Lamivudine/zidovudine, sold under the brand name Combivir among others, is a fixed-dose combination antiretroviral medication used to treat HIV/AIDS. It contains two antiretroviral medications, lamivudine and zidovudine. It is used together with other antiretrovirals. It is taken by mouth twice a day. Common side effects include headache, feeling tired, nausea, diarrhea, and fever. Severe side effects may include bone marrow suppression, muscle damage, worsening of hepatitis B if previously infected, high blood lactate and liver enlargement. It may be part of a recommended treatment during pregnancy. The medications are both of the nucleoside reverse transcriptase inhibitor (NRTI) class. They work by blocking the action of the enzyme, reverse transcriptase, that the virus requires to reproduce. Lamivudine/zidovudine was approved for medical use in the United States in 1997, and in the European Union in 1998. It is on the World Health Organization's List of Essential Medicines. It is available as a generic medication. Medical uses It is indicated for use in combination with an additional antiretroviral agent for the treatment of human immunodeficiency virus type 1 (HIV-1) infection. Pregnancy Lamividine/zidovudine is categorized pregnancy category C in the United States, meaning there are potential risks to the baby during pregnancy, but potential benefits may outweigh the risks. Data supports the safety of this combination during pregnancy and is often preferred over other fixed dose combinations during pregnancy. Side effects The most common adverse effects of Lamividine/zidovudine are similar to other NRTI's and includes headache, neutropenia, anemia, nausea, vomiting, myopathy and nail pigmentation. More serious and potentially life-threatening adverse effects reported include lactic acidosis with hepatic steatosis, but this rare adverse event is mostly associated with Zidovudine. HIV-positive patients with chronic hepatitis B virus (HBV) infections are at risk for potential flares of hepatitis that can occur with abrupt discontinuation of Lamividine/zidovudine because Lamivudine is also used in low doses for treatment against active HBV. Interactions Drug-drug interactions Lamividine/zidovudine interacts with stavudine and zalcitabine by competing intracellularly for activation and results in inhibiting phosphorylation. There is also a known interaction with nephrotoxic or bone marrow suppressive agents (e.g. doxorubicin) which increases the risk of hematologic toxicity of zidovudine. Monitoring renal function and hematologic tests can be used to assess these potential interactions. Drug-food interactions Half lives of lamivudine and Zidovudine are not affected by food and absorption rates were slowed when taken with food but were not clinically significant, therefore, lamivudine/zidovudine may be