Cimduo
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.
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
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)
Less Common Side Effects
- Upset stomach
- Vomiting
- Muscle aches
- Trouble sleeping (insomnia)
- Dizziness
- Numbness and tingling in your limbs
- Pneumonia
Cimduo (lamivudine / tenofovir) 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
The following Cimduo (lamivudine / tenofovir) 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):
- Back pain
- Diarrhea
- Fever
- Headache
- Nausea
- Skin rash
- Worsening mood, feelings of depression
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Pros and cons of Cimduo (lamivudine / tenofovir)
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
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 for Cimduo (lamivudine / tenofovir)
- 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)).
Common questions about Cimduo (lamivudine / tenofovir)
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.
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.
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.
The CDC doesn't recommend people living with HIV to breastfeed, due to the risk of passing HIV to the breastfed infant.
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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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.
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.
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.
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.
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.
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.
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).
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.
Cimduo (lamivudine / tenofovir) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 300mg/300mg | 30 tablets | $1,200.73 | $40.02 |
Typical dosage 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).
How much does Cimduo (lamivudine / tenofovir) cost?
$1,200.73
