Triomune Tablet (Stavudine + Lamivudine + Nevirapine)

Information of Triomune Tablet (Stavudine + Lamivudine + Nevirapine)

Triomune 30 Tablets are a Stavudine Lamivudine Nevirapine combination of three drugs commonly used in the management of the human immunodeficiency virus (HIV-1) infection. Both stavudine and lamivudine belong to the nucleoside analog class of antiretroviral drugs. Both drugs act by terminating the growth of the DNA chain and inhibiting the reverse transcriptase of HIV-1. Nevirapine is a non-nucleoside reverse transcriptase inhibitor. It acts by directly inhibiting reverse transcriptase.

Each tablet of Triomune 30 contains half of the commonly prescribed daily doses of lamivudine, nevirapine, and stavudine. All three drugs are to be administered twice daily, permitting a fixed-dose combination to be formulated. With the availability of this combination formulation, patients may be better able to adhere to triple drug regimens, thereby enhancing compliance.

Each tablet contains:

• Lamivudine …. 150 mg
• Nevirapine ….. 200 mg
• Stavudine ……. 30 mg

What is Triomune?

Lamivudine is an antiviral medicine that prevents human immunodeficiency virus (HIV) or hepatitis B virus cells from multiplying in your body. Epivir is for treating HIV, which causes acquired immunodeficiency syndrome (AIDS). Epivir is not a cure for HIV or AIDS. Epivir-HBV is for treating hepatitis B. Epivir-HBV should not be used in people who are infected with both hepatitis B and HIV. Lamivudine may also be used for purposes not listed in this medication guide. Nevirapine is an antiviral medication that prevents human immunodeficiency virus (HIV) cells from multiplying in your body. Nevirapine is used to treat HIV, which causes acquired immunodeficiency syndrome (AIDS). Nevirapine will not prevent or cure HIV or AIDS. Nevirapine may also be used for purposes not listed in this medication guide. Stavudine is an antiviral medication that prevents human immunodeficiency virus (HIV) cells from multiplying in your body. Stavudine is used to treat HIV, which causes acquired immunodeficiency syndrome (AIDS). Stavudine is not a cure for HIV or AIDS. Stavudine may also be used for purposes not listed in this medication guide.

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Indications of Triomune Tablet (Stavudine + Lamivudine + Nevirapine)

Triomune 30 Tablets are indicated for the treatment of HIV-1 infection, once patients have been stabilized on the maintenance regimen of nevirapine 200 mg b.i.d. and have demonstrated adequate tolerability to nevirapine.

Additional important information regarding the use of nevirapine for the treatment of HIV-1 infection:

Based on serious and life-threatening hepatotoxicity observed in controlled and uncontrolled trials, Triomune 30 Tablets should not be initiated in adult females with CD4+ cell counts greater than 250 cells/mm3 or in adult males with CD4+ cell counts greater than 300 cells/mm3 unless the benefit outweighs the risk
The 14-day lead-in period with nevirapine 200 mg daily dosing must be strictly followed, it has been demonstrated to reduce the frequency of rash
If the rash persists beyond the 14-day lead-in period, do not dose escalate to 200 mg twice daily? The 200 mg once-daily dosing regimen should not be continued beyond 28 days, at which point an alternative regimen should be sought.

Dosage and Administration

TRIOMUNE 30 Tablets: For patients weighing less than 60 kg TRIOMUNE 30: 1 tablet twice daily

Triomune 30 Tablets should not be administered to patients who have just initiated therapy with nevirapine. This is because an initial lead-in dosing of 200 mg nevirapine once daily for 2 weeks is recommended. Following this lead-in dose, a dose escalation (maintenance dose) to 200 mg nevirapine b.i.d. may be carried out in the absence of any hypersensitivity reactions (e.g., rash, liver function test abnormalities;

Stavudine + Lamivudine + Nevirapine brand name: Stavudine + Lamivudine + Nevirapine Tablet is commonly known by its brand name Triomune. At onlinegenericmedicine.com, we offer Triomune and other generic equivalents of this medication. You can trust us to provide high-quality products and reliable options to suit your healthcare needs.

Stavudine + Lamivudine + Nevirapine contraindications

The combination of Stavudine + Lamivudine + Nevirapine has certain contraindications. These contraindications include:

• Hypersensitivity: Individuals who have known hypersensitivity or allergic reactions to any of the components of Stavudine, Lamivudine, or Nevirapine should avoid using this combination.
• Hepatic Impairment: Stavudine + Lamivudine + Nevirapine is contraindicated in individuals with severe liver disease or significant liver dysfunction, as it may worsen the condition or lead to adverse effects.
• Renal Impairment: Individuals with severe renal impairment, including those requiring dialysis, should avoid the use of Stavudine + Lamivudine + Nevirapine due to the risk of drug accumulation and potential toxicity.
• Pregnancy: The use of Stavudine + Lamivudine + Nevirapine during pregnancy is generally not recommended, especially in the first trimester. Pregnant individuals should consult with their healthcare provider for alternative treatment options.
• Concurrent Use of Didanosine: Stavudine and didanosine should not be co-administered due to an increased risk of mitochondrial toxicity and lactic acidosis.

Monitoring of Patients

Intensive clinical and laboratory monitoring, including liver enzyme tests, is essential at baseline and during the first 18 weeks of treatment with nevirapine. The optimal frequency of monitoring during this period has not been established. Some experts recommend clinical and laboratory monitoring more often than once per month, and in particular, would include monitoring of liver enzyme tests at baseline, prior to dose escalation, and at two weeks post-dose escalation. After the initial 18-week period, frequent clinical and laboratory monitoring should continue throughout nevirapine treatment. In some cases, hepatic injury has progressed despite discontinuation of treatment.

Overdosage

Lamivudine
There is no known antidote for lamivudine. One case of an adult ingesting 6 g of lamivudine was reported; there were no clinical signs or symptoms noted and hematologic tests remained normal. If an overdose occurs, the patient should be monitored, and standard supportive treatment applied as required.

Nevirapine

There is no known antidote for nevirapine overdosage. Cases of nevirapine overdose at doses ranging from 800 to 1800 mg/day for up to 15 days have been reported. Patients have experienced adverse events, including edema, erythema nodosum, fatigue, fever, headache, insomnia, nausea, pulmonary infiltrates, rash, vertigo, vomiting, and weight decrease. All events subsided following the discontinuation of nevirapine.

Stavudine

Experience with adults treated with 12 to 24 times the recommended daily dosage revealed no acute toxicity. Complications of chronic overdose include peripheral neuropathy and hepatic toxicity. Stavudine can be removed by hemodialysis; the mean & plus; SD hemodialysis clearance of stavudine is 120 & plus; 18 ml/min. Whether stavudine is eliminated by peritoneal dialysis has not been studied.

Drug Interactions of Triomune Tablet (Stavudine + Lamivudine + Nevirapine)

• Nevirapine may decrease the concentration of hormonal contraceptives, potentially reducing their effectiveness.
• Stavudine may increase the risk of peripheral neuropathy when used with other drugs that have neurotoxic effects.
• Lamivudine may decrease the concentration of methadone, potentially leading to withdrawal symptoms in individuals receiving methadone maintenance therapy.
• Nevirapine may interact with certain antifungal medications, such as ketoconazole or itraconazole, affecting their effectiveness or increasing the risk of side effects.
• Stavudine and lamivudine may interact with other drugs that can cause bone marrow suppression, potentially increasing the risk of hematological toxicities.

Frequently Asked Questions (FAQ) about Triomune Tablet (Stavudine + Lamivudine + Nevirapine)

Q: What is Triomune Tablet used for?

A: Triomune Tablet is a combination medication used in the treatment of HIV infection.

Q: How should I take Triomune Tablet?

A: Triomune Tablet should be taken as prescribed by your healthcare provider. Follow the instructions carefully and do not alter the dosage without medical advice.

Q: Can I drink alcohol while taking Triomune Tablet?

A: It is generally recommended to avoid or limit alcohol consumption while taking Triomune Tablet, as alcohol may increase the risk of liver-related side effects.