Triomune 40 Tablet

Buy Triomune 40 Tablets Online

Triomune is a fixed dose combination treatment for Human Immunodeficiency Virus (HIV) infection in adults. Triomune 40 Tablets are used to treat HIV patients who have already been treated with other HIV medications and have responded well to each of the drugs in the combination; and are also able to tolerate each of these medications, at the recommended doses without requiring a dose adjustment due to low weight. HIV impairs the immune system by attacking specific immune cells called CD4+ cells that are involved in fighting infection, which can lead to opportunistic life-threatening infection (infections that would not normally be harmful); also if too many CD4+ cells are destroyed this can result in acquired immune deficiency syndrome (AIDS).

Triomune tablets prevent or slow down the ability of HIV to replicate and spread, which keeps the amount of virus (viral load) down to a low level; allowing the numbers of CD4+ cells to increase, so that the immune system can recover, reducing the risk of disease progression. Triple drug therapy with Triomune 40 makes it easier to take the medications regularly, which helps improve compliance and helps prevent resistance of HIV to individual drugs.

How does Triomune work?

Triomune tablets contain a combination of 3 antiretroviral drugs stavudine, lamivudine and nevirapine, which are effective only against RNA viruses (retroviruses) like Human Immunodeficiency Virus (HIV). These three drugs each work by inhibiting the action of the viral-specific enzyme reverse transcriptase (RT) which is needed for the virus to be able to replicate. Retroviruses convert RNA to DNA, which is then integrated into the DNA of infected immune cells so that the virus can replicate. Nevirapine in Triomune 40 Tablets is a dipyridodiazepine derivative non-nucleoside reverse transcriptase inhibitor (NNRTI); nucleosides are the precursors to the building blocks of DNA and RNA.

Nevirapine in Triomune 40 Tablets acts by binding to a specific site on the RT enzyme, the enzyme’s active site known as the NNRTI pocket, disrupting the catalytic site of the enzyme, and blocking its action in a manner that is noncompetitive with nucleosides. Stavudine and lamivudine are both nucleoside analogue reverse transcriptase inhibitors (NRTI), which means that they block the action of RT by competing with one of the nucleosides needed to transcribe the viral RNA into DNA, becoming incorporated into the chain of newly synthesized viral DNA and preventing it from growing (chain termination). Stavudine is an analogue of thymidine and lamivudine is an analogue of cytidine.

The combined action of the three antiiretroviral drugs in Triomune tablets prevents the integration of the virus into the DNA of the infected CD4+ immune cell by 2 different mechanisms, which inhibits the replication of HIV so that no more virus can be produced and this reduces the viral load (amount of virus). Triomune 40 slows down the replication of HIV within your body but does not kill the virus already incorporated in the CD4+ cells or prevent the spread of the infection to others.

Adverse effects

Lactic acidosis is a potentially fatal side effect that has been reported with use of antiretroviral agents. If you notice nausea, vomiting and abdominal pain, difficulty breathing, loss of appetite, weight loss, or muscle weakness tell your doctor as soon as possible.

Side effects of triomune’s active ingredients include:

Stavudine: severe peripheral neuropathy (usually dose related, and more common in patients with advanced HIV infection or people who have previously experienced peripheral neuropathy

Lamivudine: nausea, vomiting, headaches, abdominal pain and discomfort, peripheral neuropathy, arthralgias, myalgias, skin rash, pancreatitis

Nevirapine: development of rash and liver toxicity (these can be potentially life-threatening so should be watched closely)

Warnings

• Do not take Triomune 40 Tablets if you had an allergic reaction to stavudine, lamivudine, or nevirapine.
• Triomune 40 Tablets may not be safe if you are pregnant or are breastfeeding.
• Triomune may be contraindicated in cases of kidney or liver disease.
• Triomune should only be taken after previous treatment for HIV, and more specifically treatment with nevirapine.

Triomune 40 Tablets can interact unfavorably with some other medicines. In some cases, these medicines may prevent Triomune from working as intended. In some cases, Triomune 40 Tablets may inhibit these other medicines. Triomune should not be taken with:

• doxorubicin
• ribavirin
• trimethoprim
• sulfamethoxazole
• rifampin
• other antiretroviral agents (efavirenz, indinavir, lopinavir, nelfinavir, saquinavir, etc)
• ketoconazole
• oral contraceptives
• methadone

Contraindication

Triomune 40 Tablets are contraindicated in patients with clinically significant hypersensitivity to any of the components contained in the formulation.

Triomune 40 Tablets are contraindicated in patients with moderate or severe (Childs- Pugh Class B or C, respectively) hepatic impairment

Triomune 40 Tablets are also contraindicated in patients who are just initiating therapy with nevirapine. These patients require a lead-in dose of nevirapine 200 mg o.d. whereas this formulation contains the maintenance dose of nevirapine 200 mg b.i.d.

Nevirapine is contraindicated for use as part of occupational and non-occupational post-exposure prophylaxis (PEP) regimens.

Overdosage

Lamivudine

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

Nevirapine

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

Stavudine

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

Frequently asked questions about Lamivudine

Can lamivudine cure hepatitis B?

Lamivudine is used to treat hepatitis B but some patients may be resistant to this drug

Can Lamivudine be crushed?

Lamivudine cannot be crushed but it can be broken into two parts to give it to children. Please go by the recommendation of the doctor

Can Lamivudine cause anemia?

Lamivudine may cause anemia as a side effect in some patients. Kindly consult your doctor in case any side effects are observed.

Frequently asked questions about Stavudine