text:
Lamivudine and Zidovudine Tablets
Dosage Form: tablet, film coated
Hematologic Toxicity: Zidovudine, one of the 2 active ingredients in Lamivudine and Zidovudine Tablets, has been associated with hematologic toxicity including neutropenia and anemia, particularly in patients with advanced HIV-1 disease [See Warnings and Precautions (5.1)].
Myopathy: Prolonged use of zidovudine has been associated with symptomatic myopathy [see Warnings and Precautions (5.2)].
Lactic Acidosis and Severe Hepatomegaly: Lactic acidosis and hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues alone or in combination, including lamivudine, zidovudine, and other antiretrovirals. Suspend treatment if clinical or laboratory findings suggestive of lactic acidosis or pronounced hepatotoxicity occur [see Warnings and Precautions (5.3)].
Exacerbations of Hepatitis B: Severe acute exacerbations of hepatitis B have been reported in patients who are co-infected with hepatitis B virus (HBV) and HIV-1 and have discontinued lamivudine, which is one component of Lamivudine and Zidovudine Tablets. Hepatic function should be monitored closely with both clinical and laboratory follow-up for at least several months in patients who discontinue lamivudine and zidovudine tablet and are co-infected with HIV-1 and HBV. If appropriate, initiation of anti-hepatitis B therapy may be warranted [see Warnings and Precautions (5.4)].
Indications and Usage for Lamivudine and Zidovudine Tablets
Lamivudine and Zidovudine Tablet, USP a combination of two nucleoside analogues, is indicated in combination with other antiretrovirals for the treatment of HIV-1 infection.
Lamivudine and Zidovudine Tablets Dosage and Administration
Adults and Adolescents Weighing ≥30 kg
The recommended oral dose of lamivudine and zidovudine tablet in HIV-1-infected adults and adolescents weighing greater than or equal to 30 kg is 1 tablet (containing 150 mg of lamivudine and 300 mg of zidovudine) twice daily.
Pediatric Patients
The recommended oral dosage of Lamivudine and Zidovudine Tablets for pediatric patients who weigh greater than or equal to 30 kg and for whom a solid oral dosage form is appropriate is 1 tablet administered twice daily.
Before prescribing Lamivudine and Zidovudine Tablets, children should be assessed for the ability to swallow tablets. If a child is unable to reliably swallow a lamivudine and zidovudine tablet, the liquid oral formulations should be prescribed: lamivudine oral solution and zidovudine oral solution.
Patients Requiring Dosage Adjustment
Because lamivudine and zidovudine is a fixed-dose combination tablet, it should not be prescribed for pediatric patients weighing less than 30 kg or patients requiring dosage adjustment, such as those with reduced renal function (creatinine clearance less than 50 mL/min), patients with hepatic impairment, or patients experiencing dose-limiting adverse reactions. Liquid and solid oral formulations of the individual components of lamivudine and zidovudine tablet are available for these populations.
Dosage Forms and Strengths
Lamivudine and Zidovudine Tablets, containing 150 mg lamivudine and 300 mg zidovudine are white to off-white, scored, capsule shaped, biconvex, film coated tablets, debossed with 'T' on one side and '115' on other side.
Lamivudine and Zidovudine Tablets are contraindicated in patients with previously demonstrated clinically significant hypersensitivity (e.g., anaphylaxis, Stevens-Johnson syndrome) to any of the components of the product.
Warnings and Precautions
Hemotologic Toxicity/Bone Marrow Suppression
Zidovudine, a component of lamivudine and zidovudine tablet, has been associated with hematologic toxicity including neutropenia and anemia, particularly in patients with advanced HIV-1 disease. Lamivudine and zidovudine should be used with caution in patients who have bone marrow compromise evidenced by granulocyte count less than 1,000 cells/mm3 or hemoglobin less than 9.5 g/dL [see Adverse Reactions (6.1)].
Frequent blood counts are strongly recommended in patients with advanced HIV-1 disease who are treated with lamivudine and zidovudine. Periodic blood counts are recommended for other HIV-1-infected patients. If anemia or neutropenia develops, dosage interruption may be needed.
Myopathy and myositis, with pathological changes similar to that produced by HIV-1 disease, have been associated with prolonged use of zidovudine, and therefore may occur with therapy with lamivudine and zidovudine.
Lactic Acidosis/Hepatomegaly With Steatosis
Lactic acidosis and hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues alone or in combination, including lamivudine, zidovudine, and other antiretrovirals. A majority of these cases have been in women. Obesity and prolonged nucleoside exposure may be risk factors. Particular caution should be exercised when administering lamivudine and zidovudine to any patient with known risk factors for liver disease; however, cases have also been reported in patients with no known risk factors. Treatment with lamivudine and zidovudine should be suspended in any patient who develops clinical or laboratory findings suggestive of lactic acidosis or pronounced hepatotoxicity (which may include hepatomegaly and steatosis even in the absence of marked transaminase elevations).
Patients With HIV-1 and Hepatitis B Virus Co-infection
Posttreatment Exacerbations of Hepatitis: In clinical trials in non-HIV-1-infected patients treated with lamivudine for chronic HBV, clinical and laboratory evidence of exacerbations of hepatitis have occurred after discontinuation of lamivudine. These exacerbations have been detected primarily by serum ALT elevations in addition to re-emergence of hepatitis B viral DNA (HBV DNA). Although most events appear to have been self-limited, fatalities have been reported in some cases. Similar events have been reported from postmarketing experience after changes from lamivudine-containing HIV-1 treatment regimens to non-lamivudine-containing regimens in patients infected with both HIV-1 and HBV. The causal relationship to discontinuation of lamivudine treatment is unknown. Patients should be closely monitored with both clinical and laboratory follow-up for at least several months after stopping treatment. There is insufficient evidence to determine whether re-initiation of lamivudine alters the course of posttreatment exacerbations of hepatitis.
Important Differences Among Lamivudine-Containing Products: Lamivudine and Zidovudine Tablets contain a higher dose of the same active ingredient (lamivudine) than EPIVIR-HBV® (lamivudine) tablets and oral solution. EPIVIR-HBV was developed for treating chronic hepatitis B. Safety and efficacy of lamivudine have not been established for treatment of chronic hepatitis B in patients co-infected with HIV-1 and HBV.
Emergence of Lamivudine-Resistant HBV: In non-HIV-infected patients treated with lamivudine for chronic hepatitis B, emergence of lamivudine-resistant HBV has been detected and has been associated with diminished treatment response (see full prescribing information for EPIVIR-HBV for additional information). Emergence of hepatitis B virus variants associated with resistance to lamivudine has also been reported in HIV-1-infected patients who have received lamivudine-containing antiretroviral regimens in the presence of concurrent infection with hepatitis B virus.
Use With Other, Lamivudine-, Zidovudine-, and/or Emtricitabine-Containing Products
Lamivudine and Zidovudine Tablet is a fixed-dose combination of lamivudine and zidovudine. Lamivudine and Zidovudine Tablet should not be administered concomitantly with other lamivudine- or zidovudine-containing products including lamivudine tablets and oral solution, EPIVIR-HBV tablets and oral solution, zidovudine tablets, capsules, syrup, and IV Infusion, EPZICOM® (abacavir sulfate and lamivudine) tablets, or TRIZIVIR® (abacavir sulfate, lamivudine, and zidovudine) tablets; or emtricitabine-containing products, including ATRIPLA® (efavirenz, emtricitabine, and tenofovir), EMTRIVA® (emtricitabine), or TRUVADA® (emtricitabine and tenofovir) or COMPLERA® (rilpivirine/emtricitabine/tenifovir).
Use With Interferon- and Ribavirin-Based Regimens
In vitro studies have shown ribavirin can reduce the phosphorylation of pyrimidine nucleoside analogues such as lamivudine and zidovudine. Although no evidence of a pharmacokinetic or pharmacodynamic interaction (e.g., loss of HIV-1/HCV virologic suppression) was seen when ribavirin was coadministered with lamivudine or zidovudine in HIV-1/HCV co-infected patients [see Clinical Pharmacology (12.3)], hepatic decompensation (some fatal) has occurred in HIV-1/HCV co-infected patients receiving combination antiretroviral therapy for HIV-1 and interferon alfa with or without ribavirin. Patients receiving interferon alfa with or without ribavirin and lamivudine and zidovudine tablet should be closely monitored for treatment-associated toxicities, especially hepatic decompensation, neutropenia, and anemia. Discontinuation of lamivudine and zidovudine tablet should be considered as medically appropriate. Dose reduction or discontinuation of interferon alfa, ribavirin, or both should also be considered if worsening clinical toxicities are observed, including hepatic decompensation (e.g., Child-Pugh greater than 6) (see the complete prescribing information for interferon and ribavirin).
Exacerbation of anemia has been reported in HIV-1/HCV co-infected patients receiving ribavirin and zidovudine. Co-administration of ribavirin and zidovudine is not advised.
Lamivudine and Zidovudine should be used with caution in patients with a history of pancreatitis or other significant risk factors for the development of pancreatitis. Treatment with lamivudine and zidovudine should be stopped immediately if clinical signs, symptoms, or laboratory abnormalities suggestive of pancreatitis occur [see Adverse Reactions (6.1)].
Immune Reconstitution Syndrome
Immune reconstitution syndrome has been reported in patients treated with combination antiretroviral therapy, including lamivudine and zidovudine. During the initial phase of combination antiretroviral treatment, patients whose immune systems respond may develop an inflammatory response to indolent or residual opportunistic infections (such as Mycobacterium avium infection, cytomegalovirus, Pneumocystis jirovecii pneumonia (PCP), or tuberculosis), which may necessitate further evaluation and treatment.
Autoimmune disorders (such as Graves' disease, polymyositis, and Guillain-Barré syndrome) have also been reported to occur in the setting of immune reconstitution, however, the time to onset is more variable, and can occur many months after initiation of treatment.
Fat Redistribution
Redistribution/accumulation of body fat including central obesity, dorsocervical fat enlargement (buffalo hump), peripheral wasting, facial wasting, breast enlargement, and "cushingoid appearance" have been observed in patients receiving antiretroviral therapy. The mechanism and long-term consequences of these events are currently unknown. A causal relationship has not been established.
Adverse Reactions
The following adverse reactions are discussed in greater detail in other sections of the labeling:
- Hematologic toxicity, including neutropenia and anemia [see Boxed Warning, Warnings and Precautions (5.1)].
- Symptomatic myopathy [see Boxed Warning, Warnings and Precautions (5.2)].
- Lactic acidosis and hepatomegaly with steatosis [see Boxed Warning, Warnings and Precautions (5.3)].
- Acute exacerbations of hepatitis B [see Boxed Warning, Warnings and Precautions (5.4)].
- Hepatic decompensation in patients co-infected with HIV-1 and hepatitis C [see Warnings and Precautions (5.6)].
- Exacerbation of anemia in HIV-1/HCV co-infected patients receiving ribavirin and zidovudine [see Warnings and Precautions (5.6)].
- Pancreatitis [see Warnings and Precautions (5.7)].
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
Lamivudine Plus Zidovudine Administered As Separate Formulations: In 4 randomized, controlled trials of lamivudine 300 mg per day plus zidovudine 600 mg per day, the following selected adverse reactions and laboratory abnormalities were observed (see Tables 1 and 2).
|Adverse Reaction
|Lamivudine plus Zidovudine
(n = 251)
Body as a whole
Malaise & fatigue
Fever or chills
Nausea & vomiting
Anorexia and/or decreased appetite
Abdominal pain
Abdominal cramps
Nervous system
Insomnia & other sleep disorders
Depressive disorders
Nasal signs & symptoms
Skin rashes
Musculoskeletal pain
Pancreatitis was observed in 9 of the 2,613 adult patients (0.3%) who received lamivudine in controlled clinical trials [see Warnings and Precautions (5.7)].
Selected laboratory abnormalities observed during therapy are listed in Table 2.
(Abnormal Level)
|Lamivudine plus Zidovudine
% (n)
|ULN = Upper limit of normal.
ANC = Absolute neutrophil count.
n = Number of patients assessed.
* Frequencies of these laboratory abnormalities were higher in patients with mild laboratory abnormalities at baseline.
Neutropenia (ANC<750/mm3)
7.2% (237)
Anemia (Hgb<8 g/dL)
2.9% (241)
Thrombocytopenia (platelets<50,000/mm3)
0.4% (240)
ALT (>5.0 x ULN)
3.7% (241)
AST (>5.0 x ULN)
1.7% (241)
Bilirubin (>2.5x ULN)
0.8% (241)
Amylase (>2.0 x ULN)
4.2% (72)
Postmarketing Experience
In addition to adverse reactions reported from clinical trials, the following reactions have been identified during post-approval use of lamivudine, zidovudine, and/or lamivudine and zidovudine tablet. Because they are reported voluntarily from a population of unknown size, estimates of frequency cannot be made. These events have been chosen for inclusion due to a combination of their seriousness, frequency of reporting, or potential causal connection to lamivudine, zidovudine, and/or lamivudine and zidovudine tablet.
Body as a Whole: Redistribution/accumulation of body fat [see Warnings and Precautions (5.9)].
Cardiovascular: Cardiomyopathy.
Endocrine and Metabolic: Gynecomastia, hyperglycemia.
Gastrointestinal: Oral mucosal pigmentation, stomatitis.
General: Vasculitis, weakness.
Hemic and Lymphatic: Anemia, (including pure red cell aplasia and anemias progressing on therapy), lymphadenopathy, splenomegaly.
Hepatic and Pancreatic: Lactic acidosis and hepatic steatosis, pancreatitis, posttreatment exacerbation of hepatitis B [see Boxed Warning, Warnings and Precautions (5.3), (5.4), (5.7)].
Hypersensitivity: Sensitization reactions (including anaphylaxis), urticaria.
Musculoskeletal: Muscle weakness, CPK elevation, rhabdomyolysis.
Nervous: Paresthesia, peripheral neuropathy, seizures.
Respiratory: Abnormal breath sounds/wheezing.
Skin: Alopecia, erythema multiforme, Stevens-Johnson syndrome.
Drug Interactions
No drug interaction studies have been conducted using Lamivudine and Zidovudine Tablets [see Clinical Pharmacology (12.3)].
Antiretroviral Agents
Lamivudine: Zalcitabine: Lamivudine and zalcitabine may inhibit the intracellular phosphorylation of one another. Therefore, use of lamivudine and zidovudine tablet in combination with zalcitabine is not recommended.
Zidovudine: Stavudine: Concomitant use of lamivudine and zidovudine tablet with stavudine should be avoided since an antagonistic relationship with zidovudine has been demonstrated in vitro.
Nucleoside Analogues Affecting DNA Replication: Some nucleoside analogues affecting DNA replication, such as ribavirin, antagonize the in vitro antiviral activity of zidovudine against HIV-1; concomitant use of such drugs should be avoided.
Zidovudine: Concomitant use of lamivudine and zidovudine tablet with doxorubicin should be avoided since an antagonistic relationship with zidovudine has been demonstrated in vitro.
Hematologic/Bone Marrow Suppressive/Cytotoxic Agents
Zidovudine: Coadministration of ganciclovir, interferon alfa, ribavirin, and other bone marrow suppressive or cytotoxic agents may increase the hematologic toxicity of zidovudine.
Interferon- and Ribavirin-Based Regimens
Lamivudine: Although no evidence of a pharmacokinetic or pharmacodynamic interaction (e.g., loss of HIV-1/HCV virologic suppression) was seen when ribavirin was coadministered with lamivudine in HIV-1/HCV co-infected patients, hepatic decompensation (some fatal) has occurred in HIV-l/HCV co-infected patients receiving combination antiretroviral therapy for HIV-1 and interferon alfa with or without ribavirin [see Warnings and Precautions (5.5), Clinical Pharmacology (12.3)].
Trimethoprim/Sulfamethoxazole (TMP/SMX)
Lamivudine: No change in dose of either drug is recommended. There is no information regarding the effect on lamivudine pharmacokinetics of higher doses of TMP/SMX such as those used to treat PCP.
Teratogenic Effects:
Pregnancy Category C.
Fetal Risk Summary: There are no adequate and well-controlled studies of lamivudine and zidovudine tablet in pregnant women. Clinical trial data demonstrate that maternal zidovudine treatment during pregnancy reduces vertical transmission of HIV-1 infection to the fetus. Animal reproduction studies performed with lamivudine and zidovudine showed increased embryotoxicity fetal malformations (zidovudine), and increased embryolethality (lamivudine). Lamivudine and Zidovudine Tablet should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Clinical Considerations: Treatment of HIV during pregnancy optimizes the health of both mother and fetus. Clinical trial data reviewed by FDA demonstrate that maternal zidovudine treatment significantly reduces vertical transmission of HIV-1 infection to the fetus [see Clinical Studies (14.2)]. Published data suggest that combination antiretroviral regimens may reduce the rate of vertical transmission even further.
Pharmacokinetics of lamivudine and zidovudine in pregnant women are similar to the pharmacokinetics in nonpregnant women. No dose adjustments are needed during pregnancy.
In a clinical trial, adverse events among HIV-1-infected women were not different among untreated women and women treated with zidovudine. It is not known whether risks of adverse events associated with lamivudine are altered in pregnant women compared with other HIV-1-infected patients (see Human data below).
Data: Human Data: Lamivudine: Lamivudine pharmacokinetics were studied in pregnant women during 2 clinical studies conducted in South Africa. The study assessed pharmacokinetics in: 16 women at 36 weeks gestation using 150 mg lamivudine twice daily with zidovudine, 10 women at 38 weeks gestation using 150 mg lamivudine twice daily with zidovudine, and 10 women at 38 weeks gestation using lamivudine 300 mg twice daily without other antiretrovirals. Lamivudine pharmacokinetics in pregnant women were similar to those seen in nonpregnant adults and in postpartum women. Lamivudine concentrations were generally similar in maternal, neonatal, and umbilical cord serum samples.
Zidovudine: A randomized, double-blind, placebo-controlled trial was conducted in HIV-1-infected pregnant women to determine the utility of zidovudine for the prevention of maternal-fetal HIV-1 transmission. Zidovudine treatment during pregnancy reduced the rate of maternal-fetal HIV-1 transmission from 24.9% for infants born to placebo-treated mothers to 7.8% for infants born to mothers treated with zidovudine. There were no differences in pregnancy-related adverse events between the treatment groups. Congenital abnormalities occurred with similar frequency between neonates born to mothers who received zidovudine and neonates born to mothers who received placebo. The observed abnormalities included problems in embryogenesis (prior to 14 weeks) or were recognized on ultrasound before or immediately after initiation of study drug [see Clinical Studies (14.2)].
Zidovudine pharmacokinetics were studied in a Phase 1 study of 8 women during the last trimester of pregnancy. As pregnancy progressed, there was no evidence of drug accumulation. The pharmacokinetics of zidovudine were similar to that of nonpregnant adults. Consistent with passive transmission of the drug across the placenta, zidovudine concentrations in neonatal plasma at birth were essentially equal to those in maternal plasma at delivery.
Animal Data: Lamivudine: Animal reproduction studies performed at oral doses up to 130 and 60 times the adult dose in rats and rabbits, respectively, revealed no evidence of teratogenicity due to lamivudine. Increased early embryolethality occurred in rabbits at exposure levels similar to those in humans. However, there was no indication of this effect in rats at exposure levels up to 35 times those in humans. Based on animal studies, lamivudine crosses the placenta and is transferred to the fetus [see Nonclinical Toxicology (13.2)].
Zidovudine: Increased fetal resorptions occurred in pregnant rats and rabbits treated with doses of zidovudine that produced drug plasma concentrations 66 to 226 times (rats) and 12 to 87 times (rabbits) the mean steady-state peak human plasma concentration following a single 100 mg dose of zidovudine. There were no other reported developmental anomalies. In another developmental toxicity study, pregnant rats received zidovudine up to near-lethal doses that produced peak plasma concentrations 350 times peak human plasma concentrations (300 times the daily exposure [AUC] in humans given 600 mg/day zidovudine). This dose was associated with marked maternal toxicity and an increased incidence of fetal malformations. However, there were no signs of teratogenicity at doses up to one-fifth the lethal dose [see Nonclinical Toxicology (13.2)].
Nursing Mothers
The Centers for Disease Control and Prevention recommend that HIV-1-infected mothers in the United States not breastfeed their infants to avoid risking postnatal transmission of HIV-1 infection. Because of both the potential for HIV-1 transmission and serious adverse reactions in nursing infants, mothers should be instructed not to breastfeed if they are receiving lamivudine and zidovudine.
Although no studies of lamivudine and zidovudine excretion in breast milk have been performed, lactation studies performed with lamivudine and zidovudine show that both drugs are excreted in human breast milk. Samples of breast milk obtained from 20 mothers receiving lamivudine monotherapy (300 mg twice daily) or combination therapy (150 mg lamivudine twice daily and 300 mg zidovudine twice daily) had measurable concentrations of lamivudine. In another study, after administration of a single dose of 200 mg zidovudine to 13 HIV-1-infected women, the mean concentration of zidovudine was similar in human milk and serum.
Pediatric Use
Lamivudine and Zidovudine should not be administered to pediatric patients weighing less than 30 kg, because it is a fixed-dose combination that cannot be adjusted for this patient population.
Geriatric Use
Clinical studies of lamivudine and zidovudine tablet did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. In general, dose selection for an elderly patient should be cautious, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Lamivudine and Zidovudine is not recommended for patients with impaired renal function (i.e., creatinine clearance less than 50 mL/min) because it is a fixed-dose combination that cannot be adjusted.
Renal Impairment
Reduction of the dosages of lamivudine and zidovudine is recommended for patients with impaired renal function. Patients with creatinine clearance less than 50 mL/min should not receive lamivudine and zidovudine because it is a fixed-dose combination that cannot be adjusted.
Hepatic Impairment
A reduction in the daily dose of zidovudine may be necessary in patients with mild to moderate impaired hepatic function or liver cirrhosis. Lamivudine and Zidovudine is not recommended for patients with impaired hepatic function because it is a fixed-dose combination that cannot be adjusted.
Lamivudine and Zidovudine Tablet: There is no known antidote for lamivudine and zidovudine tablet.
Lamivudine: One case of an adult ingesting 6 grams of lamivudine was reported; there were no clinical signs or symptoms noted and hematologic tests remained normal. Because a negligible amount of lamivudine was removed via (4-hour) hemodialysis, continuous ambulatory peritoneal dialysis, and automated peritoneal dialysis, it is not known if continuous hemodialysis would provide clinical benefit in a lamivudine overdose event.
Zidovudine: Acute overdoses of zidovudine have been reported in pediatric patients and adults. These involved exposures up to 50 grams. The only consistent findings were nausea and vomiting. Other reported occurrences included headache, dizziness, drowsiness, lethargy, confusion, and 1 report of a grand mal seizure. Hematologic changes were transient. All patients recovered. Hemodialysis and peritoneal dialysis appear to have a negligible effect on the removal of zidovudine, while elimination of its primary metabolite, 3'-azido-3'-deoxy-5'- O-β- D-glucopyranuronosylthymidine (GZDV), is enhanced.
Lamivudine and Zidovudine Tablets Description
Lamivudine and Zidovudine Tablets, USP: Lamivudine and Zidovudine Tablets, USP are combination tablets containing lamivudine and zidovudine. Lamivudine and zidovudine (azidothymidine, AZT, or ZDV) are synthetic nucleoside analogues with activity against HIV-1.
Lamivudine and Zidovudine Tablets, USP are for oral administration. Each film-coated tablet contains 150 mg of lamivudine USP, 300 mg of zidovudine USP, and the inactive ingredients hypromellose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polysorbate 80, sodium starch glycolate and titanium dioxide.
Lamivudine: The chemical name of lamivudine is 2(1H) - Pyrimidinone, 4-amino-1- [2- (hydroxymethyl)-1,3-oxathio-lan-5-yl], (2R-cis)-. It has a molecular formula of C8H11N3O3S and a molecular weight of 229.26. It has the following structural formula:
Lamivudine is white to an off-white solid. Soluble in water.
Zidovudine: The chemical name of zidovudine is Thymidine, 3'-azido-3'-deoxy-. It has a molecular formula of C10H13N5O4 and a molecular weight of 267.24. It has the following structural formula:
Zidovudine is a white to yellowish powder. Sparingly soluble in water and soluble in alcohol.
This product meets USP Dissolution Test 2.
Lamivudine and Zidovudine Tablets - Clinical Pharmacology
Mechanism of Action
Lamivudine and Zidovudine Tablet is an antiviral agent [see Clinical Pharmacology (12.4)].
Pharmacokinetics in Adults: Lamivudine and Zidovudine Tablet: One lamivudine and zidovudine tablet was bioequivalent to 1 lamivudine tablet (150 mg) plus 1 zidovudine tablet (300 mg) following single-dose administration to fasting healthy subjects (n = 24).
Lamivudine: The pharmacokinetic properties of lamivudine in fasting patients are summarized in Table 3. Following oral administration, lamivudine is rapidly absorbed and extensively distributed. Binding to plasma protein is low. Approximately 70% of an intravenous dose of lamivudine is recovered as unchanged drug in the urine. Metabolism of lamivudine is a minor route of elimination. In humans, the only known metabolite is the trans-sulfoxide metabolite (approximately 5% of an oral dose after 12 hours).
Zidovudine: The pharmacokinetic properties of zidovudine in fasting patients are summarized in Table 3. Following oral administration, zidovudine is rapidly absorbed and extensively distributed. Binding to plasma protein is low. Zidovudine is eliminated primarily by hepatic metabolism. The major metabolite of zidovudine is GZDV. GZDV area under the curve (AUC) is about 3-fold greater than the zidovudine AUC. Urinary recovery of zidovudine and GZDV accounts for 14% and 74% of the dose following oral administration, respectively. A second metabolite, 3'-amino-3'-deoxythymidine (AMT), has been identified in plasma. The AMT AUC was one-fifth of the zidovudine AUC.
|* Data presented as mean ± standard deviation except where noted.
† Median [range].
‡ Children.
§ Adults.
║ Approximate range.
Oral bioavailability (%)
86 ± 16
64 ± 10
n = 5
Apparent volume of distribution (L/kg)
1.3 ± 0.4
1.6 ± 0.6
n = 8
Plasma protein binding (%)
CSF:plasma ratio †
0.12 [0.04 to 0.47]
n = 38 ‡
0.60 [0.04 to 2.62]
Systemic clearance (L/hr/kg)
0.33 ± 0.06
1.6 ± 0.6
n = 6
Renal clearance (L/hr/kg)
0.22 ± 0.06
0.34 ± 0.05
n = 9
Elimination half-life (hr) ║
5 to 7
0.5 to 3
Effect of Food on Absorption of Lamivudine and Zidovudine: Lamivudine and Zidovudine may be administered with or without food. The lamivudine and zidovudine AUC following administration of lamivudine and zidovudine with food was similar when compared to fasting healthy subjects (n = 24).
Special Populations:
Pregnancy: See Use in Specific Populations (8.1).
Lamivudine and Zidovudine: No data are available.
Zidovudine: Zidovudine pharmacokinetics has been studied in a Phase 1 study of 8 women during the last trimester of pregnancy. As pregnancy progressed, there was no evidence of drug accumulation. The pharmacokinetics of zidovudine was similar to that of nonpregnant adults. Consistent with passive transmission of the drug across the placenta, zidovudine concentrations in neonatal plasma at birth were essentially equal to those in maternal plasma at delivery. Although data are limited, methadone maintenance therapy in 5 pregnant women did not appear to alter zidovudine pharmacokinetics. In a nonpregnant adult population, a potential for interaction has been identified.
Nursing Mothers: See Use in Specific Populations (8.3).
Pediatric Patients: Lamivudine and Zidovudine Tablet should not be administered to pediatric patients weighing less than 30 kg.
Geriatric Patients: The pharmacokinetics of lamivudine and zidovudine have not been studied in patients over 65 years of age.
Gender: A pharmacokinetic study in healthy male (n = 12) and female (n = 12) subjects showed no gender differences in zidovudine AUC∞ or lamivudine AUC∞ normalized for body weight.
Race: Lamivudine: There are no significant racial differences in lamivudine pharmacokinetics.
Zidovudine: The pharmacokinetics of zidovudine with respect to race have not been determined.
Drug Interactions: See Drug Interactions (7).
No drug interaction studies have been conducted using Lamivudine and Zidovudine Tablets. However, Table 4 presents drug interaction information for the individual components of lamivudine and zidovudine tablet.
Lamivudine Plus Zidovudine: No clinically significant alterations in lamivudine or zidovudine pharmacokinetics were observed in 12 asymptomatic HIV-1-infected adult patients given a single dose of zidovudine (200 mg) in combination with multiple doses of lamivudine
(300 mg q l2 hr).
Table 4. Effect of Coadministered Drugs on Lamivudine and Zidovudine AUCa
|Drugs That May Alter Lamivudine Blood Concentrations
|Coadministered Drug and Dose
|Concentration of
↑ = Increase; ↓ = Decrease; ↔ = no significant change; AUC = area under the concentration versus time curve; CI = confidence interval.
aThis table is not all inclusive.
bEstimated range of percent difference.
750 mg q 8 hr x 7 to10 days
|single 150 mg
1% to 20%
|Trimethoprim 160 mg/
800 mg daily x 5 days
|single 300 mg
32% to 55%
|Drugs That May Alter Zidovudine Blood Concentrations
|Coadministered Drug and Dose
|Concentration of
750 mg q 12 hr
with food
|200 mg q 8 hr
23% to 78%b
500 mg twice daily
|100 mg q 4 hr x 7 days
↓34% to ↑14%
|Not Reported
400 mg daily
|200 mg q 8 hr
54% to 98%
|Not Reported
30 to 90 mg daily
|200 mg q 4 hr
16% to 64%b
750 mg q 8 hr x 7 to 10 days
|single 200 mg
28% to 41%
500 mg q 6 hr x
2 days
|2 mg/kg q
8 hr x 3 days
100% to
|Not Assessed
600 mg daily x 14 days
|200 mg q 8 hr x 14 days
|90% CI: 41% to 53%
|Not Assessed
300 mg q 6 hr x
4 days
|200 mg q 8 hr x 4 days
15% to 34%
|Valproic acid
250 mg or 500 mg q
8 hr x 4 days
|100 mg q 8 hr x 4 days
64% to 130%b
|Not Assessed
Ribavirin: In vitro data indicate ribavirin reduces phosphorylation of lamivudine, stavudine, and zidovudine. However, no pharmacokinetic (e.g., plasma concentrations or intracellular triphosphorylated active metabolite concentrations) or pharmacodynamic (e.g., loss of HIV-1/HCV virologic suppression) interaction was observed when ribavirin and lamivudine (n = 18), stavudine (n = 10), or zidovudine (n = 6) were coadministered as part of a multi-drug regimen to HIV-1/HCV co-infected patients [see Warnings and Precautions (5.5)].
Mechanism of Action: Lamivudine: Intracellularly, lamivudine is phosphorylated to its active 5'-triphosphate metabolite, lamivudine triphosphate (3TC-TP). The principal mode of action of 3TC-TP is inhibition of reverse transcriptase (RT) via DNA chain termination after incorporation of the nucleotide analogue. 3TC-TP is a weak inhibitor of cellular DNA polymerases α, β, and γ.
Zidovudine: Intracellularly, zidovudine is phosphorylated to its active 5'-triphosphate metabolite, zidovudine triphosphate (ZDV-TP). The principal mode of action of ZDV-TP is inhibition of RT via DNA chain termination after incorporation of the nucleotide analogue. ZDV-TP is a weak inhibitor of the cellular DNA polymerases α and γ and has been reported to be incorporated into the DNA of cells in culture.
Antiviral Activity: Lamivudine Plus Zidovudine: In HIV-1-infected MT-4 cells, lamivudine in combination with zidovudine at various ratios exhibited synergistic antiretroviral activity.
Lamivudine: The antiviral activity of lamivudine against HIV-1 was assessed in a number of cell lines (including monocytes and fresh human peripheral blood lymphocytes) using standard susceptibility assays. EC50 values (50% effective concentrations) were in the range of 0.003 to 15 µM (1 µM = 0.23 mcg/mL). HIV-1 from therapy-naive subjects with no amino acid substitutions associated with resistance gave median EC50 values of 0.429 µM (range: 0.200 to 2.007 µM) from Virco (n = 92 baseline samples from COL40263) and 2.35 µM (1.37 to 3.68 µM) from Monogram Biosciences (n = 135 baseline samples from ESS30009). The EC50 values of lamivudine against different HIV-1 clades (A-G) ranged from 0.001 to 0.12 µM, and against HIV-2 isolates from 0.003 to 0.12 µM in peripheral blood mononuclear cells. Ribavirin (50 µM) decreased the anti-HIV-1 activity of lamivudine by 3.5 fold in MT-4 cells.
Zidovudine: The antiviral activity of zidovudine against HIV-1 was assessed in a number of cell lines (including monocytes and fresh human peripheral blood lymphocytes). The EC50 and EC90 values for zidovudine were 0.01 to 0.49 µM (1 µM = 0.27 mcg/mL) and 0.1 to 9 µM, respectively. HIV-1 from therapy-naive subjects with no amino acid substitutions associated with resistance gave median EC50 values of 0.011 µM (range: 0.005 to 0.110 µM) from Virco (n = 92 baseline samples from COL40263) and 0.0017 µM (0.006 to 0.0340 µM) from Monogram Biosciences (n = 135 baseline samples from ESS30009). The EC50 values of zidovudine against different HIV-1 clades (A-G) ranged from 0.00018 to 0.02 µM, and against HIV-2 isolates from 0.00049 to 0.004 µM. In cell culture drug combination studies, zidovudine demonstrates synergistic activity with the nucleoside reverse transcriptase inhibitors (NRTIs) abacavir, didanosine, lamivudine, and zalcitabine; the non-nucleoside reverse transcriptase inhibitors (NNRTIs) delavirdine and nevirapine; and the protease inhibitors (PIs) indinavir, nelfinavir, ritonavir, and saquinavir; and additive activity with interferon alfa. Ribavirin has been found to inhibit the phosphorylation of zidovudine in cell culture.
Resistance: Lamivudine Plus Zidovudine Administered As Separate Formulations: In patients receiving lamivudine monotherapy or combination therapy with lamivudine plus zidovudine, HIV-1 isolates from most patients became phenotypically and genotypically resistant to lamivudine within 12 weeks. In some patients harboring zidovudine-resistant virus at baseline, phenotypic sensitivity to zidovudine was restored by 12 weeks of treatment with lamivudine and zidovudine. Combination therapy with lamivudine plus zidovudine delayed the emergence of amino acid substitutions conferring resistance to zidovudine.
HIV-1 strains resistant to both lamivudine and zidovudine have been isolated from patients after prolonged lamivudine and zidovudine therapy. Dual resistance required the presence of multiple amino acid substitutions, the most essential of which may be G333E. The incidence of dual resistance and the duration of combination therapy required before dual resistance occurs are unknown.
Lamivudine: Lamivudine-resistant isolates of HIV-1 have been selected in cell culture and have also been recovered from patients treated with lamivudine or lamivudine plus zidovudine. Genotypic analysis of isolates selected in cell culture and recovered from lamivudine-treated patients showed that the resistance was due to a specific amino acid substitution in the HIV-1 reverse transcriptase at codon 184 changing the methionine to either isoleucine or valine (Ml84V II).
Zidovudine: HIV-1 isolates with reduced susceptibility to zidovudine have been selected in cell culture and were also recovered from patients treated with zidovudine. Genotypic analyses of the isolates selected in cell culture and recovered from zidovudine-treated patients showed substitutions in the HIV-1 RT gene resulting in 6 amino acid substitutions (M41L, D67N, K70R, L210W, T215Y or F, and K219Q) that confer zidovudine resistance. In general, higher levels of resistance were associated with greater number of amino acid substitutions.
Cross-Resistance: Cross-resistance has been observed among NRTIs.
Lamivudine Plus Zidovudine: Cross-resistance between lamivudine and zidovudine has not been reported. In some patients treated with lamivudine alone or in combination with zidovudine, isolates have emerged with a substitution at codon 184, which confers resistance to lamivudine. Cross-resistance to abacavir, didanosine, tenofovir, and zalcitabine has been observed in some patients harboring lamivudine-resistant HIV-1 isolates. In some patients treated with zidovudine plus didanosine or zalcitabine, isolates resistant to multiple drugs, including lamivudine, have emerged (see under Zidovudine below).
Lamivudine: See Lamivudine Plus Zidovudine (above).
Zidovudine: In a study of 167 HIV-1-infected patients, isolates (n = 2) with multi-drug resistance to didanosine, lamivudine, stavudine, zalcitabine, and zidovudine were recovered from patients treated for ≥1 year with zidovudine plus didanosine or zidovudine plus zalcitabine. The pattern of resistance-associated amino acid substitutions with such combination therapies was different (A62V, V75I, F77L, Fl16Y, Q151M) from the pattern with zidovudine monotherapy, with the Q151M substitution being most commonly associated with multi-drug resistance. The substitution at codon 151 in combination with substitutions at 62, 75, 77, and 116 results in a virus with reduced susceptibility to didanosine, lamivudine, stavudine, zalcitabine, and zidovudine. Thymidine analogue mutations (TAMs) are selected by zidovudine and confer cross-resistance to abacavir, didanosine, stavudine, tenofovir, and zalcitabine.
Carcinogenesis, Mutagenesis, Impairment of Fertility
Carcinogenicity: Lamivudine: Long-term carcinogenicity studies with lamivudine in mice and rats showed no evidence of carcinogenic potential at exposures up to 10 times (mice) and 58 times (rats) those observed in humans at the recommended therapeutic dose for HIV-1 infection.
Zidovudine: Zidovudine was administered orally at 3 dosage levels to separate groups of mice and rats (60 females and 60 males in each group). Initial single daily doses were 30, 60, and 120 mg/kg/day in mice and 80, 220, and 600 mg/kg/day in rats. The doses in mice were reduced to 20, 30, and 40 mg/kg/day after day 90 because of treatment-related anemia, whereas in rats only the high dose was reduced to 450 mg/kg/day on day 91 and then to 300 mg/kg/day on day 279.
In mice, 7 late-appearing (after 19 months) vaginal neoplasms (5 nonmetastasizing squamous cell carcinomas, 1 squamous cell papilloma, and 1 squamous polyp) occurred in animals given the highest dose. One late-appearing squamous cell papilloma occurred vagina of a middle-dose animal. No vaginal tumors were found at the lowest dose.
In rats, 2 late-appearing (after 20 months), nonmetastasizing vaginal squamous cell carcinomas occurred in animals given the highest dose. No vaginal tumors occurred at the low or middle dose in rats. No other drug-related tumors were observed in either sex of either species.
At doses that produced tumors in mice and rats, the estimated drug exposure (as measured by AUC) was approximately 3 times (mouse) and 24 times (rat) the estimated human exposure at the recommended therapeutic dose of 100 mg every 4 hours.
It is not known how predictive the results of rodent carcinogenicity studies may be for humans.
Mutagenicity: Lamivudine: Lamivudine was mutagenic in an L5178Y/TK +/- mouse lymphoma assay and clastogenic in a cytogenetic assay using cultured human lymphocytes. Lamivudine was negative in a microbial mutagenicity assay, in an in vitro cell transformation assay, in a rat micronucleus test, in a rat bone marrow cytogenetic assay, and in an assay for unscheduled DNA synthesis in rat liver.
Zidovudine: Zidovudine was mutagenic in an L5178Y/TK +/- mouse lymphoma assay, positive in an in vitro cell transformation assay, clastogenic in a cytogenetic assay using cultured human lymphocytes, and positive in mouse and rat micronucleus tests after repeated doses. It was negative in a cytogenetic study in rats given a single dose.
Impairment of Fertility: Lamivudine: In a study of reproductive performance, lamivudine, administered to male and female rats at doses up to 130 times the usual adult dose based on body surface area considerations, revealed no evidence of impaired fertility (judged by conception rates) and no effect on the survival, growth, and development to weaning of the offspring.
Zidovudine: Zidovudine, administered to male and female rats at doses up to 7 times the usual adult dose based on body surface area considerations, had no effect on fertility judged by conception rates.
Reproductive and Developmental Toxicology Studies
Lamivudine: Reproduction studies have been performed in rats and rabbits at orally administered doses up to 4,000 mg/kg/day and 1,000 mg/kg/day, respectively, producing plasma levels up to approximately 35 times that for the adult HIV dose. No evidence of teratogenicity due to lamivudine was observed. Evidence of early embryo lethality was seen in the rabbit at exposure levels similar to those observed in humans, but there was no indication of this effect in the rat at exposure levels up to 35 times those in humans. Studies in pregnant rats and rabbits showed that lamivudine is transferred to the fetus through the placenta.
Zidovudine: Oral teratology studies in the rat and in the rabbit at doses up to 500 mg/kg/day revealed no evidence of teratogenicity with zidovudine. Zidovudine treatment resulted in embryo/fetal toxicity as evidenced by an increase in the incidence of fetal resorptions in rats given 150 or 450 mg/kg/day and rabbits given 500 mg/kg/day. The doses used in the teratology studies resulted in peak zidovudine plasma concentrations (after one-half of the daily dose) in rats 66 to 226 times, and in rabbits 12 to 87 times, mean steady-state peak human plasma concentrations (after one-sixth of dose) achieved with the recommended daily dose (100 mg every 4 hours). In an in vitro experiment with fertilized mouse oocytes, zidovudine exposure resulted in a dose-dependent reduction in blastocyst formation. In an additional teratology study in rats, a dose of 3,000 mg/kg/day (very near the oral median lethal dose in rats of 3,683 mg/kg) caused marked maternal toxicity and an increase in the incidence of fetal malformations. This dose resulted in peak zidovudine plasma concentrations 350 times peak human plasma concentrations. (Estimated AUC in rats at this dose level was 300 times the daily AUC in humans given 600 mg/day.) No evidence of teratogenicity was seen in this experiment at doses of 600 mg/kg/day or less.
Clinical Studies
There have been no clinical trials conducted with lamivudine and zidovudine tablet. See Clinical Pharmacology (12.3) for information about bioequivalence. One lamivudine and zidovudine tablet given twice daily is an alternative regimen to lamivudine tablets 150 mg twice daily plus zidovudine 600 mg per day in divided doses.
Lamivudine Plus Zidovudine: The NUCB3007 (CAESAR) study was conducted using lamivudine 150 mg tablets (150 mg twice daily) and zidovudine 100 mg capsules (2 x 100 mg 3 times daily). CAESAR was a multi-center, double-blind, placebo-controlled study comparing continued current therapy (zidovudine alone [62% of patients] or zidovudine with didanosine or zalcitabine [38% of patients]) to the addition of lamivudine or lamivudine plus an investigational non-nucleoside reverse transcriptase inhibitor, randomized 1:2:1. A total of 1,816 HIV-1-infected adults with 25 to 250 (median 122) CD4 cells/mm3 at baseline were enrolled: median age was 36 years, 87% were male, 84% were nucleoside-experienced, and 16% were therapy-naive. The median duration on study was 12 months. Results are summarized in Table 5.
|Current Therapy
(n = 460)
|Lamivudine plus
Current Therapy
(n = 896)
|Lamivudine plus a
NNRTI* plus
Current Therapy
(n = 460)
|* An investigational non-nucleoside reverse transcriptase inhibitor not approved in the United States.
HIV-1 progression or death
90 (19.6%)
86 (9.6%)
41 (8.9%)
27 (5.9%)
23 (2.6%)
14 (3%)
Prevention of Maternal-Fetal HIV-1 Transmission
The utility of zidovudine alone for the prevention of maternal-fetal HIV-1 transmission was demonstrated in a randomized, double-blind, placebo-controlled trial conducted in HIV-1-infected pregnant women with CD4+ cell counts of 200 to 1,818 cells/mm3 (median in the treated group: 560 cells/mm3) who had little or no previous exposure to zidovudine. Oral zidovudine was initiated between 14 and 34 weeks of gestation (median 11 weeks of therapy) followed by IV administration of zidovudine during labor and delivery. Following birth, neonates received oral zidovudine syrup for 6 weeks. The study showed a statistically significant difference in the incidence of HIV-1 infection in the neonates (based on viral culture from peripheral blood) between the group receiving zidovudine and the group receiving placebo. Of 363 neonates evaluated in the study, the estimated risk of HIV-1 infection was 7.8% in the group receiving zidovudine and 24.9% in the placebo group, a relative reduction in transmission risk of 68.7%. Zidovudine was well tolerated by mothers and infants. There was no difference in pregnancy-related adverse events between the treatment groups.
How Supplied/Storage and Handling
Lamivudine and Zidovudine Tablets, USP containing 150 mg lamivudine USP and 300 mg zidovudine USP are white to off-white, scored, capsule shaped, biconvex, film coated tablets, debossed with 'T' on one side and '115' on other side. They are supplied as follows:
Bottle of 60 Tablets (NDC 76282-115-60)
Bottle of 500 Tablets (NDC 76282-115-05)
Store at 20° to 25°C (68° to 77°F). [see USP Controlled Room Temperature].
Patient Counseling Information
Advice for the Patient
Neutropenia and Anemia: Patients should be informed that the important toxicities associated with zidovudine are neutropenia and/or anemia. They should be told of the extreme importance of having their blood counts followed closely while on therapy, especially for patients with advanced HIV-1 disease [see Boxed Warning, Warnings and Precautions (5.1)].
Myopathy: Patients should be informed that myopathy and myositis with pathological changes, similar to that produced by HIV‑1 disease, have been associated with prolonged use of zidovudine [see Warnings and Precautions (5.2)] .
Lactic Acidosis/Hepatomegaly: Patients should be informed that some HIV medicines, including lamivudine and zidovudine tablet, can cause a rare, but serious condition called lactic acidosis with liver enlargement (hepatomegaly) [see Warnings and Precautions (5.3)] .
HIV‑1/HBV Co‑Infection: Patients co‑infected with HIV‑1 and HBV should be informed that deterioration of liver disease has occurred in some cases when treatment with lamivudine was discontinued. Patients should be advised to discuss any changes in regimen with their physician [see Warnings and Precautions (5.4)] .
Use With Other Lamivudine-, Zidovudine-, and/or Emtricitabine‑Containing Products: Lamivudine and Zidovudine tablet should not be coadministered with drugs containing lamivudine, zidovudine, or emtricitabine, including lamivudine, EPIVIR-HBV (lamivudine), zidovudine, EPZICOM (abacavir sulfate and lamivudine), TRIZIVIR (abacavir sulfate, lamivudine, and zidovudine), ATRIPLA (efavirenz, emtricitabine, and tenofovir), EMTRIVA (emtricitabine), TRUVADA (emtricitabine and tenofovir), or COMPLERA™ (rilpivirine/emtricitabine/tenofovir) [see Warnings and Precautions (5.5)].
HIV‑1/HCV Co‑Infection: Patients with HIV-1/HCV co-infection should be informed that hepatic decompensation (some fatal) has occurred in HIV‑1/HCV co-infected patients receiving combination antiretroviral therapy for HIV‑1 and interferon alfa with or without ribavirin [see Warnings and Precautions (5.6)] .
Drug Interactions: Patients should be cautioned about the use of other medications, including ganciclovir, interferon alfa, and ribavirin, which may exacerbate the toxicity of zidovudine [see Drug Interactions (7.3)] .
Redistribution/Accumulation of Body Fat: Patients should be informed that redistribution or accumulation of body fat may occur in patients receiving antiretroviral therapy and that the cause and long-term health effects of these conditions are not known at this time [see Warnings and Precautions (5.9)] .
Information About HIV-1 Infection: Lamivudine and zidovudine tablet is not a cure for HIV‑1 infection and patients may continue to experience illnesses associated with HIV‑1 infection, including opportunistic infections. Patients should remain under the care of a physician when using lamivudine and zidovudine tablet.
Patients should be advised to avoid doing things that can spread HIV-1 infection to others.
Do not share needles or other injection equipment.
Do not share personal items that can have blood or body fluids on them, like toothbrushes and razor blades.
Do not have any kind of sex without protection. Always practice safe sex by using a latex or polyurethane condom or other barrier method to lower the chance of sexual contact with semen, vaginal secretions, or blood.
Do not breastfeed. Lamivudine and zidovudine are excreted in human breast milk. Mothers with HIV-1 should not breastfeed because HIV-1 can be passed to the baby in the breast milk.
Patients should be informed to take all HIV medications exactly as prescribed.
EPZICOM and TRIZIVIR are registered trademarks of ViiV Healthcare.
The other brands listed are trademarks of their respective owners and are not trademarks of Exelan Pharmaceuticals, Inc. The makers of these brands are not affiliated with and do not endorse Exelan Pharmaceuticals, Inc or its products.
Manufactured for:
Exelan Pharmaceuticals, Inc.
Lawrenceville, GA 30046
Manufactured by:
Ascent Pharmaceuticals, Inc.
Central Islip, NY 11722
Rev.: 04/15
Bar Code: 115-04-2015
Lamivudine and Zidovudine Tablets, USP 150/300 mg
Rx only 60 Tablets
lamivudine and zidovudine tablet, film coated
|Labeler - Exelan Pharmaceuticals Inc. (967795266)
|Ascent Pharmaceuticals Inc.
|manufacture(76282-115), analysis(76282-115)


text:
The definitive sounds of vintage electric piano in one powerful instrument.
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subset: commoncrawl


text:
Lyfe Jennings I Still Believe LyricsArtist: Lyfe Jennings
Publishers: ©Warner/Chappell Music, Inc.
Popularity : 0 users have visited this page.
Length: 3:22
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I still believe in Sunday dinners and giving thanks before you eat.
I still believe in breastfeeding babies and looking both ways before you cross the street.
I still believe in taking care of grandma and not taking her to no damn nursing home yea, and
I still believe in whooping kids cause sometimes that's the only way they gonna get it.
I still believe in miracles.
I still believe in magic and rainbows.
I still believe in family, the laws of gravity, and where there's a will there's a way.
And I still believe in Santa Claus, no not the man,
I believe in the principle, of giving back to the community,
Rebuilding family, make this world a better place, I still believe.
I still believe in church on Sunday and praying before you go sleep.
I still believe in teaching bad examples cause kids mimick what they see.
I still believe in home school, washing your hands after you go to the bathroom yea.
I still believe in prayer changes things, it's something about giving all that we need.
One heart, one soul, one voice, one people united together (I still believe)
One life, one love, one world, cause nobody lives forever
We know, we getting better and better,
And I know that we will so why raise my voice cause I still believe yea yea yea
I still (I still) believe (believe) we give (we give) we trust (we trust)
In life (in life) in love (in love) I still (I still)
The hottest lyrics from Lyfe Jennings


text:
No in-room bathroom but pretty large public bathroom equipped. Location is very poor for train rider. It takes 10 minutes from Shin-isesaki station and little eatery nor convenience store nearby. Breakfast buffet is good deal and you can try typical Japanese breakfast like raw egg, seaweed, and Natto soybeans.
Top-rated Attractions Nearby
Top-rated Restaurants Nearby


text:
Environmentalists: America's Cup not green enough
A preliminary planning document for the America's Cup doesn't go far enough to protect San Francisco's natural environment, a coalition of environmental organizations has said.
The Environmental Council -- made up of a group of nonprofits including the Sierra Club, San Francisco Baykeeper, Turtle Island Restoration Network, the Dolphin Swimming and Boating Club, and others closely tracking planning for the America's Cup -- were gearing up to offer feedback to the San Francisco Planning Commission Aug. 11 on a hefty draft environmental impact review (DEIR) of the prestigious yachting event's impacts on marine life, air quality, and parklands.
The draft EIR "does not go far enough to protect San Francisco's air, water, and marine life," said Teri Shore of the Turtle Island Restoration Network. She advocated for requiring vessels to use the cleanest possible fuels and to travel at slow speeds so as not to collide with dolphins, porpoises, seals, sea lions, or whales once outside the Golden Gate.
Ken Coren, Vice President of the Dolphin and Swimming Club, voiced concerns about the effects the race would have on swimming and recreational boating. "The bay would be sealed off -- it would only be spectator viewing," he said. Activities like swimming around Aquatic Park or entering the bay on rowboats "would be prevented if you were going to take the EIR as it stands today at its word."
Jon Golinger, president of the Telegraph Hill Dwellers, said the report "dramatically underestimates the impact" to individual San Francisco neighborhoods.
Jon Golinger speaks at a press conference on the steps of City Hall. Video by Rebecca Bowe
Jennifer Clary, of San Francisco Tomorrow, said the groups' concerns centered on three key areas: Impacts to the water, such as the potential for oil spills or degraded water quality; impacts that huge crowds would have on surrounding lands, especially in protected areas such as the Presidio; and neighborhood impacts. "You have already busy locations, and they're going to packing more people in," she said.
While they raised concerns, the nonprofit representatives also made it clear that they were not opposed to the America's Cup, and only wanted to see the city strengthen environmental protections during the event. David Anderson, Conservation Committee Chair with the Golden Gate Audubon Society, noted that the world-famous regatta would result in a major economic boon. "Certainly the city can afford some mitigation to make it right," he said.


text:
I am Single, Giving, and own a big warm heart
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64 • Saint Charles, MO • Woman
I'm looking for
- Men
- Ages 50-65
- Near me
- Who are single
- For long-term dating
My details
- Last online
- Today – 1:50am
- Orientation
- Straight
- Ethnicity
- White
- Status
- Single
- Height
- 5' 6" (1.68m)
- Body Type
- Full figured
- Smoking
- No
- Drinking
- Socially
- Drugs
- Never
- Religion
- Christianity but it's not important
- Sign
- Virgo
- Offspring
- Has kid(s)
- Speaks
- English
My self-summary
Write a little about yourself. Just a paragraph will do.
Life is full of twist and turns, you never know what lies ahead unless you are willing to venture out, work on whats in front of you and go down that trail together, getting to know one another without assumptions, everything based on your own sought after and discovered facts. I don't think I'm high maintenance, rather low keyed and more than willing to wrap my life around the right person as long as he doesn't take things for granted (me included). I go out of my way for the ones that are important to me a lot more than I do for myself. My concerns are more for my family and obligations before I do fun things. I'm pretty much a stay at home person, don't get me wrong I do enjoy going out etc, but it's not a necessity 2-3 times a week. Don't pamper myself, not into getting my nails done each week or hair combed by someone else, those things I can mange very well on my own. I'm more of a people person than a materialistic one. I don't pick and choose my friends or partners based on their height, hair color or lack of it, what type of car they drive, where they live , the type of job they have or how deep their pockets are. Those things are material item and have no place as far as meeting someone, dating them or even getting down to the nitty gritty. I'd like to think of myself as one who'll accept people for who and what they are, just as I'd want them to do for me. I try not to pre-judge someone and would much rather form my own opinion of things and people than listen to gossip and hear say and get the wrong ideas about people. You can email me at chriss underscore mom 1986 at att ddot net.
I am Single, Giving, and own a big warm heart
I am Single, Giving, and own a big warm heart
What I'm doing with my life
Don't overthink this one; tell us what you're doing day-to-day.
Enjoying it to the best of my abilities, perhaps differently than what others may do, but thats what makes us each individuals.
Waiting for that 1 special person to want to be a part of my life.
Waiting for that 1 special person to want to be a part of my life.
I'm really good at
Go on, brag a little (or a lot). We won't judge.
Accepting others for who and what they are.
The first things people usually notice about me
I'm an empty essay… fill me out!
My eyes (of all things, go figure).
Favorite books, movies, shows, music, and food
Help your potential matches find common interests.
Favorite movie, one that is really old but always brings tears rolling down the face, Danny Kaye and Louis Armstrong in "FIVE PENNIES"
The six things I could never do without
Think outside the box. Sometimes the little things can say a lot.
My daughter, the phone to be able to talk to her, air, people in my life, hhmmm 3 is that good enough for a start ?? I would say love but since there isn't any in my life and I've been doing without...........
I spend a lot of time thinking about
Global warming, lunch, or your next vacation… it's all fair game.
My daughter and where my life is headed
The most private thing I'm willing to admit
I'm an empty essay… fill me out!
If I admitted it here, it wouldn't be private anymore !!
You should message me if
Offer a few tips to help matches win you over.
You're interested in seriously getting to know more about me and know what you want for yourself in life. Feel ayou can accept me for who and what I am just as I would do for you.
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text:
Join Now
Join ePHOTOzine, the friendliest photography community.
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This is my first submission, this is a portrait of Frank, an elderly relative who is not usually easy to capture. I was pleased to capture him in this relaxed moment before he noticed the camera, I shot this the moment he looked in my direction to see that I had the camera. A moment later and his composure would have changed.
I chose B&W as I think it gives the right mood for a gentleman from this generation and it masks the changes in pigmentation that tends to occur to skin with people in their 80's like he is, giving a more flattering result.
Converted to B&W using Aperture
ISO 100, 70mm, +0.7ev, f8, 1/250
I think pushing the lens to the full 70mm end is not great, but am trying to get the most out of the kit lens before getting some new glass.
|Sony Alpha 200
|Recording media:
|RAW (digital)
|Being Frank
|29 Jul 2010 - 8:28 PM
|Black & white, Portraits / people
|VS Mode Rating
100 (33.33% won)
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Nominating Constructive Critique
I agree with everything you have to say, and think you have been very kind to this gentleman by presenting his portrait in mono. I feel he is a little tight in the frame, but you were probably concerned about the bits and pieces in the background, and because it was a quick shot, there was probably little you could do about setting up any alternative. Love his whispy hair and sparkling eyes.
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Nominating Constructive Critique
Yes it was a wedding anniversary party so there was a lot of activity going on in the background.
Nominating Constructive Critique
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Lots going on at picturesque Strawhouse Café
Long before their business started appearing in pages of National Geographic Traveler (May 2014), Sunset magazine (twice), Via and others, the owners of the Strawhouse Café simply wanted to serve the best coffee and espresso they possibly could. That sentiment remains a priority for Don and Julia Ellis, however there's a lot more going on these days at the picturesque establishment along the banks of the Trinity River in Big Flat.
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by Oman Sail
Kieler Woche (Kiel Week) 2014 is being held from from June 21 to 29. Oman Sail's magnificent MOD70 racing machine Musandam-Oman Sail will be flying the flag for the Sultanate of Oman in Germany next week when the mixed Omani and European sailing team takes pride of place at the world's largest sailing event and Northern Europe's biggest summer festival.
Kieler Woche (Kiel Week) 2014
Over nine days from June 21-29, the Baltic Sea port festival is expected to attract around three million visitors, guaranteeing some high volume exposure for the Omani boat which will be supported by a special shoreside exhibition to promote Oman as a premium tourist and sailing destination.
Practice race - 2015 J22 North American Championship
Mr Salim Al Maamari, Director General of Tourism Promotion at the Ministry of Tourism of Oman said Kieler Woche offers a valuable opportunity to spread the country's message: 'Kieler Woche is one of the most important European sailing events, and one of the biggest with three million people expected to visit during the week-long event, in which 4,500 crew members and 1,800 boats will be competing.
'The presence of the Ministry of Tourism Exhibition Pavillion and also Musandam-Oman Sail, our flagship sailing campaign, during this festival is an unparalleled opportunity for Oman to speak directly to its target tourism market.'
As well as representing the Sultanate, the crew onboard Musandam-Oman Sail will be focussed on setting a new record in the 28 nautical mile Welcome Race from Kiel to Eckernfoerde with a target of 2 hours 6 minutes and 50 seconds set by the SAP Extreme 40 in 2013 to beat.
Ireland's greatest sailor Damian Foxall will skipper the Oman Sail flagship in the absence of Sidney Gavignet (who is training with the M34 team for the Tour de France a la Voile) with the help of one of Oman's star sailors Mohsin Al Busaidi who in 2009 became the first Arab to sail around the world, plus two Omani sailors new to MOD70 racing Sami Al Shukaili and Yassir Al Rahbi.
2012 MOD70 ET Kiel City Race - Kieler Woche (Kiel Week) 2014
Two of Germany's leading offshore sailors Anna-Maria Renken and Tim Kroger will also join the team for Kiel Week lending some key local knowledge to the team.
'It will be very nice to sail the MOD70 again,' said Mohsin Al Busaidi. 'We are very much looking forward to returning to Germany.
'Aside from Damian, our team does not have much MOD70 experience, so we will be learning the ropes a bit in the absence of the wider squad that includes Fahad Al Hasni and Sidney Gavignet,' he added. 'But having said that, we will be trying our hardest. We are all looking forward to it!'
Shoreside, the Oman Sail team will be having their own race, to see how many visitors they can introduce to Oman at the Exhibition Pavilion, which was extremely popular when it was last in Kiel two years ago.
VX ONE Winter Series 2014
With regular direct flights between Germany's Frankfurt and Munich to Muscat in Oman, interest levels were high in 2012 as representatives from the Ministry of Tourism talked guests through a range of unique experiences in sailing, adventure and nature activities illustrated in images throughout the exhibition and treated them to traditional Omani hospitality that included strong Omani coffee and succulent dates.
The Pavilion hosts are expecting another surge of interest in 2014 as the word about Oman's appeal starts to gain momentum.
2012 MOD70 ET Kiel City Race - Kieler Woche (Kiel Week) 2014
Practice race - 2015 J22 North American Championship
Practice race - 2015 J22 North American Championship


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I was a bit disappointed in this item. It was the perfect size, which I had a hard time finding. However, the glass had some scratches on it and the weight of the glass, matched with the design of it, has the glass tilting forward, instead of staying level. I would not recommend this item.
- Did the color match the color displayed onsite? Yes
- How is the quality of the product? OK
We recently remodeled our bathroom and the 16" glass shelf is a perfect fit for our space. The brushed nickel finish matches the faucets. It was easy to install with the template that came with the instructions and it looks very nice! Thanks for the good service. It was received in less than a week.
Great quality and beautiful! I looked everywhere for a 16-inch shelf--they are hard to find. Most are 20+ inches and I didn't have that much space to work with. The box was unmarked and a bit tattered, but when I saw the shelf, I was delighted. It is heavy duty and finished nicely. It fastened to the wall very securely. I have several heavy things sitting on it and no fear it will fall off the wall. The brushed or satin nickel matches our Kohler satin nickel bathroom fixtures. I highly recommend this product. The photo doesn't do it justice.
This shelf is made of heavy glass and is of good quality, however it did not include a vital part to put it together. It is missing an allen wrench. Typical overstock problem.
This shelf is very attractive.. Nice solid look, very good quality. The glass has a substantial quality to it, thick and hinting of the sea-glass color you get with this type of glass on the edge. Installs similarly to mounting a towel bar. You do loose some real estate with the 'ball' nuts that come through the glass.


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Is this a picture of a young Fabio with tits???
LOL. Holy shit I almost spit my drink on the computer screen. Bravo.
Buffalo Bill is way hotter
She must do a chin surgery that implies a little bit of bone trimming. Quite a bit actually.
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A few years ago, the editors of Guitar World compiled what we feel is the ultimate guide to the 100 Greatest Guitar Solos of All Time.
The list, which has been quoted by countless artists, websites and publications around the world, starts with Richie Sambora's work on Bon Jovi's "Wanted Dead or Alive" (100) and builds to a truly epic finish with Jimmy Page's solo on "Stairway to Heaven" (01).
To quote our "Stairway to Heaven" story that ran with the list, "If Jimmy Page is the Steven Spielberg of guitarists, then 'Stairway' is his Close Encounters."
On June 10, we kicked off a summer blockbuster of our own — a no-holds-barred six-string shootout. We pitted Guitar World's top 64 guitar solos against each other in an NCAA-style, 64-team single-elimination tournament. Every day, we asked you to cast your vote in a different guitar-solo matchup as dictated by the 64-team-style bracket. Now Rounds 1, 2, 3 (Sweet 16) and 4 (Elite Eight) have come and gone, leaving us with a mere four guitar solos!
So ...
WELCOME TO THE FINAL FOUR, where last the four still-standing solos will go head to head before your eyes! As always, you can vote once per matchup, and the voting ends as soon as the next matchup is posted.
As we've been saying since June 10, genre might clash against genre in these last few polls. But get real, people! They're all guitar solos, played on guitars, by guitarists. When choosing, it might have to come down to, "Which solo is more original and creative for its time? Which is more iconic or important? or Which one kicks a larger, more impressive assemblage of asses?"
Results from the Final Sweetwater Elite Eight Matchup
Winner: "Comfortably Numb" (54.16 percent)
Loser: "Mr. Crowley" (45.84 percent)
Today's Sweetwater Final Four Matchup (1 of 2)
"Eruption" Vs. "Voodoo Child (Slight Return)"
Welcome to the Final Four! Today we'll kick things off with tunes by two rock heavyweights: Eddie Van Halen's "Eruption" (02) against Jimi Hendrix's "Voodoo Child (Slight Return)" (11). Which classic guitar solo should advance to the final matchup? Only you can decide!
• "Eruption" defeated Red Hot Chili Peppers' "Scar Tissue" (63) in Round 1, Ted Nugent's "Stranglehold" (31) in Round 2, Jimi Hendrix's "Little Wing" (18) in the Sweet 16 round and Eric Clapton's solo on "While My Guitar Gently Weeps" (42) in the Elite Eight round.
• "Voodoo Child (Slight Return)" defeated Smashing Pumpkins' "Geek USA" (54) in Round 1, Dire Straits' "Sultans of Swing" (22) in Round 2, Led Zeppelin's "Whole Lotta Love" (38) in the Sweet 16 round and Lynyrd Skynyrd's "Free Bird" (03) in the Elite Eight round.
Vote now! You'll find the poll at the very bottom of the story.
02. "Eruption"
Soloist: Eddie Van Halen
Album: Van Halen—Van Halen (Warner Bros., 1978)
It is hard to imagine a more appropriately titled piece of music than Edward Van Halen's solo guitar showcase, "Eruption." When the wildly innovative instrumental was released in 1978, it hit the rock guitar community like a hydrogen bomb. Two-handed tapping, gonzo whammy bar dips, artificial harmonics—with Van Halen's masterly application of these and other techniques, "Eruption" made every other six-stringer look like a third-stringer.
But the most remarkable thing, perhaps, about the unaccompanied solo is that it almost didn't make it on to Van Halen's debut album.
"The story behind 'Eruption' is strange," says Van Halen. "While we were recording the album, I showed up at the studio early one day and started to warm up because I had a gig on the weekend and I wanted to practice my solo-guitar spot. Our producer, Ted Templeman, happened to walk by and he asked, 'What's that? Let's put it on tape!'
"I played it two times for the record, and we kept the one that seemed to flow. Ted liked it, and everyone else agreed that we should throw it on the album. I didn't even play it right—there's a mistake at the top end of it. Whenever I hear it, I always think, Man, I could've played it better."
As for the distinctive echo effect on the track, Eddie recalls that he used a relatively obscure unit—a Univox echo chamber. "It had a miniature 8-track cassette in it, and the way it would adjust the rate of repeat was by the speed of the motor, not by tape heads. So, if you recorded something on tape, the faster you played the motor back, the faster it would repeat and vice versa. I liked some of the noises I got out of it, but its motor would always burn out.
"I like the way 'Eruption' sounds. I'd never heard a guitar sound like that before."
11. "Voodoo Child (Slight Return)"
Soloist: Jimi Hendrix
Album: The Jimi Hendrix Experience—Electric Ladyland (Experience Hendrix/MCA, 1968)
Jimi Hendrix's publicist, Michael Goldstein, had successfully arranged for ABC-TV to produce a short news feature based primarily on the Experience's triumphant success in America. Filming began on May 3, 1968, with 16mm cameras capturing the recording of "Voodoo Child (Slight Return)," which, like many Hendrix songs, borrowed both musical and lyrical themes from Muddy Waters and other Delta bluesmen.
" 'Voodoo Child' was something Jimi brought in, and we learned that song right on the spot in front of the cameras," recalls bassist Noel Redding. "We ran through it about three times, and that was it."
It is not known whether ABC ever used any of the footage. And, unfortunately, all the camera originals were stolen from ABC's archives sometime after Jimi's death. The reel also included footage of the group performing at the Fillmore East and the Miami Pop Festival.
Engineer Eddie Kramer recalls: " 'Voodoo Child (Slight Return)' was recorded the day after Jimi tracked 'Voodoo Chile,' the extended jam on Electric Ladyland featuring Traffic's Stevie Winwood on organ and Jefferson Airplane bassist Jack Casady. Basically, Jimi used the same setup—his Strat through a nice, warm Fender Bassman amp. Jimi's sound on both tracks is remarkably consistent, leading some to think they were recorded at the same session."
[[ When you're done voting, start learning most of the guitar solos in this poll — and and a whole lot more! Check out a new TAB book from Guitar World and Hal Leonard: 'The 100 Greatest Guitar Solos of All Time: A Treasure Trove of Guitar Leads Transcribed Note-for-Note, Plus Song Notes for More Than 40 of the Best Solos.' It's available now at the Guitar World Online Store for $29.99. NOTE: Neil Young's "Cortez the Killer" guitar solo (solo number 39 on our list) is NOT included in this book. ]]
Head HERE to see the current matchup and all the matchups that have taken place so far!
Van Halen to Perform on the 2015 Billboard Music Awards, May 17 (5/4/2015)
Billboard and Dick Clark Productions have announced that one of the greatest rock and roll bands of all-time, Van Halen, will perform on the 2015 Billboard Music Awards, marking the band's first-ever performance on an awards show with Eddie, Ale...
Jimi Hendrix's Playing Secrets Revealed in New Lesson Series! (4/30/2015)
Jimi Hendrix Playing Secrets, Guitar World's exclusive new lesson series, is now available through the Guitar World Lessons App and Webstore. It joins the ranks of the hundreds of lessons already available through Guitar World Lessons.
Eddie Van Halen Discusses 'Tokyo Dome Live in Concert,' Van Halen's First Official Live Record with David Lee Roth (4/22/2015)
Van Halen accomplished a lot during the seven and a half years between the release of the band's debut album in 1978 and David Lee Roth's departure from the band in 1985. However, one thing Van Halen never did during that period was release an ...
The Eddie Van Halen Tremolo Mechanic — Video (4/6/2015)
Van Halen's recent Jimmy Kimmel Live performance affords an almost perfect glimpse of Eddie Van Halen's legendarily unique approach to tremolo picking. The incredible speed and consistency of his take on this technique has been a source of fasci...
Van Halen Perform "Hot for Teacher," "Eruption" and "You Really Got Me" on 'Jimmy Kimmel Live' — Video (4/1/2015)
As we reported yesterday morning, ABC's Jimmy Kimmel Live closed down part of Hollywood Boulevard Monday night so that Van Halen could perform in front of 6,000 die-hard fans. The first half of the band's outdoor performance, which included "Pan...
Van Halen Perform "Panama" and "Runnin' with the Devil" on 'Jimmy Kimmel Live' — Video (3/31/2015)
It took a few decades, but Van Halen finally performed on live TV in the U.S. with David Lee Roth. Last night, a portion of Hollywood Boulevard was shut down so the band could perform before a crowd of about 6,000 die-hard fans (and a few last-m...
Van Halen Announce 2015 North American Tour (3/25/2015)
Van Halen will tour North America this summer and fall in support of their new live album, Tokyo Dome Live in Concert. The tour, which will feature David Lee Roth at vocals, is expected to kick off July 5 in Seattle and wrap up October 2 in Los...
Jimi Hendrix's Curtis Knight Recordings to Be Released in March — Hear "Hornet's Nest" (2/24/2015)
On March 24, we'll finally get to hear early recordings of Jimi Hendrix when he was a member of Curtis Knight and the Squires. A new album, You Can't Use My Name: Curtis Knight & The Squires (featuring Jimi Hendrix) The RSVP/PPX Sessions, wi...
Eddie Van Halen Plays Guitar (and Discusses Innovation) at the Smithsonian (2/13/2015)
Last night (February 12), Eddie Van Halen spoke at Washington, D.C.'s Smithsonian National Museum of American History and Zocalo Public Square as part of the institution's "What It Means to Be American" series. The Dutch-born Van Halen, 60, dis...
Crosstown Traffic: Dave Mason Talks "Traffic Jam" Tour and Recording with Jimi Hendrix (2/11/2015)
Dave Mason's name is synonymous with Traffic, a legendary British band that was inducted into the Rock and Roll Hall of Fame in 2004. These days, the guitarist can be found doing shows from coast to coast with his "Traffic Jam" project. But Mas...
Daft Punk's "Get Lucky" in the Styles of 10 Guitarists, from Steve Vai to Eddie Van Halen — Video (2/11/2015)
Like most of you, I've often wondered what it would sound like if 10 of the world's most famous guitarists got together and jammed on Daft Punk's "Get Lucky." I'm joking, of course. However, Andre Antunes actually thought about this topic. He ev...
Micky Dolenz Talks Music, Monkees, Jimi Hendrix and The Beatles (2/6/2015)
Fifty years ago, Micky Dolenz's agent called him about an audition for a new pilot about music and comedy. It was the beginning of a journey that would take Dolenz, Davy Jones, Michael Nesmith and Peter Tork to the world of super-stardom. ...
Doug Wimbish, 11-Year-Old Brandon Niederauer and Friends Play Jimi Hendrix's "Voodoo Child (Slight Return)" — Video (2/5/2015)
Even though the 2015 Winter NAMM Show has come and gone, there's still a fair amount of NAMM coverage in the pipeline. Case in point, this new video of a fine performance at the Behringer/Bugera booth at the Anaheim Convention Center. Below, che...
Foo Fighters Enlist Van Halen's David Lee Roth, Slash, Kiss' Paul Stanley and More for Dave Grohl's Birthday Show (1/12/2015)
Late last week, when Foo Fighters told the universe about frontman Dave Grohl's "surprise" birthday show scheduled for this past Saturday at the Forum in LA, we knew we'd have some interesting clips to share with you this morning. Turns out we w...
In Deep with Andy Aledort: Constructing Solo Phrases in the Style of Jimi Hendrix (12/30/2014)
These videos and audio files are bonus content related to the February 2015 issue of Guitar World. For the full range of interviews, features, tabs and more, pick up the new issue on newsstands now or at the Guitar World Online Store. All things...
Jimi Hendrix Biopic, 'All Is By My Side,' to Be Released on DVD January 13 (12/5/2014)
If you—like a lot of us—haven't seen Jimi: All Is by My Side, the Jimi Hendrix biopic that was released earlier this year, you're in luck. It'll be released on DVD and Blu-ray January 13. The movie, which was written and directed by Academy Awar...


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'We are happy you are with us'Comment on this story
Pretoria - President Jacob Zuma thanked about 18 000 people on the lawns of the Union Buildings for attending his inauguration on Saturday and for supporting the ANC.
"Thank you very much for coming to be with us today as we take the oath for the next five years," he said.
"In the last few weeks...we were all over the country campaigning...and finally the people of this country made their choice emphatically to give the ANC once again the opportunity to govern the country."
Zuma said he was happy so many people came.
"Today we are taking the oath as mandated by the overwhelming majority of this country. We are happy you are with us here." The crowd waved and cheered as he spoke, some waving South African flags. - Sapa
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I thought this turned out really well. This is the praise team at my church. Yea, that's me on bass!
I'm really enjoying this new Android Wear watch face. It's called Bits. Free in the play store.
The Sky was pretty scary for a while. Luckily, it was over with in about twenty minutes.
So if you know me, and I mean you are a real life friend, or family member, you know that I love Chromebooks. I am a proponent. I'm convinced that they are the perfect choice for most of the non-tech public that I know! Very secure, fast boot times, great battery life, and compact. But even I will admit that Chromebooks could be so much more when it comes to the hardware choices that most manufacturers make. Most of these devices are almost always lots of plastic, and run with a minimal configuration when it come to whats inside. (2 gigs of RAM and 16 Gigs of storage) Often, the display choices at the $200 pricepoint is barely decent. One bit of good news is there are a many models now that come in all shapes, sizes and configurations. Some have touch screens, some have Intel Processors, Some include HD displays, some include 360 degree displays to turn your computer into a touch screen web tablet. . . . But if you want an aluminum body, touch screen, HD display, backlit keyboard, USB C connection all in one Chromebook, then be prepared for real hurt on your wallet, because we are now talking the $1000+ Chrome Pixel.
I am an Avid G+ user! I hangout most weekdays evenings in a room called Tech and Coffee. Click on the Cup to go directly to the Hangout.
By day I try to keep a Chemical Company safe. But on my time, I seem to have an obsession with Technology. I've been following mobile advancements in Technology since the mid-90s. I've used Palm OS, Windows Mobile, iOS and Android devices. With this experience comes a lot of opinion. I offer those opinions here.


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- 112Promote
Canvas Print
mindscape 1by Garima Dhawan
Fine art print on bright white, fine poly-cotton blend, matte canvas using latest generation Epson archival inks. Individually trimmed and hand stretched museum wrap over 1-1/2" deep wood stretcher bars. Includes wall hanging hardware.
"The mind is everything. What you think you become." - Buddha
very cool piece. love the colors Garima!
Love this minimalism ♥♥♥
Thanks so much RvHART & Magdalla...I am excited about this series.
Thanks so much micklyn!
gorgeous as ever!!
Beautiful colors!
Great color combo, Garima!
your prints are beautiful, full of sunshine!
Love :)
Beautiful colours!
Thanks so much Eric, Nandita, Natt ;-), Judith, TheCore & anipani ♥
So simple yet it looks so good, loving these colors! :)
love the warm color in the middle in this one, it pulls it all together, very pretty :)
Thanks so much Rich! Yes its really fun to just play with colors and how they work next to each-other.
Thanks so much Linn!
Thanks so much Pame!
Fun colours
Lovely colors!
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Dee Anna McPherson
Revolving Door (1)
Who's coming and who's going. Tell us about your job move! Receive the Revolving Door Newsletter with expert analysis by email twice a week.
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Spotted around the media universe
Yammer VP Of Marketing Dee Anna McPherson Assumes Same Role At HootSuite - Posted March 13, 2013
Social-media-management platform HootSuite has a new vice president of marke... [AllFacebook]


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Alliance for Nursing Informatics
Our Vision: Transform health and health care through nursing informatics
Our Mission: To advance nursing informatics practice, education, policy, research and leadership through a unified voice of nursing informatics organizations.
We represent thousands of nurses and bring together nursing informatics groups that function separately at local, regional, national and international levels.
One of ANI's objectives is to identify leadership, provide mentorship, and encourage nursing informatics participation in national nursing informatics activities. As part of this objective, we support the ANI Nursing Informatics Emerging Leaders Program. Explore the ANI Emerging Leader Website for more info. Application Deadline – October 30, 2015.
ANI Consumer eHealth Toolkit
Nurses are the most-trusted health professionals and have a long history of patient advocacy. We expect nurses to have a significant impact on consumer participation in Health IT to increase use of Personal Health Records and Patient Portals from 10% today to over 25% in the next 2 years


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Just getting started learning WP but do have web experience. I'm about to make the decision on the sites folder architecture and could use some advice.
I understand wp is installed in a folder that doesn't necessarily have to be the root (i.e. could be a subfolder). Is there any wisdom on which architecture to choose? There's only going to be one hosted site in the root area. (I do have another host area where there are multiple "sites" but I'll ask about that in a later post).
One thought is to have a folder structure outside the folder with wp installed to take advantage of being able to organize the non-wp folder structure and leave the wp structure "native". This means I could store much of the media outside the wp folder and link to it.
Sorry if I'm not asking a very specific question. I'm early in the wp learning curve.
Maybe the question is "what are the best site folder architectures for wp sites"?


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>Sonora / Tuolumne News, Sports, & Weather, Angels Camp, Twain Harte, Jamestown | Union Democrat
Anthony Tony' John Botell
Sept. 27, 1939 May 4, 2004
Anthony "Tony" John Botell of Groveland died Tuesday at his home. He was 64.
He was born in Kings Norton, England, and lived in Groveland for five years. He worked as a beverage distributor for 35 years.
His family said he enjoyed traveling, camping, hiking, gardening, kayaking, reading and music.
Mr. Botell is survived by his wife of 20 years, Carolyn Botell of Groveland; sons and daughter-in-law, Bob Botell of Dublin and Tom and Jennifer Botell of Red Bluff; a daughter and son-in-law, Lisa and Rob Ching of England; a sister and brother-in-law, Joan and Jerry Johnson of San Leandro; grandchildren, Katrina, Brittany and Tom Botell, Matthew Ranford and Alister Ching; nieces and nephews, Nicola Hull and John Johnson, both of Missouri, James Johnson of Tahoe, Nev., and Rebecca Corral of the Bay Area; many great nieces and nephews; many cousins, aunts and uncles in the United States and England; and his parents, Tom and Dorothy Botell of England.
No services are scheduled.
Terzich and Wilson Funeral Home is handling arrangements.
The Union Democrat is now online in a Replica E-edition form and publishes Tuesday through Saturday. E-Edition or Print Plus subscribers have full access.
If you are not a current subscriber, subscribe today for immediate access. Circulation: 209-533-3614
Weekly Arts and entertainment guide for Calaveras and Tuolumne counties
Available online every Friday or get it early in Thursday's print edition.