Amiviren

Amiviren – antiviral medicine, nukleozidny inhibitor of the return transcriptase.

Form of release and structure

Amiviren is issued in the form of tablets, film coated: white, biconvex, round (150 mg) or oval with risky on one of the parties (300 mg), white or white with a yellowish shade on cross section (on 10 pieces in a blister strip packaging from polyvinylchloride and aluminum foil, on 1, 2, 3, 5, 6 or 10 packagings in a cardboard pack; on 60 or 100 pieces in a polymeric can, in a cardboard corrugated box of 1 bank (for hospitals)).

Structure of 1 tablet:

• Active ingredient: ламивудин – 150 mg or 300 mg;
• Auxiliary components: starch prezhelatinizirovanny, cellulose microcrystallic, carboxymethylstarch of sodium, magnesium stearate, silicon dioxide colloid;
• Structure of a film cover: коповидон, polydextrose, gidroksipropilmetiltsellyuloza, triglyceride caprylic/capric acids, titanium dioxide, macrogoal 6000.

Indications to use

Amiviren apply as a part of complex treatment of HIV infection at children and adults (along with other anti-retrovirus means).

Patients are 16 years old and drug is more senior appoint at a chronic viral hepatitis of B against the background of HBV replication.

Contraindications

Absolute:

• Renal failure (CC (clearance of creatinine) less than 30 ml/min.);
• The children's age up to 3 years and body weight is less than 14 kg;
• Lactation period;
• Hypersensitivity to drug components.

Relative (Amiviren apply with care):

• Renal failure with KK of 30-50 ml/min.;
• The heavy cirrhosis caused by a hepatitis B virus;
• Advanced age;
• Pregnancy period.

Route of administration and dosage

Amiviren can appoint only the specialist having experience of treatment of HIV infection.

Pill is taken inside, swallowing completely, without division, to food, in time or after meal. The children and patients experiencing difficulties with a proglatyvaniye of the whole tablet can accept drug in the crumbed view with addition of a small amount of liquid or semisolid food.

The recommended doses:

• Adult patients and children are more senior than 12 years with body weight more than 30 kg: on 150 mg twice a day or 300 mg a day once;
• Children with the body weight of 21-30 kg: on 225 mg a day;
• Children weighing 14-21 kg: on 150 mg a day once.

At a renal failure of moderate severity the initial dose of Amiviren should not exceed 150 mg a day. At a heavy renal failure this dosage form of a lamivudin is contraindicated.

At a liver failure of average and heavy degree dose adjustment is not required.

Side effects

• Digestive tract: often – vomiting, diarrhea, pains in upper parts of a stomach, nausea, a loss of appetite; seldom – increase in activity of serumal amylase, pancreatitis;
• Respiratory system: often – nasal symptoms, cough, respiratory infections;
• Nervous system: often – sleeplessness, a headache; very seldom – paresthesias; separate cases – peripheral neuropathy;
• Musculoskeletal system and connecting fabric: often – muscular disturbances, an arthralgia; seldom – рабдомиолиз;
• Metabolism: often – increase in serumal concentration of lactic acid; infrequently – a hyperglycemia, a gipertriglitseridemiya, resistance to insulin, a hypercholesterolemia; seldom – lactoacidosis; frequency is unknown – redistribution or accumulation of a hypodermic fatty tissue;
• Gepatobiliarny system: infrequently – passing increase in activity of liver enzymes; seldom – hepatitis;
• Bodies of a hemopoiesis: infrequently – anemia, a neutropenia, thrombocytopenia; very seldom – a partial krasnokletochny aplasia;
• Allergic reactions: Quincke's disease;
• Skin and its derivatives: often – baldness, rash;
• Other reactions: often – fatigue, fever, an indisposition.

At patients at late stages of HIV infection or at the long combined anti-retrovirus therapy osteonecrosis cases were noted (frequency of emergence is unknown).

Special instructions

Amiviren do not apply along with a zidovudine at anemia (hemoglobin level less than 4,65 mmol/l) or neutropenias (quantity of neutrophils less 750/mkl).

At emergence of side effects from the alimentary system (nausea, vomiting, abdominal pains) or increase in plasma of level of enzymes of a pancreas drug it is necessary to cancel and not to apply it to an exception of the diagnosis of pancreatitis.

Amiviren does not prevent a possibility of infection with HIV infection through blood or at sexual contact.

During treatment development of consecutive infection is possible.

Experience of use of drug for children is younger than 3 months is absent. At renal failures at children's age the mode of dosing is adjusted in the same proportions, as at adult patients.

Medicinal interaction

At joint reception ламивудин increases duration of therapeutic action of a zidovudine by 13% and for 28% increases its maximum concentration in a blood plasma.

At simultaneous use of Amiviren with a zidovudine and other antiviral drugs which are used at treatment of HIV infections, a synergism is noted.

Streptocides, диданозин and зальцитабин increase risk of development of pancreatitis.

At co-administration with an isoniazid, dapsone, zaltsitabiny, didanoziny or stavudiny the probability of emergence of a peripheral neuropathy increases.

Trimethoprimum increases plasma concentration of a lamivudin.

Terms and storage conditions

To store at a temperature no more than 25 °C. To protect from children. A period of validity – 3 years.