Generic name: lamivudine and tenofovir
Drug class: Antiviral combinations
Medically reviewed by A Ras MD.
What is Cimduo?
Cimduo is a prescription medicine that is used with other antiretroviral medicines to treat Human Immunodeficiency Virus-1 (HIV-1) in adults and children weighing at least 35 kg. HIV-1 is the virus that causes AIDS (Acquired Immune Deficiency Syndrome).
Cimduo contains the prescription medicines lamivudine and tenofovir disoproxil fumarate.
CIMDUO tablets contain lamivudine (also known as 3TC), a synthetic nucleoside analogue with activity against HIV-1 and tenofovir disoproxil fumarate or tenofovir DF, a fumaric acid salt of bis-isopropoxycarbonyloxymethyl ester prodrug of tenofovir. In vivo tenofovir DF is converted to tenofovir, an acyclic nucleoside phosphonate (nucleotide) analog of adenosine 5’-monophosphate. Tenofovir exhibits activity against HIV-1 reverse transcriptase.
The chemical name of lamivudine is (-)-1-[2R,5S)–2-Hydroxymethyl)-1,3-oxathiolan-5-yl]cytosine. Lamivudine is the (-)enantiomer of a dideoxy analogue of cytidine. Lamivudine has also been referred to as (-)2′,3′-dideoxy, 3′-thiacytidine. It has a molecular formula of C8H11N3O3S and a molecular weight of 229.26 g per mol. It has the following structural formula:
Lamivudine is a white to off-white solid with a solubility of approximately 70 mg per mL in water at 20°C.
The chemical name of tenofovir DF is 9-[(R)-2-[[Bis[[(isopropoxycarbonyl)oxy]methoxy]phosphinyl]methoxy]propyl]adenine fumarate (1:1). It has a molecular formula of C19H30N5O10P•C4H4O4 and a molecular weight of 635.51. It has the following structural formula:
Tenofovir DF is a white to off-white powder with a solubility of 13.4 mg/mL in distilled water at 25°C. It has an octanol/phosphate buffer (pH 6.5) partition coefficient (log p) of 1.25 at 25°C.
CIMDUO tablets are for oral administration. Each film-coated tablet contains 300 mg of lamivudine and 300 mg of tenofovir disoproxil fumarate, which is equivalent to 245 mg of tenofovir disoproxil, and the following inactive ingredients: croscarmellose sodium, lactose monohydrate, magnesium stearate and microcrystalline cellulose. The tablet coating contains polyethylene glycol, titanium dioxide, polyvinyl alcohol and talc
What is the most important information I should know about Cimduo?
Cimduo can cause serious side effects, including:
- Too much lactic acid in your blood (lactic acidosis). Lactic acidosis is a serious medical emergency that can lead to death.
Tell your healthcare provider right away if you get any of the following symptoms that could be signs of lactic acidosis:
- Severe liver problems. In some cases, severe liver problems can lead to death. Your liver may become large (hepatomegaly) and you may develop fat in your liver (steatosis).
Call your healthcare provider right away if you get any of the following signs or symptoms of liver problems:
- your skin or the white part of your eyes turns yellow (jaundice)
- dark or “tea-colored” urine
- light-colored stools (bowel movements)
- loss of appetite for several days or longer
- nausea and vomiting
- pain, aching, or tenderness on the right side of your stomach-area
- Worsening of hepatitis B infection. If you have Human Immunodeficiency Virus type 1 (HIV-1) and hepatitis B Virus (HBV) infection, your HBV may get worse (flare-up) if you stop taking Cimduo. A “flare-up” is when your HBV infection suddenly returns in a worse way than before. Your healthcare provider will test you for HBV infection before you start treatment with Cimduo.
- It is not known if Cimduo is safe and effective in people who have both HIV-1 and HBV infection.
- Do not run out of Cimduo. Refill your prescription or talk to your healthcare provider before your Cimduo is all gone.
- Do not stop Cimduo without first talking to your healthcare provider. If you stop taking Cimduo, your healthcare provider will need to check your health often and do blood tests regularly for several months to check your liver.
- New or worse kidney problems, including kidney failure. Your healthcare provider may do blood and urine tests to check your kidneys before and during treatment with Cimduo. Tell your healthcare provider if you get signs and symptoms of kidney problems, including bone pain that does not go away or worsening bone pain, pain in your arms, hands, legs or feet, broken (fractured) bones, muscle pain or weakness.
For more information about side effects, see “What are the possible side effects of Cimduo?”
Who should not take Cimduo?
Do not take Cimduo if you:
- are allergic to lamivudine, tenofovir disoproxil fumarate, or any of the ingredients in Cimduo. See the end of this Patient Information leaflet for a complete list of ingredients in Cimduo.
What should I tell my healthcare provider before taking Cimduo?
Before you take Cimduo, tell your healthcare provider about all of your medical conditions, including if you:
- have liver problems, including hepatitis B or C infection
- have kidney problems, including end-stage renal disease (ESRD) that requires dialysis
- have bone problems, including a history of bone fractures
- are pregnant or plan to become pregnant. It is not known if Cimduo will harm your unborn baby. There is a pregnancy registry for women who take Cimduo during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. Talk to your healthcare provider about how you can take part in this registry.
- are breastfeeding or plan to breastfeed. Do not breastfeed if you take Cimduo.
- You should not breastfeed if you have HIV-1 because of the risk of passing HIV-1 to your baby.
- Talk to your healthcare provider about the best way to feed your baby.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins and herbal supplements.
Some medicines interact with Cimduo. Cimduo may affect the way other medicines work, and other medicines may affect how Cimduo works. Keep a list of your medicines and show it to your healthcare provider and pharmacist when you get a new medicine.
- You can ask your healthcare provider or pharmacist for a list of medicines that interact with Cimduo.
- Do not start taking a new medicine without telling your healthcare provider. Your healthcare provider can tell you if it is safe to take Cimduo with other medicines.
How should I take Cimduo?
- Take Cimduo exactly as your healthcare provider tells you to take it.
- Take Cimduo 1 time each day with or without food.
- Do not miss a dose of Cimduo. If you miss a dose, take the missed dose as soon as you remember. If it is almost time for your next dose of Cimduo, do not take the missed dose. Take the next dose at your regular time.
- Stay under the care of your healthcare provider during treatment with Cimduo.
- Do not run out of Cimduo. The virus in your blood may increase and the virus may become harder to treat. When your supply starts to run low, get more from your healthcare provider or pharmacy.
- If you take too much Cimduo, go to the nearest hospital emergency room right away.
What should I avoid while taking Cimduo?
You should avoid taking medicines that contain sorbitol during treatment with Cimduo.
What are the possible side effects of Cimduo?
Cimduo may cause serious side effects, including:
- See “What is the most important information I should know about Cimduo?”
- Use with interferon- and ribavirin-based regimens. Worsening of liver disease that has caused death has happened in people infected with HIV-1 and hepatitis C virus who were taking antiretroviral medicines for HIV-1 and were also being treated for hepatitis C with interferon alfa with or without ribavirin. If you are taking Cimduo and interferon alfa with or without ribavirin, tell your healthcare provider if you have any new symptoms.
- Risk of inflammation of the pancreas (pancreatitis). Children may be at risk for developing pancreatitis during treatment with Cimduo if they:
- have taken nucleoside analogue medicines in the past
- have a history of pancreatitis
- have other risk factors for pancreatitis
- Call your healthcare provider right away if your child develops signs and symptoms of pancreatitis including severe upper stomach-area pain, with or without nausea and vomiting. Your healthcare provider may tell you to stop giving Cimduo to your child if their symptoms and blood test results show that your child may have pancreatitis.
- Bone problems can happen in some people who take Cimduo. Bone problems include bone pain, softening or thinning (which may lead to fractures). Your healthcare provider may need to do tests to check your bones. Tell your healthcare provider if you have any bone pain, pain in your hands or feet, or muscle pain or weakness during treatment with Cimduo.
- Changes in your immune system (Immune Reconstitution Syndrome) can happen when you start taking HIV-1 medicines. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Tell your healthcare provider if you start having new symptoms after starting your HIV-1 medicine.
- Changes in body fat can happen in some people who take HIV-1 medicines. These changes may include increased amount of fat in the upper back and neck (“buffalo hump”), breast, and around the main part of your body (trunk). Loss of fat from the legs, arms, and face may also happen. The cause and long-term health effects of these conditions are not known.
The most common side effects of Cimduo include:
Tell your healthcare provider if you have any side effect that bothers you or that does not go away.
These are not all the possible side effects of Cimduo. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
General information about the safe and effective use of Cimduo
Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use Cimduo for a condition for which it was not prescribed. Do not give Cimduo to other people, even if they have the same symptoms that you have. It may harm them. If you would like more information, talk with your healthcare provider. You can ask your pharmacist or healthcare provider for information about Cimduo that is written for health professionals.
How should I store Cimduo?
- Store Cimduo tablets at room temperature between 68°F to 77°F (20°C to 25°C).
- Keep Cimduo tablets in the original container.
Keep Cimduo and all medicines out of the reach of children.
What are the ingredients in Cimduo?
Active ingredient: lamivudine and tenofovir disoproxil fumarate
Inactive ingredients: croscarmellose sodium, lactose monohydrate, magnesium stearate and microcrystalline cellulose. The tablet coating contains polyethylene glycol, titanium dioxide, polyvinyl alcohol and talc.
PRINCIPAL DISPLAY PANEL – 300 MG/300 MG
- NDC 49502-450-93 Rx only
300 mg/300 mg
- Each film-coated tablet contains:
Lamivudine, USP 300 mg
Fumarate 300 mg
equivalent to 245 mg
of tenofovir disoproxil)
- Usual Dosage: See accompanying
- Keep this and all medication
out of the reach of children.
SRC: NLM .