What Adverse Impact Can Duovir-N (Lamivudine/Zidovudine/Nevirapine) Bring?
Duovir-N is a blend of 3 drugs commonly used to teat Human Immunodeficiency Virus (HIV) infection. It is a common clinical remedy offered in the form of film-coated tablets. The main ingredients of this product are Zidovudine, Lamivudine and Nevirapine. These medical substances have a history of being employed in the effective management of the infection with the well known HIV virus. The following side effects may occur with Duovir-N (Lamivudine/Zidovudine/Nevirapine):
Lamivudine
The use of lamivudine can rarely cause pancreatitis. In addition some people have reported lactic acidosis and hepatic steatosis, hepatitis and liver failure with the use of antiretroviral nucleoside analogs, alone or in combination.
Besides there are a lot of side effects resulted from the use of lamivudine such as, headache, arthralgias, myalgias, skin rash, nausea and vomiting, diarrhea, malaise and fatigue, abdominal pain and discomfort, peripheral neuropathy, pruritus, transient neutropenia and thrombocytopenia. This medication have rarely resulted in momentarily increased levels of hepatic enzymes and bilirubin (> 5 times the normal level) during therapy. Inform your doctor or to the clinical professional about it that observes your therapy course with Duovir-N (Lamivudine/Zidovudine/Nevirapine). Apart from that resolution of transient neutropenia and raised hepatic and bilirubin levels takes place without dosage modification or discontinuation of therapy.
Zidovudine
Some patients with advanced HIV disease receiving zidovudine observed anaemia and thrombocytopenia. The former symptoms may be due to impaired erythrocyte maturation. A gentle rise in total bilirubin levels rarely occur in patients treated for asymptomatic HIV infection.
Some of the infrequent adverse events were observed in clinical trials in 5% patients with advanced HIV disease treated with 1,500 mg/day of zidovudine. These were: fever, headache, nausea, vomiting, anorexia, myalgia, insomnia, dizziness, paraesthesias, dyspnoea and rash. Malaise, gastrointestinal pain, dyspepsia and taste perversion were also reported.
Nevirapine
Clinical test shows some of the adverse events related to nevirapine therapy which include rash and increases in liver function tests. Some hypersensitivity reactions have been studied during trials. Rash is the major clinical toxicity caused by nevirapine occurring in 16% of patients in combination regimens in Phase II/III controlled studies. Another study showed thirty-five percent of patients treated with nevirapine observed rash compared with 19% of patients treated in control groups of either zidovudine + didanosine or zidovudine alone. 6.6% of nevirapine-treated patients experienced serious or life-threatening rash compared with 1.3% of patients treated in the control groups.
Rashes may be mild to moderate, maculopapular erythematous cutaneous eruptions; with or without pruritus, located on the trunk, face and extremities. Patients within the first 28 days of treatment noticed severe rashes. 25% of the patients with severe rashes required hospitalization, and one patient required surgical intervention. Overall, 7% of patients stopped nevirapine because of rash.
Regarding laboratory abnormalities, asymptomatic elevations in GGT levels are more common in nevirapine recipients than in controls. Since nevirapine-treated patients have reported clinical hepatitis, monitoring of ALT (SGPT) and AST (SGOT) is strongly suggested, especially during the first six months of nevirapine treatment. Some patients have also accused decreased neutrophils (< 750/mm3), platelets (< 50,000/mm3) and Hb (< 8.0 g/dL), and increased total bilirubin (> 2.5 mg/dL).