Ladivine

Ladivin is an antiviral drug that directly affects HIV (Human Immunodeficiency Virus).

HIV belongs to the family of retroviruses, the subfamily of lentiviruses (slow viruses). The most important of them for modern medicine are the HIV-1, HIV-2 and SIV viruses. Infection occurs through contact of damaged skin, mucous membrane with biological fluids of the patient: blood, sperm, vaginal secretion, breast milk. The virus is not transmitted by airborne droplets or household means. HIV affects the cells of the immune system: monocytes, macrophages, T-helpers. In the cytoplasm of these cells, the synthesis of viral DNA begins, and the body's own cells die. As a result, the immune system is suppressed and acquired immune deficiency syndrome (AIDS) develops. There are 3 phases of the disease: acute, latent and terminal, as a result of which immunity is reduced so much that the body can no longer resist infections that are not dangerous for healthy people. Bacterial, fungal, viral and protozoan infections, tumors occur, which leads to the death of the patient if antiretroviral therapy is not carried out. According to statistics, there are about 35 million people in the world diagnosed with HIV.

Indications Ladivine

In people infected with HIV, death occurs on average 9-11 years after infection in the absence of antiretroviral therapy. Antiretroviral drugs prevent HIV from reproducing in the cells of the human immune system, blocking their penetration into cells and disrupting the process of assembling new viruses at different stages. Timely treatment with antiretroviral drugs reduces the risk of developing AIDS and subsequent death by hundreds of times. It should be remembered that antiretroviral drugs cannot cure HIV infection, and patients taking this therapy can still transmit HIV to others. Indications for the use of Ladivin are monotherapy of HIV-infected adults and children with progressive disease, as well as in combination with cidovudine. Treatment with Ladivin is not affected by whether the patient has previously received antiretroviral drugs.

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Release form

Many tablet medications are coated. This is done in several cases: to protect the unstable contents of the tablet from the destructive action of gastric and intestinal juice, or, conversely, to protect the mucous membrane of the internal organs of a person from the negative effect of the drug. Therefore, you should never divide a coated tablet with a knife or dissolve it in your mouth, waiting for the outer coating to melt! The tablet should be swallowed whole, washed down with water (unless otherwise specified in the instructions). The active substance of Ladivin is lamivudine. Ladivin is available in the form of coated tablets of 150 mg in packages of 10 and 100 tablets.

Pharmacodynamics

Among other retroviral drugs, Ladivin is considered a strong inhibitor of HIV-1 and HIV-2. The main mechanism of antiviral action of Ladivin is the wedging of monophosphate into the DNA chain of the HIV virus, which disrupts and stops its replication. It should be noted that Lamivudine inhibits the HIV virus within tumor cells and in blood lymphocytes, monocyte-macrophage lines, so Ladivin can be used to treat such manifestations of AIDS. When used in combination with cidovudine or zidovidine (international nonproprietary name recommended by WHO - cidovudine) slows the development of viral resistance to cidovudine in patients who have not previously received treatment.

Pharmacokinetics

Ladivin is well absorbed in the gastrointestinal tract. Approximately 80-85% of the drug, released from the dosage form - a coated tablet, enters the bloodstream and interacts with cellular targets - that is, its bioavailability in an adult. The average distribution volume is 1.3 l / kg. Ladivin is excreted mainly in the urine by renal excretion in an unchanged form. This should be taken into account when treating patients with impaired renal function. The half-life is 5-7 hours.

Dosing and administration

Ladivin is prescribed to adults and adolescents (12 to 16 years old) at 150 mg 2 times a day (in combination with cidovudine at a dose of 600 mg / day, divided into 2 or 3 doses). Children from 3 months are prescribed at the rate of 4 mg per 1 kg of body weight 2 times a day, up to a maximum dose of 150 mg 2 times a day (in combination with cidovudine at a dose of 360-720 mg / m ² per day, divided into several doses). The maximum daily dose of lamivudine is 300 mg, cidovudine - 200 mg every 6 hours. For adults weighing less than 50 kg, Ladivin is prescribed at a dose of 2 mg per kg of body weight 2 times a day, used in combination with cidovudine. In patients with renal insufficiency, the dosage regimen must be adjusted taking into account creatinine clearance: at a level of more than 30 ml/min, lamivudine is used at a dose of 150 mg once a day; at a level of 5–30 ml/min, periodically at a dose of 150 mg once a day.

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Use Ladivine during pregnancy

Unfortunately, the generally applicable thesis "during pregnancy - drugs in extreme cases" does not apply to HIV-infected pregnant women. All pregnant women with an acute phase of HIV infection should begin immediate treatment with antiretroviral drugs to prevent transmission of HIV to the fetus. However, the selection of the drug should be made by the attending physician. There are no direct indications of the teratogenic effect of Ladivin, or changes in reproductive function due to treatment with it. The doctor prescribes Ladivin to pregnant women only after analyzing the expected effect for the woman and the risk to the fetus.

Contraindications

Ladivin is contraindicated in neutropenia (neutrophil granulocyte count less than 0.75x10 ⁹ /l, severe anemia (decrease in hemoglobin level to 7.5 g / dl), severe renal failure (creatinine clearance less than 5 ml / min), hypersensitivity to lamivudine, zidovudine. It should be used with caution in patients with liver cirrhosis caused by the hepatitis B virus, given the risk of hepatitis after discontinuation of lamivudine, hypersensitivity to any component of the drug, components of the drug.

Side effects Ladivine

When using Ladivin, unfortunately, general malaise, increased fatigue, headache, fever, pain and discomfort in the epigastric region, nausea and vomiting, diarrhea, paresthesia and peripheral neuritis, pancreatitis, neutropenia, thrombocytopenia, anemia, increased activity of liver transaminases, increased levels of amylase in the blood plasma, and the development of secondary infection are possible.

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Overdose

No cases of overdose have been reported. In any case, the patient should be monitored to prevent the development of toxic changes. General supportive therapy is administered if necessary. The antidote for Ladivin is unknown. It is also unknown whether Lavidin can be eliminated by peritoneal dialysis or hemodialysis.

Interactions with other drugs

When using Ladivin together with trimethoprim, the content of Ladivin in the blood plasma increases by 40%. Concomitant use of Ladivin with ganciclovir or foscarnet is not recommended. The use of paracetamol increases the likelihood of neutropenia, especially in the case of chronic therapy. Acetylsalicylic acid, codeine, morphine, indomethacin, ketoprofen, naproxen, oxazepam, lorazepam, clofibrate, cimetidine can change the processes of breakdown and absorption of Ladivin.

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Storage conditions

Ladivin is a potent medicinal substance. Please make sure that it does not fall into the hands of children under any circumstances! Also, do not store the drug in direct sunlight or without the appropriate primary packaging. Storage temperature - up to 25 degrees Celsius.

Shelf life

Ladivin, as an antiretroviral drug, is usually taken throughout the patient's life. Therefore, it is unlikely to be left lying around. However, always check the expiration date of the drug indicated on the package - the life of your loved ones or yourself depends on it.

The shelf life of Ladivin is 2 years from the date of production.