What Is Combivir?

Brand Name: Combivir
Generic Name: Lamivudine/zidovudine, 3TC/ZDV

Uses

Combivir is a fixed or single dose combination medication used to treat HIV, the virus that causes AIDS. Combivir contains 150 milligrams (mg) milligrams of lamivudine and 300 mg of zidovudine. The U.S. Food and Drug Administration has approved the medication for use in children and adults weighing 30 kilograms (66 pounds) or more.

Read the FDA description of Combivir.

What Does Combivir Do?

When used in combination the lamivudine and zidovudine found in Combivir have been shown to reduce the number of HIV viruses in the blood. Combivir does not cure HIV. The medication is intended to slow the disease’s progression.

What Are the Typical Doses?

The adult dose of Combivir is one tablet twice daily, taken with or without food.  Since the drug only comes in one strength patients who have kidney disease and require lower doses, or children who weigh less than 30 kilograms (66 pounds) should not be given Combivir. These patients may be able to take lower doses of lamivudine and zidovudine in the single dose products. 

This information is a summary. Before starting this medication, discuss questions with your healthcare provider and make sure you understand dosage instructions.

What Should I Tell My Doctor Before Starting Combivir?

Tell your doctor if you:

  • are breastfeeding or are planning on breastfeeding
  • are pregnant or are thinking of becoming pregnant
  • have ever experienced a hypersensitivity reaction to medication, such as Stevens-Johnson syndrome or anaphylaxis
  • have pancreatitis

What Medications May Interact with Combivir?

Always tell your physician about any prescription medications or herbal remedies you are taking.

Some of the medications that can adversely interact with Combivir include:

  • antiretroviral agents, like stavudine (Zerit)
  • bone marrow suppression agents, such as ganciclovir (Cytovene and Cymevene), interferon alfa (Multiferon) or ribavirin (Copegus, Rebetol, Ribasphere, Vilona, Virazole)
  • doxorubicin (Doxil), a chemotherapy drug
  • medications that also contain lamivudine and/or zidovudine, such as Epivir, Epivir-HBV, Retrovir, Epzicom, or Trizivir
  • medications that contain emtricitabine, such as Trizivir, Atripla, Emtriva, Truvada, or Complera

Possible Side Effects of Combivir

Possible Adverse and Emergency Side Effects

The following are severe and emergent side effects of these medications. Report to your medical provider immediately if you experience any of the following:

  • blood disorders, including anemia, lactic acidosis and others.  Symptoms may include severe fatigue, shortness of breath, headache, difficulty breathing, feeling cold, pale skin, chest pain, headache, or coldness in the hands or feet; feeling cold, dizzy or having stomach pain. 
  • enlarged liver or tenderness over the liver.  Symptoms may include dark urine, decrease in appetite, fatigue, jaundice or yellowing of the skin, and nausea.   
  • immune reconstitution syndrome, a condition that causes an inflammatory response in viruses in the blood, such as pneumonia or tuberculosis
  • severe rash or skin changes
  • myopathy or myositis (muscle pain or muscle inflammation)
  • pancreatitis
  • worsening of hepatitis B symptoms. A doctor should monitor a patient with hepatitis B and HIV for liver function closely. If combivir is discontinued, hepatitis B symptoms may worsen. 

Possible Nonemergency Side Effects

The following side effects may occur, but do not usually represent an emergency. Discuss with your doctor if they continue or are bothersome:

  • redistribution of body fat, including an enlargement of fat on the back of the neck (often called a buffalo hump), gaining weight in the midsection, and losing weight in the face and extremities
  • cough
  • diarrhea
  • dizziness
  • fatigue
  • headaches
  • malaise
  • muscle pain
  • nausea

This list may not describe all possible side effects. Call your doctor or healthcare provider for advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Where Should I Keep Combivir?

Combivir can be refrigerated or stored between 36 and 86 degrees Fahrenheit (2 to 30 degrees Celsius). 

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Important FDA Warnings

FDA WARNING: COMBIVIR CARRIES A BLACK BOX WARNING (MEANING THE MEDICATION HAS POTENTIALLY LETHAL SIDE EFFECTS). THE ZIDOVUDINE FOUND IN COMBIVIR CAN PUT PATIENTS AT RISK FOR HEMATOLOGIC TOXICITY, INCLUDING NEUTROPENIA AND SEVERE ANEMIA. ADDITIONALLY, BOTH LAMIVUDINE AND ZIDOVUDINE IN COMBIVIR CAN CAUSE LACTIC ACIDOSIS OR HEPATOMEGALY, WHICH CAN HAVE DEADLY EFFECTS.

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