleeping problems, cimetidine for peptic ulcers, clofibrate for high cholesterol, the antiinfective dapsone, the immune modulator and antiviral Isoprinosine, the antiinfectives, pentamidine, dapsone, pyrimethamine, co-trimoxazole, amphotericin and flucytosine, vincristine, vinblastine and doxorubicin for cancer treatment, the immune modulator interferon

What medications interact with Duovir?

Several medications interact with Duovir and should either not be taken while you are taking Duovir or only after discussion and instruction from your doctor:

• Drugs that cause a serious reaction with Duovir: the antiinfectives, pentamidine, dapsone, pyrimethamine, co-trimoxazole, amphotericin and flucytosine, the antiviral ganciclovir, , vincristine, vinblastine and doxorubicin for cancer treatment, the immune modulator interferon
• Drugs that affect Duovir: the antibiotic trimethoprim, the antiinfective atovaquone, probenecid for gout, the antiviral ribavirin, the antibiotic rifampicin, the narcotic analgesics codeine and morphine, methadone for treatment of narcotic withdrawal, the non-steroidal antiinflammatoires (NSAID) aspirin, indomethacin, ketoprofen and naproxen, oxazepam and lorazepam for anxiety and sleeping problems, cimetidine for peptic ulcers, clofibrate for high cholesterol, the antiinfective dapsone, the immune modulator and antiviral isoprinosine
• Drugs that are affected by Duovir: the antriretrovirals zalicitabine and stavudine, the anticonvulsant phenytoin

How should Duovir be taken?

You should take your Duovir tablets, 1 tablet twice daily, with a glass of water and with or without food. Your dose may be adjusted by your doctor, depending on your condition and you should take your Duovir tablets continually for as long as recommended by your doctor.

How long should you take Duovir?

You should take your Duovir tablets continually for as long as recommended by your doctor.

Missed dose of Duovir

If you miss a dose of Duovir take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.

How should Duovir be stored?

You keep your Duovir tablets in their blister packs until use and store your below 30°C in a cool dry place.