Description of Duovir
* Brand Name: Duovir
* Composition: Lamivudine & Zidovudine
* Manufactured by : Cipla Ltd.
* Strength: 150 mg and 300 mg
* Dosage Form: Tablets
* Packing: Pack of 60 Tablets
Duovir belongs to the classification of antiretroviral drugs which associates to nucleoside polymerase. Duovir is an combination drugs of lamivudine 150mg and Zidovudine 300mg.
Pharmacology of Duovir
MECHANISM OF ACTION:
Lamivudine (Duovir) and Zidovudine (duovir) is a synthetic nucleoside analogue. Both drugs acts like inside cell Lamivudine (Duovir) and Zidovudine (Duovir) is phosphorylated to its active 5-triphosphate metabolite and forms Zidovudine (Duovir) triphosphate and Lamivudine (Duovir) triphosphate (L-TP). The basic action of L-TP and ZDV-TP is inhibition of reverse transcriptase (RT) via DNA chain termination after incorporation of the nucleoside correlated.Both L-TP and ZDV-TP is a weak inhibitor of mammalian DNA polymerases a and b, and mitochondrial DNA polymerase g which has been reported to be incorporated into DNA of cells in culture.
Absorption: Fastly absorbed from the GI tract. Absorption with food is delayed Bioavailability: 80-87% (lamivudine); approx 60-70% (zidovudine). Time to peak plasma concentration: Approx 1 hr.
Distribution: Passes through blood-brain barrier and placenta that enters breast milk and Detected in semen (zidovudine). Volume of distribution: 1.3 L/kg (lamivudine); 1-2.2 L/kg (zidovudine). Plasma protein binding: Up to 36% (lamivudine); 34-38% (zidovudine).
Metabolism: Both regimens are metabolized inside the cells to form the active triphosphate . Zidovudine go through hepatic metabolism, mainly to the inactive glucuronide.
Excretion: Lamiudine and zidovudine excreted Via urine, (mainly as unchanged drug) Elimination half-life: 5-7 hr (lamivudine); 0.5-3 hr (zidovudine).
Indication of Duovir
Duovir is used for the treatment of HIV-1 infection by combination with other antiretrovirals drugs. Duovir is a nucleoside analogue with combination of lamivudine and zidovudine.
Dose & Dosage's of Duovir
Duovir dosage in adults is lamivudine 150mg and zidovudine 300mg with weight of >30kg one tablet twice in a day
Childern of 14-21 kg one half tablet bid and for 22-30kg one half tablet in the morning or one half tab tid.
Duovir may be taken with or without food.
Side Effects of Duovir
If any of these side effects occurs while taking Duovir , you should consult with doctor urgently.
More common: Chills,fever, pale skin, sore throat weakness, head pain
Less common: stomach ache, nausea, skin rash, vomiting, yellow eyes, coughing, loss of appetite, sleeping trouble
Incident not known: blurred vision, dry mouth, hair loss, increased (hunger,thirst,urination), chest discomfort,wheezing, myalgia, convulsions.
Contraindication of Duovir
Previously demonstrating clinically significant in patients are hypersensitivity to any of the component of duovir.
The patient with low body weight should not be receive Duovir dose.
Drug Interaction of Duovir
Duovir given with Emtricitabine may develop cross –resistance.
Continue use of zidovudine with Ribavirin leads to Excerabtion of anemia.
Lamivudine and zalcitabine may prevent intracellularily phosphorylation of one another.
Interaction of zidovudine with stavudine and doxorubicin will produce antagonistic effects.
Duovir used with interferon alfa in HIV may develop risk of hepatic decompenstion.
Precaution of Duovir
Obese women with hepatomegaly, hepatitis or other risk factors causes liver disease and hepatic steatosis; hepatitis B or C virus co-infection leads risk factors for pancreatitis Patient with poor bone marrow reserve before the treatment. Renal and severe hepatic impairment. Childern Pregnancy.
Monitoring Parameters :Monitor haematological parameters observe for appearance of hardened infections and signs and symptoms of pancreatitis. Periodically check liver function test and for several month following discontinuation of therapy for patients co-infected with hepatitis B virus and HIV.
Usage & Safety profile of Duovir Pregnancy & Lactation
Category C: Animal reproduction studies have shown adverse effect on fetus while in human there is no sufficient and well tolerated studies, but possible use may warrant the in drug in pregnant women produce possible risk.
Storage of Duovir
* Duovir stored at 2-300C
* Store in cool and dry place and keep away from children and lights.
* Duovir should be used before expiry date.