- Delivery from India up to 20 days.
- The minimum order is 4 packs.
- Pack of 30 tablets.
Tudobest L (Lamivudine 300mg + Tenofovir 300mg) buy at profitable price in India
Tudobest-L is indicated for adult patients weighing over 40 kg with HIV infection.
Pharmacodynamics
Tenofovir: Tenofovir disrupts the development of transcriptase, destroys the usual substrate deoxyadenosine-5'-triphosphate and after being added to DNA with a viral DNA strand eliminator. Tenofovir is used to stop the synthesis of viral DNA, which is necessary for the strand removal process.
Lamivudine belongs to the class of synthetic nucleoside analogs. Lamivudine is phosphorylated intracellularly to the active 5'-triphosphate metabolite (lamivudine triphosphate 3TC-TP). This active metabolite is involved in the prevention of reverse transcriptase through chain termination after nucleotide analog infusion.
Pharmacokinetics
Suction
The maximum concentration of tenofovir in blood plasma is: 1 hour ± 0.4 hours and bioavailability is 25%
Lamivudine: 1.5 ± 0.5 μg / ml. The bioavailability of lamivudine is 80-87%
Distribution
Protein binding for tenofovir, lamivudine is <0.7-7.2% and 36%.
Metabolism
Tenofovir is metabolized into the cytochrome P450 enzyme, where trans-sulfoxide occurs during the metabolism of lamivudine, and biotransformation is catalyzed by sulfotrnsferases.
Withdrawal
Lamivudine is excreted unchanged in the urine by 5.2% ± 1.4% through the trans-sulfoxide metabolite.
The terminal half-life of tenofovir is 17 hours and that of lamivudine is 5-7 hours.
Method of administration and dosage
The drug is taken before meals.
To reduce the risk of neurological side effects, this drug should be taken at bedtime.
Renal failure:
Dosage adjustment is necessary for patients with baseline creatinine clearance <50 ml / min.
Liver failure:
In patients with mild to moderate hepatic impairment, dose adjustment is not required.
Geriatric Use: Use with caution in elderly patients.
Side effects
Lactic acidosis
Exacerbation of HBV
Kidney damage
Psychiatric problems
Nerve problems
Skin problems
Liver toxicity
Decompensated liver cirrhosis
pancreatitis
Bone defects
Immune reconstitution syndrome
Redistribution of fat
Most common side effects
Headache, pain, fever, abdominal pain, back pain, asthenia, diarrhea, nausea, dyspepsia, vomiting, lipodystrophy, arthralgia, insomnia
Laboratory deviations
Elevated cholesterol, increased creatine kinase, increased AST and ALT, hematuria, neutropenia, increased serum amylase
Interaction
Viropil with CYP3A inducers causes an increase in drug clearance and leads to a decrease in plasma concentration.
Viropil with warfarin causes fluctuations in prothrombin time and INR values.
Viropil with anticonvulsants causes a decrease in the effect of the concentration of these drugs.
Viropil with antifungal, antidepressant or anti-infectious agents reduces the effect of the concentration of these drugs.
Viropil with antimalarial, antimycobacterial, calcium channel blockers or lipid-lowering drugs causes a decrease in the concentration of these drugs.
When interaction with metformin or dofetilide will lead to an increase in plasma concentrations of these drugs.
Interaction with food
There is a slight food interaction with the drug.
The diet should only be maintained after consulting a medical consultant.
Conventional food
Grapes and grape juice;
Oranges;
Products containing vitamins E, C;
Garlic;
Calcium supplements.
Contraindications
A hypersensitivity reaction occurs in patients while taking it with dofetilide.
Precautions
Severe hepatomegaly with stetosis / lactic acidosis: While the use of nucleoside analogs involves the use of lamivudine alone or a combination thereof, it is harmful to the fetus. Lamivudine should be used with caution in patients with liver disease with a known factor
Renal neoplasm or worsening: Cases such as acute renal failure and Fanconi syndrome have been reported with tenofovir. There are no data on safety and efficacy in patients with tenofovir. Routine monitoring of calculated creatinine and serum phosphorus clearance should be performed.
Patients coinfected with HIV-1 and HBV: A post-therapeutic exacerbation of hepatitis may occur in patients infected with both HIV-1 and HBV when changing the lamivudine regimen containing the HIV-1 regimen to the lamivudine regimen.
Pregnancy and lactation
Pregnancy category lamivudine: C
Pregnancy category tenofovir: B
The drug Tudobest-L crosses the placenta well, no birth defects were observed in the first trimester
This medication should be used with the likely benefits that justify the likely risk.
Breastfeeding should not be allowed.
Storage and handling
Store below 30oC
