Lamivudine zidovudine drug interactions: Difference between revisions
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===Antiretroviral Agents=== | ===Antiretroviral Agents=== | ||
Lamivudine:Zalcitabine: Lamivudine and zalcitabine may inhibit the intracellular phosphorylation of one another. Therefore, use of COMBIVIR in combination with zalcitabine is not recommended. | '''Lamivudine''':Zalcitabine: Lamivudine and zalcitabine may inhibit the intracellular phosphorylation of one another. Therefore, use of COMBIVIR in combination with zalcitabine is not recommended. | ||
Zidovudine:Stavudine: Concomitant use of COMBIVIR with stavudine should be avoided since an antagonistic relationship with zidovudine has been demonstrated in vitro. | '''Zidovudine''':Stavudine: Concomitant use of COMBIVIR with stavudine should be avoided since an antagonistic relationship with zidovudine has been demonstrated in vitro. | ||
Nucleoside Analogues Affecting DNA Replication: Some nucleoside analogues affecting DNA replication, such as [[ribavirin]], antagonize the in vitro antiviral activity of zidovudine against HIV-1; concomitant use of such drugs should be avoided. | Nucleoside Analogues Affecting DNA Replication: Some nucleoside analogues affecting DNA replication, such as [[ribavirin]], antagonize the in vitro antiviral activity of zidovudine against HIV-1; concomitant use of such drugs should be avoided. | ||
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===Doxorubicin=== | ===Doxorubicin=== | ||
Zidovudine: Concomitant use of COMBIVIR with doxorubicin should be avoided since an antagonistic relationship with zidovudine has been demonstrated in vitro. | '''Zidovudine''': Concomitant use of COMBIVIR with doxorubicin should be avoided since an antagonistic relationship with zidovudine has been demonstrated in vitro. | ||
===Hematologic/Bone Marrow Suppressive/Cytotoxic Agents=== | ===Hematologic/Bone Marrow Suppressive/Cytotoxic Agents=== | ||
Zidovudine: Coadministration of [[ganciclovir]], interferon alfa, [[ribavirin]], and other bone marrow suppressive or cytotoxic agents may increase the hematologic toxicity of zidovudine. | '''Zidovudine''': Coadministration of [[ganciclovir]], interferon alfa, [[ribavirin]], and other bone marrow suppressive or cytotoxic agents may increase the hematologic toxicity of zidovudine. | ||
===Interferon- and ribavirin-Based Regimens=== | ===Interferon- and ribavirin-Based Regimens=== | ||
Latest revision as of 02:51, 10 January 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sheng Shi, M.D. [2]
Drug Interactions
No drug interaction studies have been conducted using COMBIVIR Tablets [see Clinical Pharmacology (12.3)].
Antiretroviral Agents
Lamivudine:Zalcitabine: Lamivudine and zalcitabine may inhibit the intracellular phosphorylation of one another. Therefore, use of COMBIVIR in combination with zalcitabine is not recommended.
Zidovudine:Stavudine: Concomitant use of COMBIVIR with stavudine should be avoided since an antagonistic relationship with zidovudine has been demonstrated in vitro.
Nucleoside Analogues Affecting DNA Replication: Some nucleoside analogues affecting DNA replication, such as ribavirin, antagonize the in vitro antiviral activity of zidovudine against HIV-1; concomitant use of such drugs should be avoided.
Doxorubicin
Zidovudine: Concomitant use of COMBIVIR with doxorubicin should be avoided since an antagonistic relationship with zidovudine has been demonstrated in vitro.
Hematologic/Bone Marrow Suppressive/Cytotoxic Agents
Zidovudine: Coadministration of ganciclovir, interferon alfa, ribavirin, and other bone marrow suppressive or cytotoxic agents may increase the hematologic toxicity of zidovudine.
Interferon- and ribavirin-Based Regimens
Lamivudine: Although no evidence of a pharmacokinetic or pharmacodynamic interaction (e.g., loss of HIV-1/HCV virologic suppression) was seen when ribavirin was coadministered with lamivudine in HIV-1/HCV co-infected patients, hepatic decompensation (some fatal) has occurred in HIV-1/HCV co-infected patients receiving combination antiretroviral therapy for HIV-1 and interferon alfa with or without ribavirin [see Warnings and Precautions (5.5), Clinical Pharmacology (12.3)].
Trimethoprim/Sulfamethoxazole (TMP/SMX)
Lamivudine: No change in dose of either drug is recommended. There is no information regarding the effect on lamivudine pharmacokinetics of higher doses of TMP/SMX such as those used to treat PCP.
References
Adapted from the FDA Package Insert.