Combivir® (Lamivudine + Zidovudine)
Compared with: Blackmores Conceive Well Gold 28 Tablets + 28 Capsules

Combivir (Lamivudine 150 mg + Zidovudine 300 mg) is a fixed‑dose NRTI combination for HIV‑1 treatment. Administered twice daily, it inhibits reverse transcriptase activity, suppresses viral replication, and reduces disease progression. Clinical trials demonstrate superior virologic and immunologic outcomes versus zidovudine monotherapy, with a well‑characterized safety profile

Lamivudine (3TC) – 150 mg

Zidovudine (AZT, AZT) – 300 mg

Other Popular and Common Names
3TC + AZT

Lamivudine/Zidovudine

CBV (abbreviation)

Retroviral NRTI Duo

Therapeutic Class: Antiretroviral Therapy, HIV‑1 Treatment

Pharmacologic Class: Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

Legal Category: Prescription Only Medicine

Lamivudine: A cytidine analogue phosphorylated intracellularly to 3TC‑triphosphate. It competitively inhibits HIV‑1 reverse transcriptase and causes chain termination upon incorporation into viral DNA

Zidovudine: A thymidine analogue converted to AZT‑triphosphate, which similarly inhibits reverse transcriptase and terminates DNA elongation

The combination provides synergistic antiviral activity and delays resistance emergence.

Uses / Indications
HIV‑1 Infection: In combination with additional antiretrovirals, for treatment of adult and pediatric patients ≥3 months of age

Post‑Exposure Prophylaxis (PEP): As part of a multidrug regimen following occupational or nonoccupational exposure.

Perinatal Prophylaxis: Reduces maternal–fetal HIV transmission risk when administered during pregnancy and labour.

Population Dose Frequency
Adults & Adolescents ≥12 years 1 tablet (150 mg/300 mg) Twice daily (every 12 h)
Children (3 months–12 years) 4 mg/kg lamivudine + 8 mg/kg zidovudine per dose (max adult dose) Twice daily
viivhealthcare.com
PEP (Adults) 1 tablet + third agent Twice daily for 28 days
Renal Impairment CrCl < 50 mL/min: increase dosing interval to every 18 h for lamivudine component; zidovudine unchanged —

Administration: Swallow whole with water. May be taken with or without food.

Missed Dose: Take as soon as remembered unless <4 hours before next dose; do not double.

Formulation: Film‑coated fixed‑dose tablet

Strength: Lamivudine 150 mg + Zidovudine 300 mg

Route: Oral

Legal Status: Prescription Only

Safety Information
Pregnancy: Category C – Recommended during pregnancy to prevent mother‑to‑child transmission; benefits outweigh risks

Breastfeeding: Avoid breastfeeding due to HIV transmission risk; use formula feeding where safe.

Pediatric: Safe for infants ≥3 months; weight‑based dosing for younger.

Elderly: No specific adjustment; monitor for anemia and neutropenia.

Common:

Headache, nausea, diarrhea, insomnia

Fatigue, myalgia

Serious:

Hematologic: Anemia, neutropenia, pancytopenia (more common with zidovudine)
viivhealthcare.com

Mitochondrial Toxicity: Lactic acidosis, hepatic steatosis (rare)

Myopathy: Including nail pigmentation and myositis

Immune Reconstitution Syndrome: Autoimmune phenomena upon therapy initiation

Bone Marrow Suppression: Monitor CBC regularly; use caution in patients with preexisting anemia.

Lactic Acidosis & Hepatic Steatosis: Monitor for unexplained fatigue, abdominal pain, hepatomegaly, lactic acid levels.

Drug Resistance: Adherence critical to prevent resistance; combination with other ART agents required.

Hypersensitivity: Rare reactions; discontinue if severe rash or systemic symptoms occur.

Agent Interaction Effect Recommendation
Didanosine Lamivudine may increase didanosine levels Separate dosing by ≥2 h or avoid pairing
Stavudine, Zalcitabine Compete for phosphorylation with zidovudine and lamivudine Avoid co‑administration
Ritonavir ↑Zidovudine levels via CYP induction Monitor for hematologic toxicity
Ganciclovir Additive hematologic toxicity Close CBC monitoring
Probenecid ↓Lamivudine renal excretion → ↑levels Dose adjustment not typically required

Clinical Evidence
Staszewski et al. (1996): Lamivudine + zidovudine achieved a 60 % greater reduction in HIV RNA versus zidovudine alone at 16 weeks (P < 0.001)
PubMed
Katlama et al. (1996): Combination therapy improved CD4 counts by mean +75 cells/µL at 24 weeks versus +25 cells/µL with monotherapy

Eron et al. (1995): Demonstrated safety and sustained virologic suppression in treatment‑naïve patients receiving lamivudine + zidovudine
New England Journal of Medicine

FAQs – Combivir (Lamivudine + Zidovudine)
Q1. Can Combivir cure HIV?
A: No. It suppresses HIV replication, improving immunologic function but not eradicating the virus.

Q2. How long until viral load decreases?
A: Significant reductions in HIV RNA typically within 4 weeks, with maximum suppression by 12–24 weeks.

Q3. Can Combivir be taken with food?
A: Yes. Food may reduce gastrointestinal upset but does not affect absorption significantly.

Q4. What monitoring is required?
A: Baseline and periodic CBC, liver function, renal function, and viral load/CD4 counts.

Q5. Is Combivir safe during pregnancy?
A: Yes. Standard component of prophylaxis to prevent mother‑to‑child transmission

Q6. What if I miss a dose?
A: Take within 4 hours; if later, skip and resume regular schedule—never double dose.

Q7. Can Combivir cause anemia?
A: Zidovudine component can cause macrocytic anemia; monitor hemoglobin and adjust therapy if severe.

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