Manufacturer: MSD Pharmaceuticals Pvt Ltd
Salt Composition : Lamivudine(300mg), Tenofovir disoproxil fumarate(300mg), Efavirenz(600mg)
Dinmek Tablet is not a cure for HIV or AIDS and only helps to decrease the amount of HIV in your body. This helps to lower your risk of getting HIV-related complications and improves your lifespan. It is prescribed in combination with other HIV medicines. Your doctor will recommend the best medicines for you and will decide the doses that you need. Follow carefully the instructions for all the medicines that you are given. It can be taken with or without food. Taking all these medicines regularly at the right times greatly increases their effectiveness and reduces the chances of HIV becoming resistant to them. It is important not to miss doses and to keep taking them until your doctor tells you it is safe to stop.
Dinmek Tablet is a combination of three antiviral medicines: Lamivudine, Tenofovir disoproxil fumarate and Efavirenz. They work by preventing HIV (virus) from multiplying, thereby reducing the amount of virus in your body.
The pharmacokinetics of lamivudine are similar in patients with HIV-1 or HBV infection, and healthy volunteers. The drug is rapidly absorbed after oral administration, with maximum serum concentrations usually attained 0.5 to 1.5 hours after the dose.The pharmacokinetics of tenofovir are dose-proportional and similar in healthy volunteers and HIV-infected individuals. The oral bioavailability of tenofovir is enhanced by administration with a high-fat meal, but is similar at steady state when administered with or without a typical meal.At standard adult doses, efavirenz exhibits linear pharmacokinetics. Efavirenz is principally metabolized by CYP450 2B6 and 3A4 to hydroxylated metabolites with subsequent glucuronidation. Efavirenz is an inducer and an inhibitor of the cytochrome P450 system and leads to self-induction.
Most side effects do not require any medical attention and disappear as your body adjusts to the medicine. Consult your doctor if they persist or if you’re worried about them
Common side effects of Dinmek
Headache
Fever
Cough
Fatigue
Joint pain
Insomnia (difficulty in sleeping)
Gastrointestinal disturbance
Rash
Hair loss
Muscle disorders
General discomfort
Dizziness
Allergic reaction
Increased liver enzymes
Agranulocytosis (deficiency of granulocytes in the blood)
Sleepiness
Anxiety
Itching
Difficulty in paying attention
Increased triglyceride level in blood
Weakness
Vomiting
Abdominal pain
Increased transaminase level in blood
Decreased phosphate level in blood
Hypersensitivity to Dinmek Tablet is a contraindication. In addition, Dinmek Tablet should not be used if you have the following conditions:
Breastfeeding
Clay-colored stools
Dark urine
Deep and rapid breathing
Drowsiness
Fast or uneven heart rate
Hypersensitivity
Impaired renal function
Itching
Jaundice
Dinmek Tablet is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.
Caution is advised when consuming alcohol with Dinmek Tablet. Please consult your doctor.
Dinmek Tablet is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.
Use with caution
Below 9years: Contraindicated
Efavirenz, lamivudine and tenofovir disoproxil fumarate tablets are indicated as a complete regimen for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in adult and pediatric patients weighing at least 35 kg.
If you use other drugs or over the counter products at the same time, the effects of Dinmek Tablet may change. This may increase your risk for side-effects or cause your drug not to work properly. Tell your doctor about all the drugs, vitamins, and herbal supplements you are using, so that you doctor can help you prevent or manage drug interactions. Dinmek Tablet may interact with the following drugs and products:
Acyclovir
Atazanavir
Cidofovir
Didanosine
Ganciclovir
Lopinavir
Ritonavir
Sulfamethoxazole
Trimethoprim
Do not chew, crush or break it. Dinmek Tablet may be taken with or without food, but it is better to take it at a fixed time.
Store below 30°C
If you miss a dose of Dinmek Tablet, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Consult a doctor before taking any medicines.
Lamivudine
You have been prescribed Lamivudine for the treatment of chronic hepatitis B virus (HBV) infection.
In combination with other medicines, it is used for the treatment of HIV infections.
Take it with food, as this increases the absorption of the medicine into the body.
Lamivudine may cause dizziness or sleepiness. Do not drive or do anything requiring concentration until you know how it affects you.
You may still develop infections or other illnesses associated with viral infection while taking this medication.
You can also pass on HIV or HBV to others. Don't share needles or personal items that can have blood or body fluids on them.
During treatment and for at least six months after stopping this medicine, regular blood tests are needed to monitor your liver function, level of hepatitis B virus and blood cells in your blood.
Tenofovir disoproxil fumarate
You have been prescribed Tenofovir disoproxil fumarate for the treatment of chronic hepatitis B virus (HBV) infection.
In combination with other medicines, it is used for the treatment of HIV infections.
Take it with food, as this increases the absorption of the medicine into the body.
Tenofovir disoproxil fumarate may cause dizziness or sleepiness. Do not drive or do anything requiring concentration until you know how it affects you.
You may still develop infections or other illnesses associated with viral infection while taking this medication.
You can also pass on HIV or HBV to others. Don't share needles or personal items that can have blood or body fluids on them.
During treatment and for at least six months after stopping this medicine, regular blood tests are needed to monitor your liver function, level of hepatitis B virus and blood cells in your blood.
Efavirenz
Efavirenz is used in combination with other medicines for the treatment of HIV (human immunodeficiency virus).
Take it on an empty stomach, preferably at bedtime to reduce side effects.
Do not skip any doses and finish the full course of treatment even if you feel better.
You can also pass on HIV or HBV to others. Don't share needles or personal items that can have blood or body fluids on them.
Your doctor may check your liver function regularly. Inform your doctor if you notice yellowing of eyes or skin, dark urine, or stomach pain.
You might experience dizziness or abnormal dreams during initial days of treatment. Consult with a doctor if it bothers you or does not go away.
Use a reliable method of contraception to prevent pregnancy while taking this medicine.
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Dinmek Tablet may be taken with or without food, but it is better to take it at a fixed time.
Lamivudine
Q. How should I take Lamivudine?
Lamivudine should be taken in the dose and duration advised by the doctor. This medicine can be taken with or without food. However, it is better to take it at a fixed time of the day to avoid the chances of missing a dose.
Q. Is Lamivudine effective?
Lamivudine is effective if used in the dose and duration advised by your doctor. Do not stop taking it even if you see improvement in your condition. If you stop using Lamivudine too early, the symptoms may return or worsen.
Q. What is drug resistance? Can I develop drug resistance with Lamivudine?
Drug resistance is a state where the medicine which was once effective in treating an infection becomes ineffective. This mainly happens due to the ability acquired by the virus or bacteria to get modified inside the body which affects the overall working of the medicine. Hence, the medicine is no longer able to fight against the virus or bacteria. Generally, drug resistance with Lamivudine is more likely to happen if you take less dose than what is recommended.
Q. How long should I take Lamivudine?
Do not stop taking entecavir without consulting your doctor. Stopping entecavir before treatment may worsen your hepatitis. This can happen during the first several months after you stop taking entecavir. Take the medicine strictly as advised and do not miss any dose.
Q. What if I forget to take a dose of Lamivudine?
If you forget a dose of Lamivudine, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take the next scheduled dose in the prescribed time. Do not double the dose to make up for the missed one as this may increase the chances of developing side effects.
Q. What if HIV infection co-exists with HBV infection? Will this affect treatment with Lamivudine?
In HBV patients who are diagnosed with HIV, Lamivudine is not recommended until and unless these patients start taking medicines for HIV management. Starting Lamivudine in such patients may cause resistance to the prescribed HIV medicines. Therefore, doctors recommend tests for HIV in patients diagnosed with HBV infection before starting treatment with Lamivudine.
Q. Can Lamivudine cure hepatitis B?
No, Lamivudine does not cure hepatitis B but may improve the condition of the liver. It may decrease the amount of hepatitis B virus (HBV) present in the body. This is done by limiting the ability of HBV to multiply and further infect new liver cells.
Q. Is Lamivudine safe?
Lamivudine is safe if used in the dose and duration advised by your doctor. Take it exactly as directed and do not skip any dose. Follow your doctor's instructions carefully and let your doctor know if any of the side effects bother you.
Tenofovir disoproxil fumarate
Q. Does Tenofovir disoproxil fumarate prevent passing of HIV-1 and HBV to others?
In case of HIV-1 infection, Tenofovir disoproxil fumarate may reduce the risk of passing the virus to others, but the chances of infecting others still persist. However, in case of HBV infection, Tenofovir disoproxil fumarate has not proven to reduce risk of transferring the virus to others. Therefore, the patients of both HIV-1 infection and HBV infection should practice safe sex and should not share dirty needles.
Q. Is Tenofovir disoproxil fumarate safe?
Tenofovir disoproxil fumarate is safe if used in the dose and duration advised by your doctor. Take it exactly as directed and do not skip any dose. Follow your doctor's instructions carefully and let your doctor know if any of the side effects bother you.
Q. How should I take Tenofovir disoproxil fumarate?
You should take Tenofovir disoproxil fumarate in the dose and duration advised by your doctor. Tenofovir disoproxil fumarate works best when taken with meals or just afterwards. However, taking it without food does not reduce its effectiveness. If you have any doubts, consult your doctor.
Q. For how long do I need to take Tenofovir disoproxil fumarate for HBV infection?
Duration of treatment will depend on the severity of HBV infection. You will need to take periodic blood tests to keep a check on the viral load and number of T cells. Your doctor will then decide the duration of the medicine accordingly. In some cases, treatment is required life long.
Q. I vomited after taking Tenofovir disoproxil fumarate. What should I do?
Take another tablet of Tenofovir disoproxil fumarate if you vomit within 1 hour of taking it. If you vomit after more than an hour of taking Tenofovir disoproxil fumarate, then you need not take another tablet. Consult your doctor if you have vomiting every time you take Tenofovir disoproxil fumarate or if the vomiting persists for a longer duration.
Q. What should I do if I forget to take Tenofovir disoproxil fumarate?
If you forget to take Tenofovir disoproxil fumarate within 12 hours of the time you usually take it, you should take Tenofovir disoproxil fumarate with food as soon as possible and resume the normal dosing schedule. If you miss a dose of Tenofovir disoproxil fumarate by more than 12 hours and it is almost time for the next dose, you should not take the missed dose and simply resume the usual dosing schedule.
Q. Can I breastfeed while receiving treatment with Tenofovir disoproxil fumarate for chronic HBV infection?
No, you should not breastfeed your baby since small amounts of Tenofovir disoproxil fumarate pass into breast milk. Further, if your baby does not have HIV or HBV, there is a chance that the baby can get HIV or HBV through breastfeeding.
Efavirenz
Q. What is Efavirenz? What is it used for?
Efavirenz belongs to a group of medicines called antiretrovirals. It is used to treat human immunodeficiency virus (HIV), which if not controlled can cause AIDS (acquired immunodeficiency syndrome). It helps to control HIV infection so your immune system can work better.
Q. Is Efavirenz safe?
Efavirenz is safe if used in the dose and duration advised by your doctor. Take it exactly as directed and do not skip any dose. Follow your doctor's instructions carefully and let your doctor know if any of the side effects bother you.
Q. How does Efavirenz work?
Efavirenz works by blocking the function of an enzyme, called reverse transcriptase, which is responsible for the HIV replication process. This helps to reduce the level of HIV in the blood.
Q. Is Efavirenz effective?
Efavirenz is effective if used in the dose and duration advised by your doctor. Do not stop taking it even if you see improvement in your condition. If you stop using Efavirenz too early, the symptoms may return or worsen.
Q. What if I forget to take a dose of Efavirenz?
If you forget a dose of Efavirenz, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take the next scheduled dose in the prescribed time. Do not double the dose to make up for the missed one as this may increase the chances of developing side effects.
Q. Is it safe to take Efavirenz in pregnancy?
No, Efavirenz is not safe to be taken in pregnancy. Some animal studies have shown that Efavirenz may cause birth defects if given to pregnant mothers. Therefore, it is advisable not to take Efavirenz if you are pregnant, planning to conceive or breastfeeding.
