Dual NRTI combination (antiretroviral)

Zidovudine with lamivudine

Brand names: Combivir

Adult dose

Dose: 1 tablet (zidovudine 300mg / lamivudine 150mg) BD

Route: Oral

Frequency: BD

Clinical pearls

Fixed-dose dual NRTI backbone; largely superseded by tenofovir/emtricitabine-based regimens
Specialist HIV physician prescribing; BHIVA guidelines

Contraindications

Abnormally low neutrophil count or haemoglobin
Creatinine clearance <50mL/min (use separate components for dose adjustment)
Hypersensitivity to either component

Side effects

Anaemia
Neutropaenia
Myopathy
Nausea
Peripheral neuropathy
Pancreatitis
Lactic acidosis / hepatic steatosis (class effect)

Interactions

Ribavirin (avoid with zidovudine)
Stavudine (avoid with zidovudine — antagonism)
Nephrotoxic drugs (lamivudine renal elimination)

Monitoring

FBC
Renal function
LFTs
Viral load / CD4

Reference: BNF; BHIVA guidelines; https://bnf.nice.org.uk/drugs/zidovudine-with-lamivudine/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways