Lamivudine + Zidovudine + Efavirenz Pharmacology

Lamivudine + Zidovudine + Efavirenz

About Lamivudine + Zidovudine + Efavirenz

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Mechanism of Action of Lamivudine + Zidovudine + Efavirenz

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Pharmacokinets of Lamivudine + Zidovudine + Efavirenz

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Onset of Action for Lamivudine + Zidovudine + Efavirenz

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Duration of Action for Lamivudine + Zidovudine + Efavirenz

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Half Life of Lamivudine + Zidovudine + Efavirenz

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Side Effects of Lamivudine + Zidovudine + Efavirenz

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Contra-indications of Lamivudine + Zidovudine + Efavirenz

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Special Precautions while taking Lamivudine + Zidovudine + Efavirenz

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Pregnancy Related Information

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Old Age Related Information

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Breast Feeding Related Information

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Children Related Information

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Indications for Lamivudine + Zidovudine + Efavirenz

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Interactions for Lamivudine + Zidovudine + Efavirenz

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Typical Dosage for Lamivudine + Zidovudine + Efavirenz

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Schedule of Lamivudine + Zidovudine + Efavirenz

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Storage Requirements for Lamivudine + Zidovudine + Efavirenz

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Effects of Missed Dosage of Lamivudine + Zidovudine + Efavirenz

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Effects of Overdose of Lamivudine + Zidovudine + Efavirenz

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Lamivudine

About Lamivudine

Nucleoside Reverse Transcriptase Inhibitor ,cytidine analogue, Antiretroviral.

Mechanism of Action of Lamivudine

Lamivudine is a deoxy cytidine nucleoside analogue. It undergoes phosphorylation in the presence of Kinase enzyme and form Lamivudine triphosphate. This Lamivudine triphosphate competitively inhibit HIV reverse transcriptase enzyme which is responsible for the conversion of viral RNA to pro viral DNA and is then added to host cell chromosome. Lamivudine triphosphate terminates elongation of pro viral DNA and results in inhibition of viral replication. Lamivudine triphosphate is also a potent inhibitor of HBV (hepatitis B virus)

Pharmacokinets of Lamivudine

Absorption: It is rapidly absorbed after oral administration. Distribution: It is widely distributed in the body. Metabolism: Metabolism is insignificant. Excretion: It is excreted in urine

Onset of Action for Lamivudine

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Duration of Action for Lamivudine

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Half Life of Lamivudine

5 - 7 hours

Side Effects of Lamivudine

1.Nausea
2.Vomiting
3.Diarrhoea
4.Anorexia
5.Headache
6.Dizziness
7.Anaemia
8.Neutropenia
9.Thrombocytopenia
10.Myalgia
11.Rash
12.Fever

Contra-indications of Lamivudine

Hypersensitivity to Lamivudine

Special Precautions while taking Lamivudine

1.Renal impairment
2.Hepatic dysfunction

Pregnancy Related Information

Use with caution

Old Age Related Information

Use with caution

Breast Feeding Related Information

Contraindicated

Children Related Information

Use with caution
NEONATES: contraindicated

Indications for Lamivudine

1.HIV infections
2.Treatment of chronic Hepatitis B

Interactions for Lamivudine

Trimethoprim, sulfamethoxazole: Results in an increase in AUC of Lamivudine and a decrease in renal clearance.
Zidovudine: Results in an increase in C max. of Zidovudine.

Typical Dosage for Lamivudine

Adult: 100 - 300 mg / day in 2 divided dose
HIV infection: 300 mg / day in 2 divided dose
Treatment of chronic Hepatitis B: 100 mg / day
Children: 4 - 8 mg / kg /day in 2 divided dose
HIV infection: 4 mg / kg /day in 2 divided dose

Schedule of Lamivudine

Storage Requirements for Lamivudine

Store it at 15 -25 degree C in a tightly closed container .Protect away from heat and light

Effects of Missed Dosage of Lamivudine

Take the missed dose as soon as noticed and if it is the time to take the next dose then skip the missed dose and do not double the dose

Effects of Overdose of Lamivudine

Give supportive measures and treatment.

Zidovudine

About Zidovudine

Nucleoside Reverse Transcriptase Inhibitor, thymidine analog, Antiretroviral.

Mechanism of Action of Zidovudine

Zidovudine is a Thymidine nucleoside analogue. It undergoes phosphorylation in the presence of Kinase enzyme and form Zidovudine triphosphate. This Zidovudine triphosphate competitively inhibit HIV reverse transcriptase enzyme which is responsible for the conversion of viral RNA to pro viral DNA and is then added to host cell chromosome. Zidovudine triphosphate terminates elongation of pro viral DNA and results in inhibition of viral replication.

Pharmacokinets of Zidovudine

Absorption: It is rapidly absorbed after oral administration.
Distribution: It is widely distributed in the body.
Metabolism: It undergoes rapid metabolism in the liver.
Excretion: It is excreted in urine.

Onset of Action for Zidovudine

30 - 90 minutes

Duration of Action for Zidovudine

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Half Life of Zidovudine

60 minutes

Side Effects of Zidovudine

1. Nausea
2. Vomiting
3. Diarrhoea
4. Anorexia
5. Headache
6. Dizziness
7. Anaemia
8. Agranulocytosis
9. Thrombocytopenia
10. Myalgia
11. Rash

Contra-indications of Zidovudine

1. Hypersensitivity to Zidovudine

Special Precautions while taking Zidovudine

1. Renal impairment
2. Hepatic dysfunction (Hepatitis, hepatomegaly)
3. Patient with severe bone marrow suppression
4. Pre existing anaemia
5. Granulocytopenia

Pregnancy Related Information

Use with caution

Old Age Related Information

Use with caution

Breast Feeding Related Information

Contraindicated

Children Related Information

May be used
NEONATES : Contraindicated

Indications for Zidovudine

1. HIV infections

Interactions for Zidovudine

Dapsone, Pentamidine, Amphotericin B, Flucytosine, Vincristine, Vinblastine, Adriamycin, Interferon: Concomitant use with drugs that are nephrotoxic, cytotoxic or myelosuppressive may increase toxicity risk.
Trimethoprim:The serum levels of Zidovudine and its metabolite may be increased.
Probenecid:Toxicity of either drug may be potentiated.
Acetaminophen: Increased incidence of granulocytopenia.
Acyclovir: Concomitant use may result in neurotoxicity.
Phenytoin: Altered phenytoin levels. Zidovudine clearance decreased by phenytoin.

Typical Dosage for Zidovudine

Adult: 600 mg / day in 2 - 3 divided dose
Asymptomatic HIV infection and for preventing HIV transmission from mother to fetus: 100 mg 5 times daily; should be taken every 4 hours.
Children: 720 mg / sq.metre / day in 4 divided dose in equal interval

Schedule of Zidovudine

Storage Requirements for Zidovudine

Store it at 15 -25 degree C in a tightly closed container . Protect away from heat and light. Keep out of the reach of children.

Effects of Missed Dosage of Zidovudine

Take the missed dose as soon as noticed and if it is the time to take the next dose then skip the missed dose and do not double the dose.

Effects of Overdose of Zidovudine

Give supportive measures and treatment.

Efavirenz

About Efavirenz

Efavirenz is a non-nucleotide reverse transcriptase inhibitor, Antiretroviral Agent.

Mechanism of Action of Efavirenz

Efavirenz noncompetitively binds to a site other than catalytic site in the HIV- 1 reverse transcriptase enzyme .This binding will results in a structural change in the enzyme and inhibits its activity i.e. conversion of viral RNA to pro viral DNA and subsequent virus replication

Pharmacokinets of Efavirenz

Absorption: It is absorbed after oral administration. Distribution: It is widely distributed in the body in protein bound form. Metabolism: It is metabolised in the liver to inactive metabolite. Excretion: The drug is primarily excreted through faeces and it is also excreted through urine.

Onset of Action for Efavirenz

3 - 5 hour

Duration of Action for Efavirenz

N/A

Half Life of Efavirenz

48 hour

Side Effects of Efavirenz

1.Rash
2.Stevens-Johnson syndrome
3.Dizziness
4.Headache
5.Insomnia
6.Hallucination
7.Diarrhoea
8.Anorexia
9.Impaired concentration
10.Dysphoria

Contra-indications of Efavirenz

Hypersensitivity to Efavirenz

Special Precautions while taking Efavirenz

1.Renal impairment
2.Hepatic impairment
3.Psychiatric patients
4.Patient with increased cholesterol level and serum transaminases level

Pregnancy Related Information

Contraindicated

Old Age Related Information

Use with caution.

Breast Feeding Related Information

Contraindicated.

Children Related Information

Use with caution.
NEONATES: contraindicated

Indications for Efavirenz

HIV-1 infection

Interactions for Efavirenz

Grapefruit juice may affect plasma efavirenz concentration.
Antibacterials: Increased risk of rash with clarithromycin. Rifampicin reduces plasma concentration of efavirenz.
Antidepressants: Avoid concomitant use of St. John?s Wort (Hypericum perforatum - a long living plant with yellow flowers).
Antihistaminics: Increased risk of ventricular arrhythmias when used with terfenadine.
Other antivirals: Efavirenz reduces plasma concentration of amprenavir, indinavir and lipinavir. Efavirenz reduces plasma concentration of saquinavir.
Anxiolytics: Risk of prolonged sedation with Midazolam.
Oestrogen and Progestogens: Possibly reduced efficacy of oral contraceptives.

Typical Dosage for Efavirenz

Adults: 600mg once daily along with other antiretroviral agent.
Children:
Over 3 years(13-14kg body weight) : 200mg once daily;
15-19kg body weight: 250mg once daily;
20-24kg body weight: 300mg once daily;
25-32.4kg body weight: 350mg once daily;
32.5-39kg body weight: 400mg once daily;
above 40kg body weight:same as adult dose

Schedule of Efavirenz

Storage Requirements for Efavirenz

Store at 15 - 30 degree C in a tightly closed container. Protect away from heat and light. Keep out of the reach of children.

Effects of Missed Dosage of Efavirenz

Take the missed dose as soon as noticed and if it is the time to take the next dose then skip the missed dose

Effects of Overdose of Efavirenz

Give supportive measures and treatment. Activated charcoal can be given to reduce the absorption of the drug

Home Delivery for Lamivudine + Zidovudine + Efavirenz in Your City

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However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for lamivudine + zidovudine + efavirenz and other medicines and health products. Home delivery services for lamivudine + zidovudine + efavirenz may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take lamivudine + zidovudine + efavirenz only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for lamivudine + zidovudine + efavirenz before they complete the sale. You can get this information while placing the order for lamivudine + zidovudine + efavirenz with the pharmacy.

Lamivudine + Zidovudine + Efavirenz is a generic medicine name and there are several brands available for it. Some of the brands for lamivudine + zidovudine + efavirenz might be better known than lamivudine + zidovudine + efavirenz itself. If the pharmacy that's willing to deliver medicines to your home doesn't have lamivudine + zidovudine + efavirenz in stock, you can ask for one of the branded alternatives for lamivudine + zidovudine + efavirenz.