Fact Sheet Number 426
- WHAT IS COMBIVIR?
- WHO SHOULD TAKE COMBIVIR?
- WHAT ABOUT DRUG RESISTANCE?
- HOW IS COMBIVIR TAKEN?
- WHAT ARE THE SIDE EFFECTS?
- HOW DOES COMBIVIR REACT WITH OHTER
DRUGS?
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PrintCombivir is a pill that contains two drugs used to fight HIV:
Retrovir (AZT) and Epivir
(3TC). Combivir is manufactured by GlaxoSmithKline.
The drugs in combivir are called nucleoside analog reverse
transcriptase inhibitors, or nukes. These drugs block the reverse
transcriptase enzyme. This enzyme changes HIV’s genetic material
(RNA) into the form of DNA. This has to occur before HIV’s genetic
code gets inserted into an infected cell’s own genetic codes.
COMBIVIR?
Combivir was approved as an antiviral drug for people with HIV
infection. There are no absolute rules about when to start antiviral
drugs. You and your doctor should consider your T-cell
count, your viral load,
any symptoms you are having, and your attitude about taking HIV
medications. Fact Sheet 411
has more information about guidelines
for the use of antiviral medications.
If you take combivir with other antiviral drugs, you can reduce
your viral load to extremely low levels, and increase your T-cell
counts. This should mean staying healthier longer.
Children under 12 years old and people with kidney problems
should not take Combivir.
Combivir provides two drugs in one pill. It can be more convenient
to use combivir that some other combinations of drugs. This could
mean fewer missed doses and better control of HIV.
RESISTANCE?
Many new copies of HIV are mutations. They are slightly different
from the original virus. Some mutations can keep multiplying even
when you are taking an antiviral drug. When this happens, the
drug will stop working. This is called “developing resistance”
to the drug. See Fact Sheet 414
for more information on resistance.
Sometimes, if your virus develops resistance to one drug, it
will also have resistance to other antiviral drugs. This is called
“cross-resistance”.
Resistance can develop quickly. It is very important to
take antiviral medications according to instructions, on schedule,
and not to skip or reduce doses.
TAKEN?
Combivir is taken by mouth as a tablet. The normal adult dose
is one tablet, two times a day. Each tablet includes 300 milligrams
(mg) of Retrovir (AZT) and 150 mg of Epivir (3TC).
Combivir can be taken with food, or between meals.
The dosage of 3TC should be reduced for people who weigh less
than 50 kilograms (110 pounds). People who weigh less than 110
pounds should normally not take Combivir.
EFFECTS?
When you start any antiviral treatment, you may have temporary
side effects such as headaches, high blood pressure, or a general
sense of feeling ill. These side effects usually get better or
disappear over time.
The most common side effects of combivir are the same as with
Retrovir (AZT) and Epivir (3TC). They include headache, upset
stomach, and fatigue. See Fact Sheet
551 for more information on fatigue.
The most serious side effects of AZT are anemia, granulocytopenia,
and myopathy. Very few people have these side effects. If they
occur, your doctor will probably have you stop using Combivir.
See Fact Sheet 420 on AZT for more
information on these side effects.
Anemia is a shortage of
red blood cells caused by damage to bone marrow. Fact
Sheet 552 has more information on anemia.
Granulocytopenia is a shortage of white blood cells
caused by damage to bone marrow.
Myopathy is muscle pain and weakness. There is no specific
treatment for myopathy.
REACT WITH OTHER DRUGS?
Combivir should not be taken with with ddC
(zalcitabine, Hivid®) or with d4T
(stavudine, Zerit®).
Blood levels of 3TC may be increased by bactrim
or septra. See Fact Sheet 535
for more information on these drugs.
AZT’s side effects may be worse if you are taking several other
drugs. Be sure your doctor knows about all the medications you
are taking.
Revised November 11, 2002
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New Mexico AIDS Education and Training Center
and the New Mexico Department of Health