What I should inform my doctor before taking Duovir-
Duovir-N is one of the most successful antiretroviral medicines on the market, because its two main ingredients (its active substances) are also antiretroviral remedies. A treatment with this medication effectively slows down one of HIV’s main enzymes (the reverse transcriptase). It stops the growth of the virus’ chain of DNA.
But before undergoing Duovir-N the patient should tell his/her healthcare provider about the following condition.
Impaired Renal Function
Inform your doctor about your renal problems so that your health care provider can recommend some dosage adjustment. In patients with a creatinine clearance of 50 ml/min or less, decrease of the dosage of both zidovudine and lamivudine should be made. The pharmacokinetics of nevirapine has not been assessed in patients with renal dysfunction. For this reason, Duovir-Ncannot be used in this patient population.
Pregnancy
You must tell your doctor if you are pregnant or planning to be pregnant. The elements of Duovir-Nsuch as lamivudine, zidovudine and nevirapine are all categorized under category C. re no adequate and well-controlled studies have been made in pregnant women. It should be used during pregnancy only if the potential benefits are more important than the potential risk.
Lactation
HIV-infected mothers must not breast-feed their infants to keep away from risking postnatal transmission of HIV infection. It is not known whether Duovir-N elements are excreted in human milk. Nevirapine and zidovudine are present in breast milk.
Pediatrics
Paediatric patients can not use Duovir-N.
Use of Other Drugs
Before using any other drugs for other diseases consult your doctor because it can cause some severe health hazardous.
With Lamivudine
Trimethoprim 160 mg/sulphamethoxazole 800 mg once daily has been shown to enhance lamivudine exposure (AUC).
With Zidovudine
The hematologic toxicity of zidovudine may be increased by simultaneous use of ganciclovir, interferon-alpha, and other bone marrow suppressive or cytotoxic agents.
With Nevirapine
Lower plasma concentrations of other concurrently administered drugs may cause by the introduction of CYP3A by nevirapine. These other drugs are widely metabolized by CYP3A. Consequently, if a patient has been steady on a dosage schedule for a drug metabolized by CYP3A, and initiates therapy with nevirapine, dose adjustments may be required.
Rifampin/Rifabutin: There are no clear data available whether dose adjustments are necessary when nevirapine and rifampin or rifabutin are administered simultaneously. Therefore, these drugs should only be used along with if clearly indicated and with careful monitoring.
Ketoconazole: patient taking Nevirapine should not take ketoconazole at the same time. If nevirapine and ketoconazole are used concurrently it may bring about a significant decrease in ketoconazole plasma concentrations.
Oral Contraceptives: it is not revealed what effects nevirapine has on the pharmacokinetics of oral contraceptives. Nevirapine may reduce plasma concentrations of oral contraceptives (also other hormonal contraceptives); as a result, these drugs should not be taken parallel with nevirapine.
Methadone: Founded on the known metabolism of methadone, nevirapine may decline plasma concentrations of methadone by raising its hepatic metabolism. patients treated with nevirapine and methadone concomitantly have experienced narcotic withdrawal syndrome. Methadone-maintained patients beginning nevirapine therapy should be monitored for evidence of withdrawal and methadone dose should be adjusted accordingly.