Zeffix

Drug name: Zeffix

Other names used:

• Epivir®
• Epivir-HBV®

Active Ingredients: Lamivudine

Therapeutic actions: Lamivudine belongs to group of medications known as nucleoside reverse transcriptase inhibitors (NRTIs). NRTI medications work by blocking a process that the HIV and hepatitis B viruses need in order to multiply.

HIV (the human immunodeficiency virus) is the virus that is responsible for AIDS, and HBV (the hepatitis B virus) is responsible for hepatitis B infection. Like other viruses, HIV and HBV must use a person's own cells to reproduce. However, HIV and HBV are different from many other viruses because they must first convert their genetic material from RNA to DNA. It is the DNA genes that allow HIV and HBV to multiply.

HIV and HBV convert their genetic material into DNA by using a special protein called the reverse transcriptase enzyme. To create DNA, this enzyme uses several different protein building blocks.

Lamivudine works by tricking reverse transcriptase into thinking it is one of these protein building blocks. However, it is just different enough that when used to create DNA, lamivudine actually stops the DNA from being made. Without DNA, HIV and HBV cannot multiply. It is important to understand that lamivudine is not a cure for HIV, AIDS, or hepatitis B.


Indications: Lamivudine is used to treat:

• AIDS and HIV infection
• Hepatitis.

Contraindications and cautions:
You should not use this medications in

• allergy to any ingredient.
• This medicine is not recommended for children under three months of age.

You should use this medication with caution in:

• Decreased kidney function
• Enlarged liver (hepatomegaly)
• Liver disease
• Hepatitis, especially chronic hepatitis B or C
• History of alcohol abuse
• Obese women.
• The safety of this medicine in pregnancy has not been established. It should only be used during pregnancy if the expected benefit to the mother outweighs any potential risk to the developing foetus. It is not recommended in the first trimester. Seek medical advice from your doctor.
• It is recommended that women infected with the HIV virus must not breastfeed their infants under any circumstances, in order to avoid transmission of the virus to the baby. Seek medical advice from your doctor.

Warning!

• The HIV virus is very good at becoming resistant to anti-HIV medicines. For this reason it is very important that you carefully follow your doctor's instructions for taking your anti-HIV medicines, in order to maintain effective levels of the medicines in your blood. If the blood levels drop, the virus will be given more chance to replicate and develop resistance to the drugs. Skipping even a few doses increases the risk of treatment failure, so you should try to ensure that you take all your doses at the correct time, and that you visit your doctor for repeat prescriptions before you run out.
• Treatment of HIV infection with anti-HIV medicines such as this one does not reduce the risk of transmitting the virus to other people through sexual contact or blood contamination. You should continue to use condoms to prevent transmitting the virus to your sexual partner.
• Combination antiretroviral therapy has been associated with a redistribution of body fat (lipodystrophy) in people with HIV. The long-term consequences of this are currently unknown, however your doctor may wish to monitor your body fat, and the levels of lipids (eg cholesterol) and sugar (glucose) in your blood, and may prescribe additional medicines for any lipid disorders that occur during treatment with this medicine. Contact your doctor if you notice any changes in your body fat during treatment with your HIV medicines.
• Some people being treated with combination antiretroviral therapy may develop a bone condition called osteonecrosis. This condition is caused by loss of blood supply to a bone, causing death of the bone tissue. The risk of the condition is thought to be increased by corticosteroid use, alcohol consumption, severe immunosuppression, higher body mass index, advanced HIV disease and long-term use of antiretroviral medicines. If you notice any joint stiffness, aches and pains (especially of the hip, knee and shoulder) or difficulty in movement while using this medicine, you should tell your doctor so this can be investigated.
• If you have any problems with your liver you should have regular blood tests to monitor your liver function while you are taking this medicine. This is especially important if you have chronic hepatitis B or C.
• If you suffer from chronic hepatitis B you should not stop taking this medicine without instructions from your doctor, as this may cause a recurrence of your hepatitis.
• The class of medicines that lamivudine belongs to can cause a rare but serious condition called lactic acidosis, which is an excess of lactic acid in the blood, together with an enlarged liver. This side effect is more likely to occur in overweight women and people with liver disease (particularly hepatitis C treated with alpha interferon and ribavirin). If it occurs, lactic acidosis usually develops after a few months of treatment. Your doctor will monitor you for this side effect, but symptoms that might indicate it's development include rapid and/or deep breathing and non-specific symptoms such as feeling weak, sick or generally unwell, vomiting, abdominal pain, loss of appetite or weight loss. You should tell your doctor if you experience any of these.
• Your doctor may also want you to have regular blood tests during treatment to check for a side effect called pancreatitis (inflammation of the pancreas). You should let your doctor know if you experience sudden unexplained stomach or abdominal pain, nausea or vomiting while taking this medicine, as these could be symptoms of pancreatitis.

Adverse effects: Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

• Headache
• Difficulty in sleeping (insomnia)
• Cough
• Disturbances of the gut such as nausea, vomiting, diarrhoea or abdominal pain
• Rash
• Hair loss (alopecia)
• Pain in the muscles and joints
• Fatigue
• General feeling of being unwell (malaise)
• Fever (pyrexia)
• Decrease in the number of a type of white blood cell (neutrophil) in the blood (neutropenia)
• Low red blood cell count (anaemia)
• Liver disorders
• Inflammation of the pancreas (pancreatitis)
• Disorder of the peripheral nerves causing weakness and numbness (peripheral neuropathy)
• Elevated levels of lactic acid in the blood (lactic acidosis)

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

Interactions: It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.
Especially pay attention to the following drugs:

• Interferon medications, such as:
• Interferon alfa-2a (Roferon®-A)
• Interferon alfa-2b (Intron® A)
• Interferon alfa-2b and ribavirin (Rebetron®)
• Interferon alfa-n3 (Alferon® N)
• Interferon alfacon-1 (Infergen®)
• Interferon beta-1a (Avonex®, Rebif®)
• Interferon beta-1b (Betaseron®)
• Interferon gamma-1b (Actimmune®)
• Peginterferon alfa-2a (Pegasys®)
• Peginterferon alfa-2b (PEG-Intron®)
• Ribavirin (Copegus®, Rebetol®, Ribasphere®, Virazole®)
• Trimethaprim and sulfamethoxazole (Bactrim®, Septra®)
• Zalcitabine (Hivid®).

Additional Information: DO NOT SHARE THIS MEDICINE with others. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS PRODUCT, as well as syringes and needles, if needed during treatment, out of the reach of children. Do not reuse needles, syringes, or other materials.