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Precautions and Warnings With Lamivudine/Zidovudine

To ensure a safe treatment process, precautions and warnings with lamivudine/zidovudine should be reviewed with your healthcare provider. This includes knowing serious side effects to watch for (frequent infections or bone marrow depression) and conditions to discuss (kidney disease or liver disease). Precautions and warnings with lamivudine/zidovudine also extend to women who are pregnant or breastfeeding.

Lamivudine/Zidovudine: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking lamivudine/zidovudine (Combivir®) if you have:
  • Anemia, neutropenia, or any other low blood count or blood disorder
  • Liver disease, such as liver failure, cirrhosis, or hepatitis
  • Kidney disease, such as kidney failure (renal failure).
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
You should also be sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Lamivudine/Zidovudine

Warnings and precautions to be aware of prior to taking lamivudine/zidovudine include the following:
  • The medication can cause bone marrow depression, which means that it can decrease the bone marrow's ability to produce blood cells. This can lead to a variety of problems, such as anemia, frequent infections, or bleeding. Your healthcare provider should check your blood counts frequently while you are taking lamivudine/zidovudine.
  • In rare cases, lamivudine/zidovudine can cause a condition called lactic acidosis and hepatic steatosis. It is caused by damage to the liver and can be very dangerous. You are at higher risk for this side effect if you are obese or have liver disease.
  • Lamivudine/zidovudine can cause muscle problems. Let your healthcare provider know if you develop muscle weakness or pain during treatment.
  • Studies of lamivudine (one of the components of the medication) for treating hepatitis B have suggested that hepatitis B may worsen after lamivudine is stopped. If you have hepatitis B and you stop taking lamivudine/zidovudine, your healthcare provider may need to monitor you more closely. Lamivudine/zidovudine has not been studied in people who have both HIV and hepatitis B.
  • The medication can change the distribution of fat on your body. You may gain fat in areas that are not typical for you, such as in the abdomen or at the back of the neck (a "buffalo hump"), and may lose weight in other areas.
  • Lamivudine/zidovudine is not a cure for HIV or AIDS. If you have HIV or AIDS, you should always use safer sex practices, regardless of whether you are taking medications.
  • As with all HIV medications, it is important that you take lamivudine/zidovudine exactly as prescribed. Missing doses may increase the chance of the virus becoming resistant to HIV medications.


  • When you first start taking this medication and your immune system begins to recover, a group of problems known as immune reconstitution syndrome may occur. Your immune system may start aggressively reacting to any infections you may have and may cause extreme inflammation. There have even been cases of autoimmune disorders (such as Graves' disease, polymyositis, and Guillain-Barré syndrome) possibly caused by this problem. 


  • The kidneys help remove lamivudine/zidovudine from the blood. Therefore, if you have kidney disease, you may need a lower dosage.
  • Lamivudine/zidovudine can interact with a number of different medications (see Drug Interactions With Lamivudine/zidovudine).
  • Lamivudine/zidovudine is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not known (see Combivir and Pregnancy).
  • Lamivudine/zidovudine passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Combivir and Breastfeeding). It is important to understand that the HIV virus can be transmitted through breast milk and that breastfeeding is usually not recommended in women with HIV or AIDS.

Information on Lamivudine/Zidovudine

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