Duovir-N (Lamivudine/Zidovudine/Nevirapine) in Treatment of HIV Infection
Duovir-N (Lamivudine/Zidovudine/Nevirapine) in Treatment of HIV Infection
Duovir-N (Lamivudine/Zidovudine/Nevirapine)is used to treat HIV infection, as a part of a combination therapy once patients have been stabilized on the upholding regimen of nevirapine 200 mg bd, and have demonstrated adequate tolerability to nevirapine.
DOSAGE AND ADMINISTRATION
In a dults the dose is1 tablet twice daily. Duovir-Nshould not be used in patients who have just started therapy with nevirapine. This is since an early lead-in dosing of 200 mg nevirapine once daily for 2 weeks is suggested. Following this lead-in dose, a dose rise (maintenance dose) to 200 mg nevirapine bd may be performed in the nonappearance of any hypersensitivity reactions such as, rash, liver function test abnormalities.
Dosage Adjustment
Lamivudine
As it is a fixed-dose combination, Duovir-Nare not meant for patients requiring dosage adjustment, such as those with low body weight (<50 kg).
Zidovudine
Duovir-N should not be approved for patients requiring dosage adjustment such as those with reduced renal function (creatinine clearance < 50 ml/min) or those experiencing dose-limiting adverse events.
Nevirapine
Duovir-N (Lamivudine/Zidovudine/Nevirapine)must be terminated if patients observe severe rash or a rash along with constitutional findings. Patients having mild to moderate rash during the 14-day lead-in period of 200 mg/day should not increase their nevirapine dose or start therapy with this medication until the rash has resolved.
Administration of this medication should be interrupted in patients observing moderate or severe liver function tests abnormalities (excluding GGT), until the liver function test altitudes have returned to normal level. Nevirapine (using Nevimune Tablets) may then be restarted at 200 mg per day. The patient can increase the daily dose to 200 mg twice daily (using Duovir-N) with due caution, after complete observation. Nevirapine should be permanently discontinued if moderate or severe liver function test abnormalities come back.
Patients discontinuing nevirapine dosing for more than 7 days should restart the intake of recommended dosing of one 200 mg Nevimune tablet daily for the first 14 days (lead-in) along with the other antiretroviral, followed by 200 mg twice daily using Duovir-N. It should be taken if you don’t find any signs of hypersensitivity. A dosage of nevirapine may not be medically approved in patients with hepatic dysfunction, renal insufficiency or undergoing dialysis.
Duovir-N Side Effects
Clinical trials have shown that a therapy course with this medication can trigger a set of adverse effects. The most common side effects during their therapy course with Duovir-Nare: dizziness, insomnia, neutropenia, cough, nasal signs, neuropathy, chills / fever, diarrhea, vomiting, anorexia, fatigue, malaise, etc. If you find any of these symptoms do not get panic, as they are usual responses of your organism. On the other hand, report all changes of this kind to your main doctor.
Warnings and Precautions
Duovir-Nis contra-indicated in patients with clinically essential hypersensitivity to any of the components containing in the formulation. It also should not be used in patients who only begin therapy with nevirapine. These patients should be able to adjust to the dosage nevirapine 200 mg o.d. whereas this formulation contains a dosage of service nevirapine 200mg b.d.