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Cimduo

lamivudine / tenofovir
Used for HIV Treatment
Used for HIV Treatment

Cimduo (lamivudine / tenofovir) is a combination HIV antiretroviral (ARV) medication. It contains two ARVs from the same class of medications and is not a full HIV regimen. When used in combination with dolutegravir (Tivicay), it's a first-choice treatment option.

Last reviewed on April 27, 2022
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What is Cimduo (lamivudine / tenofovir)?

What is Cimduo (lamivudine / tenofovir) used for?

  • HIV treatment, in combination with other HIV ARVs

How Cimduo (lamivudine / tenofovir) works

Cimduo (lamivudine / tenofovir) is a combination tablet containing two ARVs from the same class of HIV medications. Lamivudine and tenofovir disoproxil fumarate are both nucleoside reverse transcriptase inhibitors (NRTIs). They insert themselves into the virus' DNA (genetic material) to stop the DNA-making process.

Drug Facts

Common BrandsCimduo, Temixys
Drug ClassHIV ARV combo
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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Avg retail price
$1383.85(save 15.20%)
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$1173.44
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What are the side effects of Cimduo (lamivudine / tenofovir)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Rash (18%)
  • Headache (14%)
  • Pain, including back, joint, and general pain (up to 13%)
  • Diarrhea (11%)
  • Depression (11%)
  • Fever (8%)
  • Nausea (8%)
  • Stomach pain (7%)
  • Anxiety (6%)
  • Lack of energy or weakness (6%)
^*Side effects listed above are for Cimduo (lamivudine / tenofovir) taken in combination with efavirenz (Sustiva)^

Other Side Effects

  • Upset stomach
  • Vomiting
  • Muscle aches
  • Trouble sleeping (insomnia)
  • Dizziness
  • Numbness and tingling in your limbs
  • Pneumonia

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • High blood acid levels (lactic acidosis): appetite loss, stomach pain, muscle pain, fast and shallow breathing, extreme tiredness, sudden weakness
  • Liver problems: fever, tiredness, nausea, vomiting, dark urine, clay-colored stool, stomach pain, yellowing of your skin and eyes
  • Kidney problems: swelling in your legs and feet, difficulty urinating, confusion, bone or muscle pain, pain in the arms or legs
  • Inflammation of the pancreas (pancreatitis): stomach pain that spreads to your back, nausea, vomiting, fast heartbeat

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
  • Bone pain
  • High lactic acid level—muscle pain or cramps, stomach pain, trouble breathing, general discomfort and fatigue
  • Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
  • Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
  • Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

pros-and-cons

Pros and cons of Cimduo (lamivudine / tenofovir)

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Pros

First-choice treatment option when used with another HIV ARV from a different class

Can be taken with or without food

One tablet contains two HIV ARVs; convenient

Can be used in children who weigh at least 77 pounds

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Cons

Not a good option for people who have kidney problems

Not a full HIV regimen since both ARVs work the same way

Interacts with other medications, including other HIV ARVs and hepatitis C treatment options

Can cause bone problems

pharmacist-tips

Pharmacist tips for Cimduo (lamivudine / tenofovir)

pharmacist
  • Take Cimduo (lamivudine / tenofovir) at the same time every day. This will keep the medication levels consistent in your body. You can take it with or without food.

    • For a complete HIV regimen, you'll have to take Cimduo (lamivudine / tenofovir) with at least one other HIV ARV. You don't have to take them at the exact same time of day, but doing so can make it easier for you to remember to take your medications.

      • Continue to take Cimduo (lamivudine / tenofovir) and your other HIV ARVs unless your provider tells you to stop. Contact your care team if you experience side effects that make it difficult for you to take your medications. There might be alternative treatment regimens.

        • Taking calcium and vitamin D supplements can help prevent bone problems while taking Cimduo (lamivudine / tenofovir).

          • Make sure your care team has a full list of the medications that you're taking so they can monitor for interactions. Also, don't start any new medications without talking to them as well. Many medications interact with Cimduo (lamivudine / tenofovir), such as hepatitis C medications, other HIV ARVs, antiviral medications, and over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., ibuprofen (Advil, Motrin)).

            faqs

            Frequently asked questions about Cimduo (lamivudine / tenofovir)

            What's the difference between Cimduo and Temixys?
            Cimduo and Temixys are two different brand names for the same combination of medications. Both tablets contain 300 mg of lamivudine and 300 mg of tenofovir disoproxil fumarate. They are made by two different manufacturers. Some insurance plans may only cover one of the two options.
            Who should take Cimduo (lamivudine / tenofovir)?
            Cimduo (lamivudine / tenofovir) is a combination tablet used for the treatment of HIV. It's an option for people who have never taken HIV ARVs in the past and for people who have experience with HIV ARVs, as long as they aren't allergic or resistant to the medications in Cimduo (lamivudine / tenofovir). It contains two different NRTIs, so it isn't a full HIV regimen and needs to be used with at least one other HIV ARV from another class.
            Can Cimduo (lamivudine / tenofovir) be used during pregnancy?
            Yes, in fact Cimduo (lamivudine / tenofovir) is one of the preferred NRTI combination tablets used during pregnancy. You're encouraged to enroll in the Antiretroviral Pregnancy Registry (APR) that monitors your health and your baby's health. If you're interested, ask your provider to help you enroll in the registry.
            Is it okay to take Cimduo (lamivudine / tenofovir) when you're breastfeeding?
            The CDC doesn't recommend people living with HIV to breastfeed, due to the risk of passing HIV to the breastfed infant.
            Can Cimduo (lamivudine / tenofovir) be used for the treatment of hepatitis B?
            Cimduo (lamivudine / tenofovir) is not approved for the treatment of hepatitis B in people who don't have HIV. Yet, it's a good option for people who have HIV and hepatitis B, since both ARVs work against the two viruses. For people who have HIV and hepatitis B, there's a chance your hepatitis B can worsen if you suddenly stop taking Cimduo (lamivudine / tenofovir). Don't stop taking your ARVs without talking to your provider.
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            What are the risks and warnings for Cimduo (lamivudine / tenofovir)?

            Cimduo (lamivudine / tenofovir) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

            risk-warning

            Worsening of hepatitis B

            • Risk factors: Hepatitis B virus (HBV) | Stopping Cimduo (lamivudine / tenofovir)

              Don't stop taking Cimduo (lamivudine / tenofovir) without talking to your provider, especially if you have a history of hepatitis B. Doing so can make your hepatitis B get worse. If you have hepatitis B and your provider has instructed you to stop the medication or switch to a different antiviral medication, make sure you follow up with your provider and get your labs drawn regularly. This is how your provider will monitor your liver and hepatitis B infection. Let your provider know if you experience symptoms of hepatitis B infection, such as fever, tiredness, nausea, vomiting, dark urine, clay-colored stool, or yellowing of your skin or eyes.

              risk-warning

              High acid levels in the blood (lactic acidosis) and liver damage

              Although rare, some people taking HIV medications similar to Cimduo (lamivudine / tenofovir) have experienced life-threatening blood acid problems and liver damage. Symptoms can include appetite loss, stomach pain with nausea or vomiting, muscle pain, fast and shallow breathing, extreme tiredness, and sudden weakness. Stop taking Cimduo (lamivudine / tenofovir) and go to the emergency room right away if this happens.

              risk-warning

              Kidney problems

              • Risk factors: History of kidney damage | Current or recent use of other medications that are known to harm kidneys

                Some people taking Cimduo (lamivudine / tenofovir) have developed kidney problems. It can happen right after starting the medication or over time. Try to avoid other medications that can also harm the kidney, like high doses of NSAIDs (e.g., ibuprofen (Motrin, Advil), naproxen (Aleve). Make sure you get your blood tests drawn regularly so your provider can monitor your kidneys. Let your provider know if you have symptoms of kidney problems, such as swelling in your legs and feet, difficulty urinating, or confusion. Contact your provider right away if you experience bone or muscle pain, pain in the arms or legs, or fractures, as these can be signs of a specific kidney problem.

                risk-warning

                Inflammation of the pancreas (pancreatitis)

                • Risk factors: Children who have a history of pancreatitis | Children who have taken NRTIs in the past

                  Some people might experience pancreatitis while taking Cimduo (lamivudine / tenofovir). Children who have taken NRTIs before, have a history of pancreatitis, or are at a high risk for pancreatitis should use Cimduo (lamivudine / tenofovir) with caution. Stop taking this medication and seek medical help right away if you or your child experiences stomach pain that spreads to the back, nausea, vomiting, fast heartbeat, or fever, as these could be signs of pancreatitis.

                  risk-warning

                  Bone problems

                  • Risk factors: History of bone fractures | Osteoporosis

                    Cimduo (lamivudine / tenofovir) can lower your bone mineral density (BMD) and weaken your bones. This can potentially lead to osteoporosis and raise your risk of fractures (broken bones). Many people take calcium and vitamin D supplements to help prevent this. Your provider might order additional tests to check your bone density if you have a fracture or other risk factors for bone problems.

                    risk-warning

                    Immune reconstitution syndrome (inflammation)

                    • Risk factors: Weakened immune system | Current untreated infection

                      Cimduo (lamivudine / tenofovir) can cause harmful inflammation in your body as it starts to work. As the medication helps your body fight against HIV, your immune system starts to recover and becomes more active in fighting other infections that you may have. Recovery of your immune system is good, but the inflammation that can result from this can be dangerous. This is called immune reconstitution syndrome. Your healthcare provider might check for opportunistic infections (underlying infections that can happen with a weakened immune system) before you start Cimduo (lamivudine / tenofovir), especially if it's your first time taking an HIV ARV. You might need medications to help treat any infections that your provider detects. Call your provider if you experience fever, difficulty breathing, or sudden changes in your health after starting Cimduo (lamivudine / tenofovir).

                      risk-warning

                      Fat distribution

                      Some people taking HIV ARVs have noticed changes in the way fat is stored in their body. This might show as more fat in the belly and upper back, and less fat in the face, arms, and legs. Scientists and healthcare providers don't really know why this happens.

                      dosage

                      Cimduo (lamivudine / tenofovir) dosage forms

                      The average cost for 30 tablets of 300mg/300mg of Cimduo (lamivudine / tenofovir) is $1173.44 with a free GoodRx coupon. This is 15.2% off the average retail price of $1383.85.
                      tablet
                      Tablet
                      DosageQuantityPrice as low asPrice per unit
                      300mg/300mg30 tablets$1173.44$39.11

                      Typical dosing for Cimduo (lamivudine / tenofovir)

                      The recommended dose is 1 tablet by mouth once a day, with or without food. Each tablet contains 300 mg of lamivudine and 300 mg of tenofovir disoproxil fumarate (TDF).

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                      How much does Cimduo (lamivudine / tenofovir) cost?

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                      What are alternatives to Cimduo (lamivudine / tenofovir)?

                      There are a number of medications that your doctor can prescribe in place of Cimduo (lamivudine / tenofovir). Compare a few possible alternatives below.
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