Lamivudine+Stavudine+Nevirapine

This combination of 3 drugs is commonly used in the management of HIV infection. Stavudine and Lamivudine belong to the nucleoside analogue class of antiretroviral drugs. Nevirapine is an NNRTI.

Stavudine and Lamivudine act by terminating the growth of the DNA chain and inhibiting the reverse transcriptase of HIV and Nevirapine acts by directly inhibiting reverse transcriptase.

This medication is not intended for use in Paediatric Patients.

Each Uncoated Tablet contains :
Lamivudine 150mg
Stavudine 30mg
Nevirapine 200mg

Each Uncoated Tablet contains :
Lamivudine 150mg
Stavudine 40mg
Nevirapine 200mg

As this is a fixed dose combination, this medication should not be prescribed for patients requiring dosage adjustment, such as those with low body weight (<50 Kgs).

Recommended Dose :

For Adults 1 tab twice daily for patients weighing <60 Kgs. Lamivudine(150 mg)+Stavudine(30 mg)+Nevirapine(200 mg)

For Adults 1 tab twice daily for patients weighing >=60 Kgs. Lamivudine(150 mg)+Stavudine(40 mg)+Nevirapine(200 mg).

This combination therapy should not be administered to patients who have just initiated therapy with Nevirapine, as the lead in dosing of 200 mg Nevirapine once daily for 2 weeks is recommended. Following this lead in dosing, a dose escalation (maintainence dose) to 200 mg Nevirapine bd maybe carried out in the absence of any hypersensitivity reactions, liver function test abnormalities. Please Consult your health care professional for the dosage and take exactly as prescribed.

This medicine is not intended for use in patients who are just initiating therapy with Nevirapine.

This medicine should be administered only to patients who have received Stavudine+Lamivudine(Standard Doses) + Nevirapine (200 MG OD) for 2 weeks and have demonstrated adequate tolerability to Nevirapine. Severe life threatening skin reactions including fatal cases have occurred in patient treated with Nevirapine. Patients developing signs or symptoms of severe skin reactions or hypersensitivity reactions must discontinue Nevirapine as soon as possible. Some other side effects of Nevirapine are Toxic Epidermal Necrolysis, Stevens-Johnsons Syndrome, Hypersensitivity reactions, Organ Dysfunction.

Consult your Doctor for more information. Lactic Acidosis and severe hepatomegaly with steatosis including fatal cases, have been reported with the use of Nucleoside Analogues alone or in combination, including Lamivudine and Stavudine.

This medication is contraindicated in patients with clinically significant hypersensitivity to any of the components contained in the formulation. This medication is also contra indicated in patients who are just initiating therapy with Nevirapine. These patients require a lead in dosing of Nevirapine 200 mg o.d., where as this formulation contains the maintainence dose of Nevirapine 200 mg b.d.

Lamivudine : There is no known antidote for lamivudine overdose. If overdose occurs the patient should be monitored and standard supportive treatment applied as required.

Stavudine : Stavudine can be removed by haemodialysis. Experience with adults treated with 12 to 24 times the recommended daily dosage revealed no acute toxicity. Complications of chronic overosage include peripheral neuropathy and hepatic toxicity.

Nevirapine : There is no known antidote for Nevirapine over dosage.

Intensive clinical and laboratory monitoring, inclusing liver function tests, is essential especially at baseline, prior to dose escalation of nevirapine, and at two weeks post dose escalation. In some cases, hepatic injury has progressed despite discontinuation of treatment.

Do not double dose to make up for the missed dose. Consult your doctor for dosages and take exactly as directed.

Store in a cool dry place.

It is recommended that HIV infected mothers do not breast feed thier infants to avoid risking potential transmission of HIV Infection. It is not known whether Lamivudine or Stavudine is excreted in breast milk, Nevirapine is present in breast milk.