Triomune 30

🧬 Introduction to Triomune

Triomune by Cipla is a fixed-dose combination of three antiretrovirals:

• ⚡ Stavudine 30mg (NRTI: inhibits viral DNA synthesis)

• 🔒 Lamivudine 150mg (NRTI: chain terminator)

• 🔥 Nevirapine 200mg (NNRTI: blocks reverse transcriptase)

Approved as first-line therapy for HIV-1 in resource-limited settings, it offers:

• ✅ Simplified dosing (1 tablet BID after 14-day Nevirapine lead-in)

• ✅ Cost-effective viral suppression

• ❗ Black-box warnings for mitochondrial toxicity (Stavudine) and hepatotoxicity (Nevirapine)

Cipla’s formulation revolutionized global HIV access but is now phased out in developed countries due to toxicity concerns.

💊 Dosage & Indications

⚠️ Side Effects, Storage & Warnings

• ❗ Common Side Effects:

  • Peripheral neuropathy (Stavudine)

  • Rash (Nevirapine)

  • Nausea (Lamivudine)

• 🚫 Serious Effects:

  • Lactic acidosis (Stavudine)

  • Fatal hepatotoxicity (Nevirapine)

  • Pancreatitis (Stavudine)

• ❄️ Storage: 15–30°C; protect from moisture (keep in blister until use).

• ⚠️ Warnings:

  • Contraindicated in moderate-severe liver disease

  • Avoid in women with CD4>250/mm³ or men with CD4>400/mm³

  • Monitor for lipoatrophy (face/limb fat loss)

🌍 Global Availability & Shipping

🔗 Related Indian Alternatives (Different in Same Category)

📚 External Medical References

1. WHO: HIV Treatment Guidelines 2023

2. FDA: Black Box Warning – Stavudine

3. DHHS: Mitochondrial Toxicity Management

🩺 Expert Commentary

Dr. Rajiv Malhotra, HIV Researcher:
*”While Triomune expanded ART access globally, its Stavudine component causes irreversible lipoatrophy in 20% of patients. Modern regimens like [viraday] (Tenofovir-based) are safer first-line options. Reserve Triomune for salvage therapy when alternatives are unavailable.”*

📌 Disclaimer

This information is not medical advice. Use under physician supervision. Cipla’s Triomune carries FDA black-box warnings for hepatotoxicity and mitochondrial toxicity.

💡 Clinical Protocol:

• Stavudine Toxicity Monitoring:

  • Baseline & quarterly: Lactate levels, liver function

  • Monthly: Peripheral sensation tests

• Nevirapine Lead-in:

  • 200mg/day × 14 days → if no rash, start Triomune BID

• Cipla Tablet ID: “CIPLA” logo + “T30” on tablets

• Discontinuation Criteria:

  • Lactate >5 mmol/L + symptoms

  • ALT >10× ULN

  • Severe lipoatrophy

• Alternative Regimen: Switch to [tenvir-em] if weight loss >10% in limbs