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Cimduo

Generic Name: lamivudine and tenofovir (la MIV ue deen and ten OF oh vir)
Brand Names: Cimduo
Cimduo (lamivudine and tenofovir disoproxil fumarate) is used to treat HIV infection. Includes Cimduo side effects, interactions and indications.
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Drug Information:
Cimduo contains a combination of lamivudine and tenofovir. Lamivudine and tenofovir are antiviral medicines that prevent human immunodeficiency virus (HIV) from multiplying in your body. Cimduo is used to treat HIV, the virus that can cause acquired immunodeficiency syndrome (AIDS). Cimduo is not a cure for HIV or AIDS. Cimduo is used in adults and children who weigh at least 77 pounds. Cimduo can cause serious side effects. Call your doctor at once if you have symptoms such as upper stomach pain, loss of appetite, dark urine, yellowing of your skin or eyes, bone pain, or muscle weakness. Learn more

Cimduo Side Effects

Cimduo Side Effects

Note: This document contains side effect information about lamivudine / tenofovir. Some of the dosage forms listed on this page may not apply to the brand name Cimduo.

For the Consumer

Applies to lamivudine/tenofovir: oral tablet

Warning

Oral route (Tablet)

Warning: Post Treatment Acute Exacerbations of Hepatitis BSevere acute exacerbations of hepatitis B have been reported in patients who are co-infected with hepatitis B virus (HBV) and human immunodeficiency virus (HIV-1) and have discontinued lamivudine or tenofovir disoproxil fumarate. Monitor hepatic function closely in these patients and, if appropriate, initiate anti-hepatitis B treatment.

Along with its needed effects, lamivudine / tenofovir may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking lamivudine / tenofovir:

More common

  • Fever
  • pain
  • stomach pain

Less common

  • Chest pain
  • chills
  • cough
  • difficulty in moving
  • joint pain or swelling
  • muscle ache, cramp, pain, or stiffness
  • sneezing
  • sore throat
  • tightness in the chest
  • troubled breathing

Incidence not known

  • Bloating
  • bloody urine
  • blurred vision
  • bone fractures, especially of the femur
  • bone pain
  • cloudy urine
  • constipation
  • dark urine
  • decreased appetite
  • decreased frequency or amount of urine
  • diarrhea
  • difficulty swallowing
  • dizziness
  • dry mouth
  • fast heartbeat
  • fast, shallow breathing
  • flushed, dry skin
  • frequent urination
  • fruit-like breath odor
  • general feeling of discomfort
  • hives, itching, skin rash
  • increased blood pressure
  • increased hunger
  • increased thirst
  • increased urination
  • increased volume of pale, dilute urine
  • indigestion
  • irregular heartbeat
  • large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
  • light-colored stools
  • loss of appetite
  • lower back or side pain
  • mood changes
  • muscle weakness
  • nausea
  • numbness or tingling in the hands, feet, or lips
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • pale skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • seizures
  • sleepiness
  • stomach discomfort
  • sweating
  • swelling of the face, fingers, or lower legs
  • troubled breathing with exertion
  • unexplained weight loss
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • upper right abdominal pain
  • vomiting
  • weight gain
  • yellow eyes or skin

Some side effects of lamivudine / tenofovir may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Anxiety
  • back pain
  • belching
  • burning, numbness, tingling, or painful sensations
  • discouragement
  • feeling sad or empty
  • headache
  • heartburn
  • indigestion
  • irritability
  • lack or loss of strength
  • loss of interest or pleasure
  • redistribution or accumulation of body fat
  • stomach upset
  • tiredness
  • trouble concentrating
  • trouble sleeping
  • unsteadiness or awkwardness
  • weakness in the arms, hands, legs, or feet

Incidence not known

  • Hair loss or thinning of hair

For Healthcare Professionals

Applies to lamivudine / tenofovir: oral tablet

General

In a controlled trial with lamivudine, tenofovir disoproxil fumarate (DF), and efavirenz, the most common side effects were mild-to-moderate gastrointestinal events and dizziness. Mild side effects (grade 1) were common and included dizziness, diarrhea, and nausea.

Metabolic

Very common (10% or more): Elevated fasting cholesterol (19%)

Uncommon (0.1% to 1%): Lipodystrophy, elevated fasting triglycerides

Frequency not reported: Higher 1,25 vitamin D levels

Lamivudine:

-Postmarketing reports: Hyperglycemia, lactic acidosis, redistribution/accumulation of body fat

Tenofovir DF:

-Postmarketing reports: Lactic acidosis, hypokalemia, hypophosphatemia

Combination antiretroviral therapy:

-Frequency not reported: Redistribution/accumulation of body fat (including central obesity, dorsocervical fat enlargement, peripheral wasting, facial wasting, breast enlargement, "cushingoid appearance")

Elevated fasting cholesterol (greater than 240 mg/dL) and fasting triglycerides (greater than 750 mg/dL) have been reported in 19% and 1% of patients using lamivudine, tenofovir DF, and efavirenz, respectively.

Lactic acidosis and severe hepatomegaly with steatosis (including fatal cases) have been reported with the use of nucleoside analogs.

Hypokalemia and hypophosphatemia may occur as a result of proximal renal tubulopathy.

Dermatologic

Very common (10% or more): Rash event (included rash, pruritus, maculopapular rash, urticaria, vesiculobullous rash, pustular rash; 18%)

Lamivudine:

-Postmarketing reports: Urticaria, alopecia, pruritus

Tenofovir DF:

-Postmarketing reports: Rash

Nervous system

Very common (10% or more): Headache (14%)

Common (1% to 10%): Dizziness

Uncommon (0.1% to 1%): Peripheral neuropathy (included peripheral neuritis, neuropathy)

Other

Very common (10% or more): Pain (13%)

Common (1% to 10%): Fever, asthenia

Lamivudine:

-Postmarketing reports: Weakness

Tenofovir DF:

-Postmarketing reports: Asthenia

Musculoskeletal

Very common (10% or more): Elevated creatine phosphokinase (12%)

Common (1% to 10%): Back pain, arthralgia, myalgia

Frequency not reported: Decreased bone mineral density, increased biochemical markers of bone metabolism (serum bone-specific alkaline phosphatase, serum osteocalcin, serum C telopeptide, urinary N telopeptide), clinically relevant fractures (excluding fingers and toes)

Lamivudine:

-Postmarketing reports: Muscle weakness, elevated creatine phosphokinase, rhabdomyolysis

Tenofovir DF:

-Postmarketing reports: Rhabdomyolysis, osteomalacia (manifested as bone pain and which may contribute to fractures), muscular weakness, myopathy

Elevated creatine phosphokinase (males: greater than 990 units/L; females: greater than 845 units/L) has been reported in 12% of patients using lamivudine, tenofovir DF, and efavirenz.

Rhabdomyolysis, osteomalacia, muscular weakness, and myopathy may occur as a result of proximal renal tubulopathy.

Gastrointestinal

Increased serum amylase (greater than 175 units/L) has been reported in 9% of patients using lamivudine, tenofovir DF, and efavirenz.

Pancreatitis (some cases fatal) has been reported in antiretroviral nucleoside-experienced pediatric patients using lamivudine alone or in combination with other antiretroviral agents.

Very common (10% or more): Diarrhea (11%)

Common (1% to 10%): Nausea, increased serum amylase, abdominal pain, vomiting, dyspepsia

Lamivudine:

-Frequency not reported: Pancreatitis

Tenofovir DF:

-Postmarketing reports: Pancreatitis, increased amylase, abdominal pain

Psychiatric

Very common (10% or more): Depression (11%)

Common (1% to 10%): Anxiety, insomnia

Genitourinary

Common (1% to 10%): Hematuria

Tenofovir DF:

-Postmarketing reports: Proteinuria, polyuria

Hematuria (greater than 100 RBC/high power field) has been reported in 7% of patients using lamivudine, tenofovir DF, and efavirenz.

Hepatic

Common (1% to 10%): Elevated AST, elevated ALT

Lamivudine:

-Postmarketing reports: Hepatic steatosis, posttreatment exacerbation of hepatitis B

Tenofovir DF:

-Postmarketing reports: Hepatic steatosis, hepatitis, increased liver enzymes (most commonly AST, ALT, GGT)

Combination antiretroviral therapy:

-Frequency not reported: Hepatic decompensation

Elevated AST (males: greater than 180 units/L; females: greater than 170 units/L) and ALT (males: greater than 215 units/L; females: greater than 170 units/L) have been reported in 5% and 4% patients using lamivudine, tenofovir DF, and efavirenz, respectively.

Lactic acidosis and severe hepatomegaly with steatosis (including fatal cases) have been reported with the use of nucleoside analogs.

Severe acute exacerbations of hepatitis B have been reported in patients coinfected with HIV-1 and hepatitis B virus after discontinuation of lamivudine or tenofovir DF.

Hepatic decompensation (some fatal) has been reported in patients coinfected with HIV-1 and hepatitis C receiving combination antiretroviral therapy for HIV-1 and interferon alfa with or without ribavirin.

Hematologic

Decreased neutrophils (less than 750/mm3) has been reported in 3% of patients using lamivudine, tenofovir DF, and efavirenz.

Common (1% to 10%): Decreased neutrophils

Lamivudine:

-Postmarketing reports: Anemia (including pure red cell aplasia and severe anemias progressing on therapy)

Respiratory

Common (1% to 10%): Pneumonia

Tenofovir DF:

-Postmarketing reports: Dyspnea

Renal

Tenofovir DF:

-Postmarketing reports: Renal insufficiency, acute renal failure, renal failure, acute tubular necrosis, Fanconi syndrome, proximal renal tubulopathy, interstitial nephritis (including acute cases), nephrogenic diabetes insipidus, increased creatinine

Hypersensitivity

Lamivudine:

-Postmarketing reports: Anaphylaxis

Tenofovir DF:

-Postmarketing reports: Allergic reaction (including angioedema)

Immunologic

Frequency not reported: Immune reconstitution syndrome, autoimmune disorders in the setting of immune reconstitution (e.g., Graves' disease, polymyositis, Guillain-Barre syndrome)

Endocrine

Frequency not reported: Higher serum parathyroid hormone levels

Editorial References and Review

Medically reviewed by BestRx Medical Team Last updated on 1/1/2020.

Source: Drugs.com Cimduo