Meds and you

27 September 2013

The combination of lamivudine, stavudine and nevirapine

The combination of lamivudine, stavudine and nevirapine is an anti-retroviral. Anti-retrovirals are drugs that suppress the activity or replication of retroviruses such as HIV.

0

The combination of lamivudine, stavudine and nevirapine is the active ingredient of Triomune 40-Tabs (Nappi Code: 705968-001) and Triomune 3-Tabs (Nappi Code: 707970-001).

General information
The combination of lamivudine, stavudine and nevirapine is an anti-retroviral. Anti-retrovirals are drugs that suppress the activity or replication of retroviruses such as HIV. This specific anti-viral is classified as a combination of different reverse transcriptase inhibitors, meaning that it blocks an enzyme which is essential for the retrovirus to multiply.

In South Africa this combination is registered for the treatment and post-exposure prevention of infection with the human immunodeficiency virus (HIV).

If not treated, HIV will advance to weaken the body's immune system, gradually chipping away to create grounds for other infections against which the body will find more and more difficult to protect itself. HIV develops into acquired immune deficiency syndrome (Aids) when your immune system has been severely weakened.

For this combination to be effective, it has to be taken regularly. By skipping even a few doses the risk for treatment failure increases substantially. Try to ensure that you take all your doses, and at the correct time.

It should be understood that the combination of lamivudine, stavudine and nevirapine is not a cure for HIV or Aids, but is one of a variety of drugs that only restricts the advance of the virus, keeping the immune system up and running. It is used in combination with other anti-retroviral drugs and should not be prescribed on its own.

This medication does not reduce transmission of HIV; you can still infect another person with the virus and the use of appropriate precautions to prevent spread to other persons is highly recommended.

How does this medication work?
When HIV infects a human T-cell, a type of white blood cell that plays a key role in the functioning of the immune system, viral genetic information in the form of RNA needs to be converted to DNA for the virus to have any effect. It makes use of an enzyme called reverse transcriptase to achieve this conversion. This combination targets and inhibits this enzyme, thus preventing the spread of HIV.

Fast facts

Drug schedule: schedule 4
Available as: the combination of lamivudine, stavudine and nevirapine is available as tablets.
What does it do? This medication has an anti-viral effect
Overdose risk: medium
Dependence risk: low
Is this combination available as a generic? no
Is this combination available on prescription only? yes

User information

Dietary advice: this medication may be taken with or without food; be sure to take this drug with plenty of water.
Stopping this medicine: do not stop taking this drug without consulting your doctor.
Prolonged use: side effects may develop with long-term use; frequent blood tests may be required with prolonged therapy to prevent serious blood disorder and to determine liver function.

Special precautions
Consult your doctor before using this drug if:

  • you have known liver or kidney problems
  • you are anaemic
  • you have a history of alcohol abuse
  • you have pancreatitis
  • you have been diagnosed with a disease affecting the nerves of the extremities (arms and legs)
  • you are taking any other medication

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: avoid. Not only can HIV infection be passed to your baby through breast milk, but this combination is also present and transmitted in breast milk.
Porphyria: avoid. This medication may cause serious adverse effects. Consult your doctor before use.
The elderly: caution is advised in the elderly as side effects may be more severe.
Infants and children: this medication is not intended for use in children.
Driving and hazardous work: caution is advised as use of this medication may lead to dizziness. Avoid such activities until you know how this medication affects you.
Alcohol: avoid concomitant use of alcohol with this medication.

Possible side effects

 

Side Effect
Frequency
Consult your doctor
 
Common
Rare
Only if severe
In all cases
nausea/vomiting
X
 
X
 
diarrhoea
X
 
X
 
abdominal pain
X
 
 
X
loss of appetite
X
 
X
 
headache
 
X
X
 
dizziness
 
X
X
 
numbness, tingling, burning or pain in the hands or feet
 
X
 
X
blisters/mouth ulcers
 
X
X
 
tiredness
 
X
X
 
insomnia
 
X
 
X
abnormal enlargement of breasts in men
 
X
 
X
muscle/joint pain
 
X
 
X
tremors
 
X
 
X
fever
 
X
 
X
seizures
 
X
 
X
sore throat
 
X
 
X
pelvic/back pain
 
X
 
X
skin rash
 
X
 
X
facial swelling
 
X
 
X
visual distrubances
 
X
 
X
severe abdominal pain
 
X
 
X
yellow tinge to eyes or skin
 
X
 
X

Interactions

Drug interactions

 

clarithromycin reduced effect of this combination
fluconazole risk of this combination toxicity
ganciclovir risk of severe blood disorders
methadone risk of this combination toxicity
paracetamol risk of bone marrow suppression
phenytoin fluctuation in phenytoin levels in body
probenecid risk of this combination toxicity
St Johns wort / rifampicin reduced effect of this combination
acyclovir risk of stavudine toxicity
doxrubicin, zidovudine reduced effect of stavudine
dapsone, didanosine, ethambutol, isoniazid increased risk of nerve damage
alcohol, valproic acid azathioprine increased risk of pancreatic inflammation, increased risk of pancreatitis
co-trimoxazole slight risk of lamivudine toxicity

Many other drugs may interact with this combination. It is important to consult your doctor or pharmacist before combining any drug with this combination.

Disease interactions
Contact your doctor if you have a liver or kidney disease.

Overdose action
This combination when taken in overdose is capable of having serious consequences. Seek immediate medical attention.

Recommended dosage
See each individual agent.

 

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 

 
 

Read Health24’s Comments Policy

Comment on this story
0 comments
Comments have been closed for this article.