Lamivudine + Zidovudine is indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection. 

HIV

• Adults and Adolescents weighing greater than or equal to 30 kg: 1 tablet orally twice daily.
• Pediatrics weighing greater than or equal to 30 kg: 1 tablet orally twice daily.
• Because Lamivudine + Zidovudine is a fixed-dose tablet and cannot be dose adjusted, Lamivudine + Zidovudine is not recommended in patients requiring dosage adjustment or with hepatic impairment or experiencing dose-limiting adverse reactions.

The most common reported adverse reactions in adults were-

• headache
• nausea
• malaise
• fatigue
• nasal signs and symptoms
• diarrhea
• cough

Headache

Nausea

Fatigue

Coughing

• Hematologic Toxicity: The use of zidovudine, a component of Lamivudine + Zidovudine, has been linked to hematologic toxicity, including neutropenia and anemia.
• Myopathy: Symptomatic myopathy associated with prolonged use of zidovudine. 
• Exacerbations of Hepatitis B: Lactic Acidosis and Severe Hepatomegaly with Steatosis: The use of nucleoside analogues has been linked to lactic acidosis and severe hepatomegaly with steatosis, including fatal cases.
• Patients who are co-infected with hepatitis B virus (HBV) and human immunodeficiency virus (HIV-1) and have stopped taking lamivudine, a component of Lamivudine + Zidovudine, have experienced severe acute exacerbations of hepatitis B. In these patients, closely monitor hepatic function and, if necessary, initiate anti-hepatitis B treatment. 

• In HIV-1/HCV co-infected patients receiving combination antiretroviral therapy and interferon alfa with/without ribavirin, hepatic decompensation, some fatal, has occurred. Discontinue lamivudine and zidovudine tablets as needed, and consider reducing or discontinuing interferon alfa, ribavirin, or both.

   

• Anemia has been reported to worsen in HIV-1/HCV co-infected patients receiving ribavirin and zidovudine. Ribavirin and zidovudine should not be taken together.

   

• In patients with a history of pancreatitis or other significant risk factors for pancreatitis, use with caution. As clinically indicated, discontinue treatment.

   

• In patients receiving combination antiretroviral therapy, immune reconstitution syndrome and redistribution/accumulation of body fat have been reported.