
PRODUCT DETAILS
Trade name : Duovir
Active ingredient : Lamivudine & Zidovudine
Strength availability : 150 mg and 300 mg
Manufactured by : Cipla
Package : 60 tablets
Duovir is a type of antiretroviral drugs which analog to nucleoside polymerase. Duovir is a combination drugs of lamivudine 150mg and Zidovudine 300mg. The drug which prevent human immunodeficiency virus (HIV) from multiplying in your body.
INDICATION
Duovir is used for the treatment of HIV-1 infection by combination with other antiretroviral drugs. Duovir is a nucleoside analogue with combination of Lamivudine and zidovudine.
DOSAGE
Duovir dosage in adults is lamivudine 150mg and zidovudine 300mg with weight of >30kg one tablet twice in a day Childern of 14-21 kg one half tablet bid and for 22-30kg one half tablet in the morning or one half tab tid. Duovir may be taken with or without food.
PHARMACOLOGY
Duovir consist of Lamivudine and Zidovudine which is a synthetic nucleoside analogue. Both drugs acts like inside cell Lamivudine and Zidovudine is phosphorylated to its active 5-triphosphate metabolite and forms Zidovudine triphosphate and Lamivudine triphosphate (L-TP). The basic action of L-TP and ZDV-TP is inhibition of reverse transcriptase (RT) via DNA chain termination after incorporation of the nucleoside correlated.Both L-TP and ZDV-TP is a weak inhibitor of mammalian DNA polymerases a and b, and mitochondrial DNA polymerase g which has been reported to be incorporated into DNA of cells in culture.
PHARMACOKINETICS
Absorption : rapidly absorbed from the GI tract. Absorption with food is delayed Bioavailability: 80-87% (Lamivudine); approx 60-70% (zidovudine). Time to peak plasma concentration: Approx 1 hr.
Distribution : Passes through blood-brain barrier and placenta that enters breast milk and Detected in semen (zidovudine). Volume of distribution: 1.3 L/kg (Lamivudine); 1-2.2 L/kg (zidovudine). Plasma protein binding: Up to 36% (Lamivudine); 34-38% (zidovudine).
Metabolism : Both regimens are metabolized inside the cells to form the active triphosphate. Zidovudine goes through hepatic metabolism, mainly to the inactive glucuronide.
Excretion : Lamivudine and zidovudine excreted Via urine, (mainly as unchanged drug) Elimination half-life: 5-7 hr (Lamivudine); 0.5-3 hr (zidovudine).
DRUG INTERACTION
Duovir given with Emtricitabine may develop cross –resistance. Continue use of zidovudine with Ribavirin leads to Excerabtion of anemia. Lamivudine and zalcitabine may prevent intracellularily phosphorylation of one another. Interaction of zidovudine with stavudine and doxorubicin will produce antagonistic effects. Duovir used with interferon alfa in HIV may develop risk of hepatic decompenstion.
CONTAINDICATION
Previously demonstrating clinically significant in patients are hypersensitivity to any of the component of Duovir. The patient with low body weight should not be receive Duovir dose.
WARNING
Monitoring Parameters , Monitor haematological parameters observe for appearance of hardened infections and signs and symptoms of pancreatitis. Periodically check liver function test and for several month following discontinuation of therapy for patients co-infected with hepatitis B virus and HIV. Obese women with hepatomegaly, hepatitis or other risk factors causes liver disease and hepatic steatosis; hepatitis B or C virus co-infection leads risk factors for pancreatitis Patient with poor bone marrow reserve before the treatment. Renal and severe hepatic impairment. Children Pregnancy.
MISSED DOSE
If dose is missed, patients should consult with medical practitioner & follow their instructions. Continue the regular dosing schedule .Avoid the missed dose if possible. Do not self medicate the drug.
SIDE EFFECTS
If dose is missed, patients should consult with medical practitioner & follow their instructions. Continue the regular dosing schedule .Avoid the missed dose if possible. Do not self medicate the drug.
More common:
Chills,
fever,
pale skin,
sore throat weakness,
head pain
Less common:
stomach ache,
nausea,
skin rash,
vomiting,
yellow eyes,
coughing, l
oss of appetite,
sleeping trouble.
Incident not known :
blurred vision,
dry mouth,
hair loss,
increased (hunger,thirst,urination),
chest discomfort,
wheezing,
myalgia,
convulsions.