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Lamivudine/zidovudine

Greta Hughson

What are lamivudine and zidovudine?

Lamivudine and zidovudine are medications used to treat HIV. They are antiretroviral drugs combined in one pill, taken twice a day along with another antiretroviral drug.

The pill combines 150mg lamivudine and 300mg zidovudine. This combination is sometimes marketed under the brand name Combivir, but generic versions are also available and these are more commonly used.

How do they work?

Lamivudine and zidovudine are from a class of drugs known as NRTIs (nucleoside reverse transcriptase inhibitors).

Your doctor will prescribe lamivudine/zidovudine as part of your HIV treatment, along with an antiretroviral from another class of drugs. It is important to take all the drugs as prescribed, every day.

Each drug class works against HIV in a different way.

The aim of HIV treatment is to reduce the level of HIV in your body (viral load). Ideally, your viral load should become so low that it is undetectable – usually less than 50 copies of virus per ml of blood. Taking HIV treatment and having an undetectable viral load protects your immune system and stops HIV being passed on to someone else during sex.

How do I take lamivudine/zidovudine?

You should take lamivudine/zidovudine twice a day, with some water. You can take it with or without food.

If you find it hard to swallow the pills whole, you can crush them and take them with a small amount of food or drink. Be careful if you do this and make sure that you take the whole dose.

Ideally, you should leave 12 hours between doses and take the doses at regular times each day.

HIV treatment works best if you take it every day. If you forget to take a dose of lamivudine/zidovudine, take it as soon as you remember. If it’s nearly time to take your next dose then don’t take a double dose, just skip the dose you’ve forgotten and carry on.

If you regularly forget to take your treatment, or you aren’t taking it for another reason, it’s important to talk to your doctor about this.

What are the side-effects of lamivudine/zidovudine?

All drugs have possible side-effects. It’s a good idea to talk to your doctor about possible side-effects before you start taking a drug. If you experience something that might be a side-effect, talk to your doctor about what can be done. A full list of side-effects, including less common side-effects, should be included in the leaflet that comes in the packaging with lamivudine/zidovudine.

We generally divide side-effects into two types:

Common – a side-effect that occurs in at least one in a hundred people (more than 1%) who take this drug.

Rare – a side-effect that occurs in fewer than one in a hundred people (less than 1%) who take this drug.

The most common side-effects of lamivudine/zidovudineare (most common in bold):

Nausea, headache, vomiting, diarrhoea, abdominal pain, loss of appetite, tiredness, dizziness, fever, insomnia (difficulty sleeping), joint or muscle pain, cough, runny nose, hair loss, rash, fat loss, anaemia, low white blood cell count, raised liver enzymes.

Do lamivudine and zidovudine interact with other drugs?

It’s important that your doctor and pharmacist know about any other drugs you are taking. That includes medicine prescribed by another doctor, drugs you have bought from a high-street chemist, herbal and alternative treatments, and recreational drugs.

Some medicines should not be taken together because if they are this can cause serious side-effects, or it can stop one or both of the drugs from working. Other drug interactions are less dangerous but still need to be taken seriously. If levels of one drug are affected, you may need to change the dose you take.

A list of drugs, known to have interactions with lamivudine/zidovudine,should be included in the leaflet that comes in the packaging with lamivudine/zidovudine. Tell your doctor if you are taking any of these drugs, and other drugs that are not on the list.

You should not take lamivudine/zidovudinewith any of the following drugs:

  • clabribine
  • high doses of cotrimoxazole
  • emtricitabine
  • ganciclovir injections
  • other medicines containing lamivudine
  • ribavirin.

There are other interactions, including with drugs used to treat epilepsy, malaria, cancer, gout, and infections and with methadone, used as a heroin substitute, so it is very important that you tell your doctor about other drugs you are taking.

Can I take lamivudine/zidovudine in pregnancy?

There are other things which are important to your health and HIV care, and which you and your doctor may take into account when making decisions about your treatment. For example, if you are considering having a baby, or want to start taking contraception.

Lamivudine/zidovudine has often been used by women who are pregnant or planning to have a baby but it is not the only option. If you are planning to have a baby or think there is the possibility you might get pregnant, talk to your doctor about which drug combination would be best for you.

Talking to your doctor

If you have any concerns about your treatment or other aspects of your health, it’s important to talk to your doctor about them.

For example, if you have a symptom or side-effect or if you are having problems taking your treatment every day, it’s important that your doctor knows about this. If you are taking any other medication or recreational drugs, or if you have another medical condition, this is also important for your doctor to know about.

Building a relationship with a doctor may take time. You may feel very comfortable talking to your doctor, but some people find it more difficult, particularly when talking about sex, mental health, or symptoms they find embarrassing. It’s also easy to forget things you wanted to talk about.

Preparing for an appointment can be very helpful. Take some time to think about what you are going to say. You might find it helpful to talk to someone else first, or to make some notes and bring them to your appointment. Our online tool Talking points may help you to prepare for your next appointment – visit www.aidsmap.com/talking-points 

Lamivudine/zidovudine

Published October 2017

Last reviewed October 2017

Next review October 2020

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.