Lamivudine and Zidovudine (Page 6 of 6)

14.2 Prevention of Maternal-Fetal HIV-1 Transmission


The utility of zidovudine alone for the prevention of maternal-fetal HIV-1 transmission was demonstrated in a randomized, double-blind, placebo-controlled trial conducted in HIV-1-infected pregnant women with CD4+ cell counts of 200 to 1,818 cells per mm 3 (median in the treated group: 560 cells per mm 3) who had little or no previous exposure to zidovudine. Oral zidovudine was initiated between 14 and 34 weeks of gestation (median 11 weeks of therapy) followed by IV administration of zidovudine during labor and delivery. Following birth, neonates received oral zidovudine syrup for 6 weeks. The trial showed a statistically significant difference in the incidence of HIV-1 infection in the neonates (based on viral culture from peripheral blood) between the group receiving zidovudine and the group receiving placebo. Of 363 neonates evaluated in the trial, the estimated risk of HIV-1 infection was 7.8% in the group receiving zidovudine and 24.9% in the placebo group, a relative reduction in transmission risk of 68.7%. Zidovudine was well tolerated by mothers and infants. There was no difference in pregnancy-related adverse events between the treatment groups.

16 HOW SUPPLIED/STORAGE AND HANDLING

Lamivudine and Zidovudine tablets, USP contain 150 mg lamivudine, USP and 300 mg zidovudine, USP are white to off-white, scored, capsule shaped, biconvex, film coated tablets, debossed with ‘I’ on one side and ‘115’ on other side. They are available as follows:
Bottle of 60 Tablets (NDC 31722-739-60)
Bottle of 500 Tablets (NDC 31722-739-05)
Unit Dose Pack of 100 (10 x 10) (NDC 31722-739-31)
Store at 20 to 25°C (68 to 77°F) [see USP Controlled Room Temperature]

17 PATIENT COUNSELING INFORMATION

Neutropenia and Anemia
Inform patients that the important toxicities associated with zidovudine are neutropenia and/or anemia. Inform them of the extreme importance of having their blood counts followed closely while on therapy, especially for patients with advanced HIV-1 disease [see Boxed Warning, Warnings and Precautions ( 5.1)].
Myopathy
Inform patients that myopathy and myositis with pathological changes, similar to that produced by HIV-1 disease, have been associated with prolonged use of zidovudine [see Warnings and Precautions ( 5.2)].
Lactic Acidosis/Hepatomegaly with Steatosis
Advise patients that lactic acidosis and severe hepatomegaly with steatosis have been reported with use of nucleoside analogues and other antiretrovirals. Advise patients to stop taking lamivudine and zidovudine if they develop clinical symptoms suggestive of lactic acidosis or pronounced hepatotoxicity [see Warnings and Precautions ( 5.3)].
Patients with Hepatitis B or C Co-infection
Advise patients co-infected with HIV-1 and HBV that worsening of liver disease has occurred in some cases when treatment with lamivudine was discontinued. Advise patients to discuss any changes in regimen with their healthcare provider [see Warnings and Precautions ( 5.4)].
Inform patients with HIV-1/HCV co-infection that 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)].
Drug Interactions
Advise patients that other medications may interact with lamivudine and zidovudine and certain medications, including ganciclovir, interferon alfa, and ribavirin, may exacerbate the toxicity of zidovudine, a component of lamivudine and zidovudine tablets [see Drug Interactions ( 7.1)].
Immune Reconstitution Syndrome
Advise patients to inform their healthcare provider immediately of any signs and symptoms of infection as inflammation from previous infection may occur soon after combination antiretroviral therapy, including when lamivudine and zidovudine is started [see Warnings and Precautions ( 5.7)].
Lipoatrophy
Advise patients that loss of subcutaneous fat may occur in patients receiving lamivudine and zidovudine and that they will be regularly assessed during therapy [see Warnings and Precautions ( 5.8)].
Pregnancy Registry
Advise patients that there is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to lamivudine and zidovudine during pregnancy [see Use in Specific Populations ( 8.1)].
Lactation
Instruct women with HIV-1 infection not to breastfeed because HIV-1 can be passed to the baby in the breast milk [see Use in Specific Populations ( 8.2)].
Missed Dose
Instruct patients that if they miss a dose of lamivudine and zidovudine, to take it as soon as they remember. Advise patients not to double their next dose or take more than the prescribed dose [see Dosage and Administration ( 2)].
The brands listed are trademarks of their respective owners and are not trademarks of Hetero Labs Limited.

camber1

Manufactured for:
Camber Pharmaceuticals, Inc.
Piscataway, NJ 08854

Manufactured by:
HETERO LABS LIMITED
Unit V, Polepally, Jadcherla,
Mahabubnagar-509 301, India. Revised: 06/2019

PACKAGE LABEL.PRINCIPAL DISPLAY PANEL

Lamivudine and zidovudine tablets 60’s count

Lamivudine and zidovudine  tablets 60's count label
(click image for full-size original)
LAMIVUDINE AND ZIDOVUDINE lamivudine and zidovudine tablet, film coated
Product Information
Product Type HUMAN PRESCRIPTION DRUG Item Code (Source) NDC:31722-739
Route of Administration ORAL DEA Schedule
Active Ingredient/Active Moiety
Ingredient Name Basis of Strength Strength
LAMIVUDINE (LAMIVUDINE) LAMIVUDINE 150 mg
ZIDOVUDINE (ZIDOVUDINE) ZIDOVUDINE 300 mg
Inactive Ingredients
Ingredient Name Strength
HYPROMELLOSES
MAGNESIUM STEARATE
CELLULOSE, MICROCRYSTALLINE
POLYSORBATE 80
SODIUM STARCH GLYCOLATE TYPE A POTATO
TITANIUM DIOXIDE
POLYETHYLENE GLYCOL, UNSPECIFIED
Product Characteristics
Color white (off white) Score 2 pieces
Shape CAPSULE (biconvex) Size 17mm
Flavor Imprint Code I;115
Contains
Packaging
# Item Code Package Description Multilevel Packaging
1 NDC:31722-739-60 60 TABLET, FILM COATED in 1 BOTTLE None
2 NDC:31722-739-05 500 TABLET, FILM COATED in 1 BOTTLE None
3 NDC:31722-739-31 100 TABLET, FILM COATED in 1 BLISTER PACK None
Marketing Information
Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
ANDA ANDA203259 02/06/2014
Labeler — Camber Pharmaceuticals, Inc. (826774775)

Revised: 02/2021 Camber Pharmaceuticals, Inc.

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