aids_info 1.0.0

data/.autotest

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+require 'autotest/bundler'

data/.gitignore

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+!.gitignore
+*.gem
+*.rbc
+*.sw[a-p]
+*.tmproj
+*.tmproject
+*.un~
+*~
+.DS_Store
+.Spotlight-V100
+.Trashes
+._*
+.bundle
+.config
+.directory
+.elc
+.redcar
+.yardoc
+/.emacs.desktop
+/.emacs.desktop.lock
+Desktop.ini
+Gemfile.lock
+Icon?
+InstalledFiles
+Session.vim
+Thumbs.db
+\#*\#
+_yardoc
+auto-save-list
+coverage
+doc/
+lib/bundler/man
+pkg
+pkg/*
+rdoc
+spec/reports
+test/tmp
+test/version_tmp
+tmp
+tmtags
+tramp

data/.rspec

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+--color
+--format=nested
+--backtrace

data/.yardopts

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+--markup markdown
+-
+LICENSE.md

data/Gemfile

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+source 'http://rubygems.org'
+
+gemspec

data/LICENSE.md

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+Copyright (c) 2011, Code for America
+All rights reserved.
+
+Redistribution and use in source and binary forms, with or without modification, are permitted provided that the following conditions are met:
+
+* Redistributions of source code must retain the above copyright notice, this list of conditions and the following disclaimer.
+* Redistributions in binary form must reproduce the above copyright notice, this list of conditions and the following disclaimer in the documentation and/or other materials provided with the distribution.
+* Neither the name of Code for America nor the names of its contributors may be used to endorse or promote products derived from this software without specific prior written permission.
+
+THIS SOFTWARE IS PROVIDED BY THE COPYRIGHT HOLDERS AND CONTRIBUTORS "AS IS" AND ANY EXPRESS OR IMPLIED WARRANTIES, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE ARE DISCLAIMED. IN NO EVENT SHALL THE COPYRIGHT HOLDER OR CONTRIBUTORS BE LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL, EXEMPLARY, OR CONSEQUENTIAL DAMAGES (INCLUDING, BUT NOT LIMITED TO, PROCUREMENT OF SUBSTITUTE GOODS OR SERVICES; LOSS OF USE, DATA, OR PROFITS; OR BUSINESS INTERRUPTION) HOWEVER CAUSED AND ON ANY THEORY OF LIABILITY, WHETHER IN CONTRACT, STRICT LIABILITY, OR TORT (INCLUDING NEGLIGENCE OR OTHERWISE) ARISING IN ANY WAY OUT OF THE USE OF THIS SOFTWARE, EVEN IF ADVISED OF THE POSSIBILITY OF SUCH DAMAGE.

data/README.md

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+# The Code for America RubyGem template
+
+If you want to create a new Code for America gem, you can use this gem as a template.
+It's similar to [suspenders][suspenders], but for RubyGems instead of Rails.
+
+[suspenders]: https://github.com/thoughtbot/suspenders
+
+For more information on RubyGems, you should read the [RubyGems Manuals][manuals].
+
+[manuals]: http://docs.rubygems.org/
+
+After cloning this gem, you'll want to make the following changes:
+
+1. Replace all instances of api_gem_template and ApiGemTemplate with the snake_case and CamelCase name of your gem, respectively
+2. Add a summary and description to the [gemspec][gemspec] file
+
+[gemspec]: https://github.com/codeforamerica/api_gem_template/blob/master/api_gem_template.gemspec
+
+This template includes:
+
+* [RSpec][rspec] for isolation testing
+* [SimpleCov][simplecov] for C0 code coverage
+* [ZenTest][zentest] for continuous testing
+* [YARD][yard] for documentation
+
+[rspec]: https://github.com/rspec/rspec
+[simplecov]: https://github.com/colszowka/simplecov
+[zentest]: https://github.com/seattlerb/zentest
+[yard]: https://github.com/lsegal/yard
+
+
+[![Code for America Tracker](http://stats.codeforamerica.org/codeforamerica/api_gem_template.png)](http://stats.codeforamerica.org/projects/api_gem_template)

data/Rakefile

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+#!/usr/bin/env rake
+
+require 'bundler'
+Bundler::GemHelper.install_tasks
+
+require 'rspec/core/rake_task'
+RSpec::Core::RakeTask.new(:spec)
+
+task :default => :spec
+task :test => :spec
+
+require 'yard'
+namespace :doc do
+  YARD::Rake::YardocTask.new do |task|
+    task.files   = ['LICENSE.md', 'lib/**/*.rb']
+    task.options = ['--markup', 'markdown']
+  end
+end

data/aids_info.gemspec

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+# -*- encoding: utf-8 -*-
+require File.expand_path('../lib/aids_info/version', __FILE__)
+
+Gem::Specification.new do |gem|
+  gem.name        = 'aids_info'
+  gem.version     = AidsInfo::VERSION
+  gem.author      = "Code for America"
+  gem.email       = 'info@codeforamerica.org'
+  gem.homepage    = ''
+  gem.summary     = %q{A very small wrapper around the AidsInfo Drug Info database}
+  gem.description = %q{A very small wrapper around the AidsInfo Drug Info database}
+
+  gem.files         = `git ls-files`.split("\n")
+  gem.test_files    = `git ls-files -- {test,spec,features}/*`.split("\n")
+  gem.executables   = `git ls-files -- bin/*`.split("\n").map{|f| File.basename(f)}
+  gem.require_paths = ['lib']
+
+    gem.add_development_dependency 'ZenTest', '~> 4.5'
+    gem.add_development_dependency 'maruku', '~> 0.6'
+    gem.add_development_dependency 'rake', '~> 0.9'
+    gem.add_development_dependency 'rspec', '~> 2.6'
+    gem.add_development_dependency 'simplecov', '~> 0.4'
+    gem.add_development_dependency 'yard', '~> 0.7'
+    gem.add_development_dependency 'webmock', '~> 1.6'
+
+    gem.add_runtime_dependency 'faraday', '~> 0.6.1'
+    gem.add_runtime_dependency 'faraday_middleware', '~> 0.6.3'
+    gem.add_runtime_dependency 'hashie', '~> 1.0.0'
+    gem.add_runtime_dependency 'multi_xml', '~> 0.2.2'
+    gem.add_runtime_dependency 'rash', '~> 0.3.0'
+  end

data/lib/aids_info.rb

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+require 'aids_info/client'
+
+module AidsInfo
+
+  def self.client
+      AidsInfo::Client.new
+    end
+
+    def self.method_missing(method, *args, &block)
+      return super unless client.respond_to?(method)
+      client.send(method, *args, &block)
+    end
+
+    def self.respond_to?(method, include_private=false)
+      client.respond_to?(method, include_private) || super(method, include_private)
+    end
+
+end

data/lib/aids_info/client.rb

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+require 'aids_info/client'
+require 'aids_info/client/connection'
+require 'aids_info/client/request'
+require 'aids_info/client/api'
+
+module AidsInfo
+  class Client
+    include AidsInfo::Client::Connection
+    include AidsInfo::Client::Request
+    include AidsInfo::Client::API
+  end
+end

data/lib/aids_info/client/api.rb

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+module AidsInfo
+  class Client
+    module API
+     def search(drug)
+      get("DrugsNew/drug.aspx?displayxml=true&name=#{drug.to_s}")
+     end
+    end
+  end
+end

data/lib/aids_info/client/connection.rb

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+require 'faraday_middleware'
+
+module AidsInfo
+  class Client
+    module Connection
+      private
+
+      def connection
+        Faraday.new(:url => 'http://aidsinfo.nih.gov') do |connection|
+          connection.use Faraday::Request::UrlEncoded
+          connection.use Faraday::Response::RaiseError
+          connection.use Faraday::Response::Rashify
+          connection.use Faraday::Response::ParseXml
+          connection.adapter(Faraday.default_adapter)
+        end
+      end
+    end
+  end
+end

data/lib/aids_info/client/request.rb

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+module AidsInfo
+  class Client
+    module Request
+      def get(path)
+        request(:get, path)
+      end
+
+      private
+
+      def request(method, path)
+        response = connection.send(method) do |request|
+          request.url(path)
+        end
+        response.body
+      end
+    end
+  end
+end

data/lib/aids_info/version.rb

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+module AidsInfo
+  VERSION = "1.0.0"
+end

data/spec/aids_info/api_spec.rb

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+require 'helper'
+
+describe AidsInfo::Client::API do
+  context 'search' do
+    it 'returns the the resutlt' do
+      stub_get('DrugsNew/drug.aspx?displayxml=true&name=combivir').
+        to_return(:status => 200, :body => "", :headers => {})
+      AidsInfo::Client.new.search('combivir')
+      a_get('DrugsNew/drug.aspx?displayxml=true&name=combivir').should have_been_made
+    end
+  end
+end

data/spec/aids_info_spec.rb

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+# -*- encoding: utf-8 -*-
+require 'helper'
+
+describe AidsInfo do
+  describe ".client" do
+    it "should be a AidsInfo::Client" do
+      AidsInfo.client.should be_a AidsInfo::Client
+    end
+  end
+end

data/spec/fixtures/combivir.xml

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+<?xml version="1.0" encoding="utf-8"?><!DOCTYPE drug SYSTEM "drug.dtd"><drug xmlns=""><names><name type="Spanish Generic" pronunciation="">Lamivudina/ zidovudina</name><name type="Generic" pronunciation="la-MI-vyoo-deen, zye-DOE-vyoo-deen">Lamivudine/Zidovudine</name><name type="Brand" pronunciation="">Combivir</name><name type="AKA" pronunciation="">ZDV/3TC</name></names><drugType>FDA-approved</drugType><drugClass>Nucleoside Reverse Transcriptase Inhibitors</drugClass><chemistry><casName>Zidovudine: Thymidine, 3'-azido-3'-deoxy-  </casName><casNumber>Zidovudine: 30516-87-1 </casNumber><formula>Lamivudine: C8-H11-N3-O3-S ; Zidovudine: C10-H13-N5-O4 </formula><elemComposition>Lamivudine: C41.91%, H4.84%, N18.33%, O20.94%, S13.99%; Zidovudine: C44.94%, H4.90%, N26.21%, O23.95%</elemComposition><meltPoint>Lamivudine: 160 to 162&amp;deg;C; Zidovudine: 106 to 112&amp;deg;C</meltPoint><boilPoint></boilPoint><weight>Lamivudine: 229.3 ; Zidovudine: 267.24 </weight></chemistry><summaries><summary type="Patient"><description>Lamivudine/zidovudine is a fixed-dose combination tablet of two antiretroviral medicines, called nucleoside reverse transcriptase inhibitors (NRTIs). Lamivudine/zidovudine works by disrupting one of the early steps in the HIV life cycle, called reverse transcription. During normal reverse transcription, HIV&amp;rsquo;s reverse transcriptase enzyme (a type of protein) converts HIV&amp;rsquo;s RNA&amp;mdash;a single strand of genetic information&amp;mdash;into DNA&amp;mdash;a double strand of genetic information. It does this by recoding the RNA building blocks into complimentary DNA building blocks. As the HIV life cycle proceeds, the newly formed DNA is used to make more copies of HIV virus.
+
+        When lamivudine/zidovudine is present, however, it competes with two of the available DNA building blocks called deoxycytidine triphosphate and thymidine triphosphate. By replacing these building blocks in the newly developing HIV DNA, lamivudine/zidovudine is able to stop reverse transcriptase from completing its job. This prevents the HIV DNA strand from being formed and halts the HIV life cycle.</description><relatedUse>Lamivudine/zidovudine (Combivir) was originally approved by the U.S. Food and Drug Administration (FDA) on September 27, 1997. It is currently approved for use in combination with other antiretroviral agents for the treatment of HIV infection in adults and children weighing greater than or equal to 30 kg (66 pounds).
+
+        Lamivudine/zidovudine does not cure or prevent HIV infection or AIDS and does not reduce the risk of passing the virus to other people.</relatedUse><dosingInformation><dosageForm>Always take this medication as your doctor instructs. Lamivudine/zidovudine is taken by mouth, without regard to food, and it is always used with other anti-HIV medications.
+
+          Dosage forms and strengths:
+
+              Tablet: lamivudine 150 mg and zidovudine 300 mg
+
+              What storage conditions are needed for this medication?
+
+                  Store lamivudine/zidovudine tablets between 36&amp;deg;F to 86&amp;deg;F (2&amp;deg;C to 30&amp;deg;C).
+
+                  Keep this medication in the container it came in, tightly closed, and out of reach of children. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
+                  In case of emergency/overdose:
+
+                  In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
+
+                  What other information should I know?
+
+                      Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
+                          &amp;nbsp;
+                              It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
+
+                              </dosageForm><dailyDose>The recommended dose of lamivudine/zidovudine in HIV-1-infected adults and children weighing greater than or equal to 30 kg (66 pounds) is 1 tablet (containing 150 mg of lamivudine and 300 mg of zidovudine) taken twice daily by mouth.
+                              Note:
+
+                                  Depending on certain factors, such as kidney function, liver problems, and possible side effects of the medicine, lamivudine/zidovudine may not be right for you. Your doctor will determine if it is appropriate for you to take this medicine. Always take lamivudine/zidovudine exactly as prescribed by your doctor.
+                                      &amp;nbsp;
+                                          Because lamivudine/zidovudine is a fixed-dose combination tablet, it should not be used in children weighing less than 30 kg (66 pounds).
+
+
+                                          What should I do if I forget a dose?
+                                          Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed dose.</dailyDose></dosingInformation><contraindications>What special precautions should I follow?&amp;nbsp;
+                                        &amp;nbsp;
+                                        Before taking lamivudine/zidovudine,
+
+                                            Tell your doctor and pharmacist if you are allergic to lamivudine, zidovudine, or any other medications.
+                                                &amp;nbsp;
+                                                    Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you more carefully for side effects.
+                                                        &amp;nbsp;
+                                                            Note that lamivudine/zidovudine should not be used if you are taking certain other medicines (see Drug and Food Interactions).
+                                                                &amp;nbsp;
+                                                                    Tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking lamivudine/zidovudine, call your doctor. Tell your doctor if you are breastfeeding. You should not breastfeed if you are infected with HIV or if you are taking lamivudine/zidovudine.
+                                                                        &amp;nbsp;
+                                                                            Tell your doctor about any medical problems you may have had or currently have, including kidney or liver problems (such as hepatitis or cirrhosis), pancreas problems (pancreatitis), alcohol use, and low red/white blood cell counts.
+                                                                            </contraindications><sideEffects>Lamivudine/zidovudine may cause side effects.
+                                                                            The following life-threatening or serious side effects have been reported. Contact your doctor immediately if you experience:
+
+                                                                            &amp;bull; Low White and Red Blood Cell Counts (Neutropenia and Anemia). Because zidovudine, one of the active ingredients of lamivudine/zidovudine, has been associated with blood cell problems, it is extremely important to have frequent tests to monitor blood cell counts while taking lamivudine/zidovudine. If you experience any of the following symptoms, let your doctor know right away:
+
+                                                                                fatigue
+                                                                                    shortness of breath
+                                                                                        dizziness or light-headedness
+                                                                                            headache
+                                                                                                chest pain
+                                                                                                    pale skin
+                                                                                                        rapid heart rate
+                                                                                                            fever
+                                                                                                                sores (ulcers) around the mouth
+                                                                                                                    chills
+                                                                                                                        cough
+
+                                                                                                                        &amp;bull; Serious Allergic Reaction (Hypersensitivity Reaction). If you develop symptoms of an allergic reaction, seek medical attention immediately:
+
+                                                                                                                            rash
+                                                                                                                                itching or swelling of the face, tongue, or throat
+                                                                                                                                    severe dizziness
+                                                                                                                                        trouble breathing
+                                                                                                                                            peeling skin
+
+                                                                                                                                            &amp;bull; Lactic acidosis (buildup of lactic acid in the blood). This can be a medical emergency and may require treatment in the hospital. Call your healthcare provider right away if you experience any of the following symptoms of lactic acidosis:
+
+                                                                                                                                                feeling weak or tired
+                                                                                                                                                    unusual muscle pain
+                                                                                                                                                        trouble breathing
+                                                                                                                                                            unusual stomach pain or discomfort
+                                                                                                                                                                nausea
+                                                                                                                                                                    vomiting
+                                                                                                                                                                        a cold sensation, especially in your arms or legs
+                                                                                                                                                                            dizziness or lightheadedness
+                                                                                                                                                                                fast or irregular heart beat
+                                                                                                                                                                                    unexplained weight loss
+
+                                                                                                                                                                                    &amp;bull; Hepatotoxicity (serious liver problem). Hepatotoxicity with hepatomegaly (liver enlargement) and steatosis (fat in the liver) has been reported in patients taking nucleoside antiretroviral medicines, including lamivudine and zidovudine. Call your healthcare provider right away if you experience the following signs/symptoms of liver problems:
+
+                                                                                                                                                                                        skin or white part of the eyes appearing yellow (jaundice)
+                                                                                                                                                                                            dark colored urine
+                                                                                                                                                                                                bowel movements turning light in color
+                                                                                                                                                                                                    loss of appetite
+                                                                                                                                                                                                        nausea
+                                                                                                                                                                                                            lower stomach area pain
+
+                                                                                                                                                                                                            &amp;bull; Pancreatitis (dangerous inflammation of the pancreas). Tell your doctor if you have ever had pancreatitis, regularly drink alcoholic beverages, or have gallstones, as pancreatitis occurs more often in patients with these conditions. Call your doctor immediately if you develop any of the following symptoms of pancreatitis:
+
+                                                                                                                                                                                                                stomach pain
+                                                                                                                                                                                                                    nausea
+                                                                                                                                                                                                                        vomiting
+
+                                                                                                                                                                                                                        &amp;bull; Myopathy and myositis (muscle disorders and inflammation of muscles). Contact your doctor if you develop:
+
+                                                                                                                                                                                                                            muscle weakness
+                                                                                                                                                                                                                                muscle cramps
+                                                                                                                                                                                                                                    muscle stiffness or spasms
+
+                                                                                                                                                                                                                                    &amp;bull; Worsening of liver disease. Patients co-infected with HIV and HBV may experience a worsening of their liver disease upon discontinuation of lamivudine, an active ingredient of Combivir. Talk to your doctor about any changes in your antiretroviral medicines.
+
+                                                                                                                                                                                                                                    &amp;bull; Changes in Body Fat. Changes may include an increased amount of fat in the upper back and neck (buffalo hump), breast, and around the middle of your body (trunk). Loss of fat from the legs, arms, and face may also occur. The exact cause and long-term health effects of these problems are not known.
+
+                                                                                                                                                                                                                                    &amp;bull; Changes in your Immune System (Immune Reconstitution Syndrome). This can occur when you start HIV medicines. As your immune system becomes stronger, your body may begin to fight infections that have been &amp;ldquo;hidden&amp;rdquo; in your body for a long time. Call your doctor immediately if you start having any new symptoms after starting your HIV medicine.
+                                                                                                                                                                                                                                    Common side effects that may be associated with lamivudine/zidovudine&amp;nbsp;include the following. Let your doctor know if any of these side effects do not go away or worsen:
+
+                                                                                                                                                                                                                                        headache
+                                                                                                                                                                                                                                            nausea
+                                                                                                                                                                                                                                                fatigue
+                                                                                                                                                                                                                                                    diarrhea
+                                                                                                                                                                                                                                                        cough
+                                                                                                                                                                                                                                                            nasal symptoms (such as stuffy nose)
+                                                                                                                                                                                                                                                                general feeling of discomfort, illness, or lack of well-being
+
+                                                                                                                                                                                                                                                                Lamivudine/zidovudine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
+                                                                                                                                                                                                                                                                If you experience a serious side effect, you or your doctor may send a report to the U.S. FDA&amp;rsquo;s MedWatch Adverse Event Reporting program online at http://www.fda.gov/Safety/MedWatch or by phone at 1-800-332-1088.</sideEffects></summary><summary type="Professional"><description>Lamivudine/zidovudine is a fixed-dose combination tablet containing two synthetic nucleoside analogues: lamivudine and zidovudine. Each tablet contains 150 mg of lamivudine and 300 mg of zidovudine, each of which inhibits HIV-1 viral reverse transcriptase. </description><relatedUse>Lamivudine/zidovudine was originally approved by the U.S. Food and Drug Administration (FDA) on September 27, 1997. Lamivudine/zidovudine is currently indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection.  </relatedUse><dosingInformation><modeOfDelivery>Oral. </modeOfDelivery><dosageForm>Film-coated tablets containing lamivudine 150 mg and zidovudine 300 mg. 
+                                                                                                                                                                                                                                                                  The recommended dose of lamivudine/zidovudine for adults and adolescents weighing greater than or equal to 30 kg is one tablet twice daily. 
+                                                                                                                                                                                                                                                                  The recommended oral dosage of scored lamivudine/zidovudine tablets for pediatric patients who weigh greater than or equal to 30 kg and for whom a solid oral dosage form is appropriate is one tablet administered twice daily. Before prescribing lamivudine/zidovudine tablets, children should be assessed for the ability to swallow tablets. If a child is unable to reliably swallow a lamivudine/zidovudine tablet, the liquid oral formulations should be prescribed: lamivudine oral solution and zidovudine syrup. 
+                                                                                                                                                                                                                                                                  Because lamivudine/zidovudine is a fixed-dose combination tablet, it should not be prescribed for pediatric patients weighing less than 30 kg or patients requiring dosage adjustment, such as those with reduced renal function (creatinine clearance less than 50 mL/min), those experiencing dose-limiting adverse events, or those with impaired hepatic function or liver cirrhosis. Liquid and solid oral formulations of the individual components of lamivudine/zidovudine are available for these populations. </dosageForm><storageInstructions>Store between 2&amp;deg;C and 30&amp;deg;C (36&amp;deg;F to 86&amp;deg;F). </storageInstructions></dosingInformation><pharmacology>Lamivudine is a synthetic nucleoside analogue that is phosphorylated intracellularly to its active 5'-triphosphate metabolite, lamivudine triphosphate (3TC-TP). The principal mode of action of 3TC-TP is inhibition of reverse transcriptase (RT) via DNA chain termination after incorporation of the nucleotide analogue. 3TC-TP is a weak inhibitor of cellular DNA polymerases &amp;alpha;, &amp;beta;, and &amp;gamma;. In vitro, lamivudine with zidovudine had synergistic antiretroviral activity. 
+                                                                                                                                                                                                                                                                Following oral dosing, lamivudine is rapidly absorbed and extensively distributed. Binding to plasma protein is low. Approximately 70% of an intravenous dose of lamivudine is recovered as unchanged drug in the urine. Metabolism of lamivudine is a minor route of elimination. In humans, the only known metabolite is the trans-sulfoxide metabolite (approximately 5% of an oral dose after 12 hours). The mean oral bioavailability, mean apparent volume of distribution, plasma protein binding, median CSF:plasma ratio, mean systemic clearance, mean renal clearance, and elimination half-life (approximate range) of lamivudine in fasting patients are 86%, 1.3 L/kg, less than 36%, 0.12, 0.33 L/hr/kg, 0.22 L/hr/kg and 5 to 7 hrs, respectively. 
+                                                                                                                                                                                                                                                                Zidovudine is also a synthetic nucleoside analogue that is phosphorylated intracellularly to its active 5'-triphosphate metabolite, zidovudine triphosphate (ZDV-TP). The principal mode of action of ZDV-TP is inhibition of RT via DNA chain termination after incorporation of the nucleotide analogue. ZDV-TP is a weak inhibitor of the cellular DNA polymerases &amp;alpha; and &amp;gamma; and has been reported to be incorporated into the DNA of cells in culture. In cell culture drug combination studies, zidovudine demonstrates synergistic activity with the nucleoside reverse transcriptase inhibitors (NRTIs) abacavir, didanosine, lamivudine, and zalcitabine; the non-nucleoside reverse transcriptase inhibitors (NNRTIs) delavirdine and nevirapine; and the protease inhibitors (PIs) indinavir, nelfinavir, ritonavir, and saquinavir; and additive activity with interferon alfa. Ribavirin has been found to inhibit the phosphorylation of zidovudine in cell culture. 
+                                                                                                                                                                                                                                                                Following oral administration, zidovudine is rapidly absorbed and extensively distributed. Binding to plasma protein is low. Zidovudine is eliminated primarily by hepatic metabolism. The major metabolite of zidovudine is 3&amp;prime;-azido-3&amp;prime;-deoxy-5&amp;prime;-O-&amp;beta;-D-glucopyranuronosylthymidine (GZDV). GZDV area under the curve (AUC) is about 3-fold greater than the zidovudine AUC. Urinary recovery of zidovudine and GZDV accounts for 14% and 74% of the dose following oral administration, respectively. A second metabolite, 3&amp;prime;-amino-3&amp;prime;-deoxythymidine (AMT), has been identified in plasma. The AMT AUC was one fifth of the zidovudine AUC. The pharmacokinetic properties (mean oral bioavailability, mean apparent volume of distribution, plasma protein binding, median CSF:plasma ratio, mean systemic clearance, mean renal clearance, and elimination half-life [approximate range]) of zidovudine in fasting patients are 64%, 1.6 L/kg, less than 38%, 0.60, 1.6 L/hr/kg, 0.34 L/hr/kg and 0.5 to 3 hrs, respectively. 
+                                                                                                                                                                                                                                                                One lamivudine/zidovudine tablet is bioequivalent to one lamivudine tablet (150 mg) plus one zidovudine tablet (300 mg) following single-dose administration to fasting healthy adults (n = 24). Lamivudine/zidovudine may be administered with or without food. The lamivudine and zidovudine AUC following administration of lamivudine/zidovudine (Combivir) with food was similar when compared to fasting healthy subjects (n = 24). 
+                                                                                                                                                                                                                                                                Lamivudine/zidovudine is in FDA Pregnancy Category C. No adequate or well-controlled studies of the combination drug have been done in pregnant women. Clinical trial data demonstrate that maternal zidovudine treatment during pregnancy reduces vertical transmission of HIV-1 infection to the fetus. Animal reproduction studies performed with lamivudine and zidovudine showed increased embryotoxicity and fetal malformations (zidovudine), and increased embryolethality (lamivudine). Lamivudine/zidovudine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. To monitor maternal-fetal outcomes of pregnant women exposed to lamivudine/zidovudine and other antiretroviral agents, an Antiretroviral Pregnancy Registry (APR) has been established. Physicians are encouraged to register patients by calling 1-800-258-4263 or online at http://www.APRegistry.com. 
+                                                                                                                                                                                                                                                                Lamivudine pharmacokinetics were studied in pregnant women during 2 clinical studies conducted in South Africa. The study assessed pharmacokinetics in: 16 women at 36 weeks gestation using 150 mg lamivudine twice daily with zidovudine, 10 women at 38 weeks gestation using 150 mg lamivudine twice daily with zidovudine, and 10 women at 38 weeks gestation using lamivudine 300 mg twice daily without other antiretrovirals. Lamivudine pharmacokinetics in pregnant women were similar to those seen in nonpregnant adults and in postpartum women. Lamivudine concentrations were generally similar in maternal, neonatal, and umbilical cord serum samples. 
+                                                                                                                                                                                                                                                                A randomized, double-blind, placebo-controlled trial was conducted in HIV-1-infected pregnant women to determine the utility of zidovudine for the prevention of maternal-fetal HIV-1 transmission. Zidovudine treatment during pregnancy reduced the rate of maternal-fetal HIV-1 transmission from 24.9% for infants born to placebo-treated mothers to 7.8% for infants born to mothers treated with zidovudine. There were no differences in pregnancy-related adverse events between the treatment groups. Congenital abnormalities occurred with similar frequency between neonates born to mothers who received zidovudine and neonates born to mothers who received placebo. The observed abnormalities included problems in embryogenesis (prior to 14 weeks) or were recognized on ultrasound before or immediately after initiation of study drug. 
+                                                                                                                                                                                                                                                                Zidovudine pharmacokinetics were studied in a Phase 1 study of 8 women during the last trimester of pregnancy. As pregnancy progressed, there was no evidence of drug accumulation. The pharmacokinetics of zidovudine were similar to that of nonpregnant adults. Consistent with passive transmission of the drug across the placenta, zidovudine concentrations in neonatal plasma at birth were essentially equal to those in maternal plasma at delivery. 
+                                                                                                                                                                                                                                                                Animal reproduction studies performed at oral doses up to 130 and 60 times the adult dose in rats and rabbits, respectively, revealed no evidence of teratogenicity due to lamivudine. Increased early embryolethality occurred in rabbits at exposure levels similar to those in humans. However, there was no indication of this effect in rats at exposure levels up to 35 times those in humans. Based on animal studies, lamivudine crosses the placenta and is transferred to the fetus. 
+                                                                                                                                                                                                                                                                Increased fetal resorptions occurred in pregnant rats and rabbits treated with doses of zidovudine that produced drug plasma concentrations 66 to 226 times (rats) and 12 to 87 times (rabbits) the mean steady-state peak human plasma concentration following a single 100-mg dose of zidovudine. There were no other reported developmental anomalies. In another developmental toxicity study, pregnant rats received zidovudine up to near-lethal doses that produced peak plasma concentrations 350 times peak human plasma concentrations (300 times the daily exposure [AUC] in humans given 600 mg/day zidovudine). This dose was associated with marked maternal toxicity and an increased incidence of fetal malformations. However, there were no signs of teratogenicity at doses up to one fifth the lethal dose. 
+                                                                                                                                                                                                                                                                The Centers for Disease Control and Prevention recommend that HIV-1-infected mothers in the United States not breastfeed their infants to avoid risking postnatal transmission of HIV-1 infection. Because of both the potential for HIV-1 transmission and serious adverse reactions in nursing infants, mothers should be instructed not to breastfeed if they are receiving lamivudine/zidovudine. Although no studies of lamivudine/zidovudine excretion in breast milk have been performed, lactation studies performed with lamivudine and zidovudine show that both drugs are excreted in human breast milk. Samples of breast milk obtained from 20 mothers receiving lamivudine monotherapy (300 mg twice daily) or combination therapy (150 mg lamivudine twice daily and 300 mg zidovudine twice daily) had measurable concentrations of lamivudine. In another study, after administration of a single dose of 200 mg zidovudine to 13 HIV-1-infected women, the mean concentration of zidovudine was similar in human milk and serum. 
+                                                                                                                                                                                                                                                                In patients receiving lamivudine monotherapy or combination therapy with lamivudine plus zidovudine, HIV-1 isolates from most patients became phenotypically and genotypically resistant to lamivudine within 12 weeks. In some patients harboring zidovudine-resistant virus at baseline, phenotypic sensitivity to zidovudine was restored by 12 weeks of treatment with zidovudine and lamivudine. Lamivudine/zidovudine combination therapy delayed the emergence of mutations conferring zidovudine resistance. HIV strains resistant to both lamivudine and zidovudine have been isolated from patients after prolonged lamivudine/zidovudine therapy. Dual resistance required the presence of multiple amino acid substitutions, the most essential of which may be G333E. The incidence of dual resistance and the duration of combination therapy required before dual resistance occurs are unknown. 
+                                                                                                                                                                                                                                                                Lamivudine-resistant isolates of HIV-1 have been selected in cell culture and have also been recovered from patients treated with lamivudine or lamivudine plus zidovudine. Genotypic analysis of isolates selected in cell culture and recovered from lamivudine-treated patients showed that the resistance was due to a specific amino acid substitution in the HIV-1 reverse transcriptase at codon 184 changing the methionine to either isoleucine or valine (M184V/I). 
+                                                                                                                                                                                                                                                                HIV-1 isolates with reduced susceptibility to zidovudine have been selected in cell culture and were also recovered from patients treated with zidovudine. Genotypic analyses of the isolates selected in cell culture and recovered from zidovudine-treated patients showed substitutions in the HIV-1 RT gene resulting in 6 amino acid substitutions (M41L, D67N, K70R, L210W, T215Y or F, and K219Q) that confer zidovudine resistance. In general, higher levels of resistance were associated with greater number of amino acid substitutions. 
+                                                                                                                                                                                                                                                                Cross-resistance between lamivudine and zidovudine has not been reported. In some patients treated with lamivudine alone or in combination with zidovudine, isolates have emerged with a substitution at codon 184, which confers resistance to lamivudine. Cross-resistance to abacavir, didanosine, tenofovir, and zalcitabine has been observed in some patients harboring lamivudine-resistant HIV-1 isolates. In some patients treated with zidovudine plus didanosine or zalcitabine, isolates resistant to multiple drugs, including lamivudine, have emerged. 
+                                                                                                                                                                                                                                                                In a study of 167 HIV-1-infected patients, isolates (n = 2) with multi-drug resistance to didanosine, lamivudine, stavudine, zalcitabine, and zidovudine were recovered from patients treated for &amp;ge;1 year with zidovudine plus didanosine or zidovudine plus zalcitabine. The pattern of resistance-associated amino acid substitutions with such combination therapies was different (A62V, V75I, F77L, F116Y, Q151M) from the pattern with zidovudine monotherapy, with the Q151M substitution being most commonly associated with multi-drug resistance. The substitution at codon 151 in combination with substitutions at 62, 75, 77, and 116 results in a virus with reduced susceptibility to didanosine, lamivudine, stavudine, zalcitabine, and zidovudine. Thymidine analogue mutations (TAMs) are selected by zidovudine and confer cross-resistance to abacavir, didanosine, stavudine, tenofovir, and zalcitabine. </pharmacology><adverseEvents>Lactic acidosis and severe hepatomegaly with steatosis have been reported with the use of nucleoside analogues alone or in combination, including lamivudine, zidovudine, and other antiretrovirals. These conditions are sometimes fatal. A majority of these cases have been in women. Obesity and prolonged nucleoside exposure may be risk factors. Caution should be exercised when administering lamivudine/zidovudine to any patient with known risk factors for liver disease; however, cases have been reported in patients with no known risk factors. Treatment with lamivudine/zidovudine should be suspended in any patient who develops clinical or laboratory findings that suggest the presence of lactic acidosis or pronounced hepatotoxicity (which may include hepatomegaly and steatosis even in the absence of marked transaminase elevations). 
+                                                                                                                                                                                                                                                                Zidovudine has been associated with hematologic toxicity, including neutropenia and severe anemia, particularly in patients with advanced HIV disease. Lamivudine/zidovudine should be used with caution in patients who have bone marrow compromise evidenced by granulocyte count less than 1,000 cells/mm3 or hemoglobin less than 9.5 g/dL. Frequent blood counts are strongly recommended in patients with advanced HIV-1 disease who are treated with lamivudine/zidovudine. Periodic blood counts are recommended for other HIV-1-infected patients. If anemia or neutropenia develops, dosage interruption may be needed. 
+                                                                                                                                                                                                                                                                Myopathy and myositis have occurred with prolonged use of zidovudine and may occur during therapy with lamivudine/zidovudine. 
+                                                                                                                                                                                                                                                                Acute exacerbations of hepatitis B have been reported in patients who are co-infected with hepatitis B virus (HBV) and HIV-1 and have discontinued lamivudine, which is one component of lamivudine/zidovudine. Hepatic function should be monitored closely with both clinical and laboratory follow-up for at least several months in patients who discontinue lamivudine/zidovudine and are co-infected with HIV-1 and HBV. If appropriate, initiation of anti-hepatitis B therapy may be warranted. 
+                                                                                                                                                                                                                                                                Post treatment Exacerbations of Hepatitis: In clinical trials in non-HIV-1-infected patients treated with lamivudine for chronic HBV, clinical and laboratory evidence of exacerbations of hepatitis have occurred after discontinuation of lamivudine. These exacerbations have been detected primarily by serum ALT elevations in addition to re-emergence of hepatitis B viral DNA (HBV DNA). Although most events appear to have been self-limited, fatalities have been reported in some cases. Similar events have been reported from post-marketing experience after changes from lamivudine-containing HIV-1 treatment regimens to non-lamivudine-containing regimens in patients infected with both HIV-1 and HBV. The causal relationship to discontinuation of lamivudine treatment is unknown. Patients should be closely monitored with both clinical and laboratory follow-up for at least several months after stopping treatment. There is insufficient evidence to determine whether re-initiation of lamivudine alters the course of posttreatment exacerbations of hepatitis. 
+                                                                                                                                                                                                                                                                Important Differences Among Lamivudine-Containing Products: Combivir tablets contain a higher dose of the same active ingredient (lamivudine) than Epivir-HBV (lamivudine) tablets and oral solution. Epivir-HBV was developed for treating chronic hepatitis B. Safety and efficacy of lamivudine have not been established for treatment of chronic hepatitis B in patients co-infected with HIV-1 and HBV. 
+                                                                                                                                                                                                                                                                Emergence of Lamivudine-Resistant HBV: In non-HIV-infected patients treated with lamivudine for chronic hepatitis B, emergence of lamivudine-resistant HBV has been detected and has been associated with diminished treatment response (see full prescribing information for EPIVIR-HBV for additional information). Emergence of hepatitis B virus variants associated with resistance to lamivudine has also been reported in HIV-1-infected patients who have received lamivudine-containing antiretroviral regimens in the presence of concurrent infection with hepatitis B virus. 
+                                                                                                                                                                                                                                                                Lamivudine/zidovudine should be used with caution in patients with a history of pancreatitis or other significant risk factors for the development of pancreatitis. Treatment with lamivudine/zidovudine should be stopped immediately if clinical signs, symptoms, or laboratory abnormalities suggestive of pancreatitis occur. 
+                                                                                                                                                                                                                                                                Immune reconstitution syndrome has been reported in patients receiving anti-HIV therapy, including lamivudine/zidovudine. Patients who exhibit an inflammatory response to indolent or residual opportunistic infections may require further evaluation before initiating certain anti-HIV regimens. 
+                                                                                                                                                                                                                                                                Redistribution/accumulation of body fat including central obesity, dorsocervical fat enlargement (buffalo hump), peripheral wasting, facial wasting, breast enlargement, and &amp;ldquo;cushingoid appearance&amp;rdquo; have been observed in patients receiving antiretroviral therapy. The mechanism and long-term consequences of these events are currently unknown. A causal relationship has not been established. 
+                                                                                                                                                                                                                                                                Reported adverse events occurring in clinical trials of lamivudine/zidovudine affected the following body systems: body as a whole (headache, malaise, fatigue, fever, chills); digestive (nausea, diarrhea, vomiting, anorexia and/or decreased appetite, abdominal pain and cramps, dyspepsia); nervous system (neuropathy, insomnia and other sleep disorders, dizziness, depressive disorders); respiratory (nasal signs and symptoms, cough); skin (rash); and musculoskeletal (musculoskeletal pain, myalgia, arthralgia). 
+                                                                                                                                                                                                                                                                Adverse events reported during post-approval use of lamivudine/zidovudine or either of the component drugs occurred in the following body systems: body as a whole (redistribution or accumulation of body fat); cardiovascular (cardiomyopathy); endocrine and metabolic (gynecomastia, hyperglycemia); gastrointestinal (oral mucosal pigmentation, stomatitis); general (vasculitis, weakness); hemic and lymphatic (anemia [including pure red cell aplasia and anemias progressing on therapy], lymphadenopathy, splenomegaly); hepatic and pancreatic (lactic acidosis and hepatic steatosis, pancreatitis, posttreatment exacerbation of hepatitis B); hypersensitivity (sensitization reactions [including anaphylaxis], urticaria); musculoskeletal (muscle weakness, creatine phosphokinase elevation, rhabdomyolysis); nervous (paresthesia, peripheral neuropathy, seizures); respiratory (abnormal breath sounds, wheezing ); and skin (alopecia, erythema multiform, Stevens-Johnson syndrome). 
+                                                                                                                                                                                                                                                                The most commonly reported adverse reactions (incidence greater than or equal to 15%) in adult and pediatric HIV-1 clinical studies of combination lamivudine and zidovudine were headache, nausea, malaise and fatigue, nasal signs and symptoms, diarrhea, and cough. </adverseEvents><drugInteractions>Lamivudine/zidovudine tablets may be administered with or without food. Administering the drug with food did not alter the area under the concentration-time curve (AUC) for lamivudine or zidovudine, as compared to administration under fasting conditions. 
+                                                                                                                                                                                                                                                                Lamivudine/zidovudine is a fixed-dose combination of lamivudine and zidovudine. Lamivudine/zidovudine should not be administered concomitantly with other lamivudine- or zidovudine-containing products including Epivir (lamivudine) tablets and oral solution, Epivir-HBV tablets and oral solution, Retrovir (zidovudine) tablets, capsules, syrup, and IV infusion, Epzicom (abacavir sulfate and lamivudine) tablets, or Trizivir (abacavir sulfate, lamivudine, and zidovudine) tablets; or emtricitabine-containing products, including Atripla (efavirenz, emtricitabine, and tenofovir), Emtriva (emtricitabine), or Truvada (emtricitabine and tenofovir). 
+                                                                                                                                                                                                                                                                In vitro studies have shown ribavirin can reduce the phosphorylation of pyrimidine nucleoside analogues such as lamivudine and zidovudine. Although no evidence of a pharmacokinetic or pharmacodynamic interaction (e.g., loss of HIV-1/HCV virologic suppression) was seen when ribavirin was coadministered with lamivudine or zidovudine in HIV-1/HCV co-infected patients, hepatic decompensation (some fatal) has occurred in HIV-1/HCV co-infected patients receiving combination antiretroviral therapy for HIV-1 and interferon alfa with or without ribavirin. Patients receiving interferon alfa with or without ribavirin and lamivudine/zidovudine should be closely monitored for treatment-associated toxicities, especially hepatic decompensation, neutropenia, and anemia. Discontinuation of lamivudine/zidovudine should be considered as medically appropriate. Dose reduction or discontinuation of interferon alfa, ribavirin, or both should also be considered if worsening clinical toxicities are observed, including hepatic decompensation (e.g., Child-Pugh greater than 6) (see the complete prescribing information for interferon and ribavirin). Exacerbation of anemia has been reported in HIV-1/HCV co-infected patients receiving ribavirin and zidovudine. Co-administration of ribavirin and zidovudine is not advised. 
+                                                                                                                                                                                                                                                                Antiretroviral agents: Lamivudine and zalcitabine may inhibit the intracellular phosphorylation of one another. Therefore, use of lamivudine/zidovudine in combination with zalcitabine is not recommended. Concomitant use of lamivudine/zidovudine with stavudine should be avoided since an antagonistic relationship with zidovudine has been demonstrated in vitro. Some nucleoside analogues affecting DNA replication, such as ribavirin, antagonize the in vitro antiviral activity of zidovudine against HIV-1; concomitant use of such drugs should be avoided. 
+                                                                                                                                                                                                                                                                Doxorubicin: Concomitant use of lamivudine/zidovudine with doxorubicin should be avoided since an antagonistic relationship with zidovudine has been demonstrated in vitro. 
+                                                                                                                                                                                                                                                                Hematologic/bone marrow suppressive/cytotoxic agents: Coadministration of ganciclovir, interferon alfa, ribavirin, and other bone marrow suppressive or cytotoxic agents may increase the hematologic toxicity of zidovudine. 
+                                                                                                                                                                                                                                                                Trimethoprim/Sulfamethoxazole (TMP/SMX): No change in dose of either TMP/SMX or lamivudine is recommended. There is no information regarding the effect on lamivudine pharmacokinetics of higher doses of TMP/SMX such as those used to treat PCP. </drugInteractions><contraindications>Lamivudine/zidovudine tablets are contraindicated in patients with previously demonstrated clinically significant hypersensitivity (e.g., anaphylaxis, Stevens-Johnson syndrome) to any of the components of the products. </contraindications><solubility>Lamivudine: 70 mg/mL in water at 20&amp;deg;C.&amp;nbsp; 
+
+                                                                                                                                                                                                                                                                Zidovudine: 20.1 mg/mL in water at 25&amp;deg;C. </solubility><stability></stability><physicalDescription>Lamivudine: White to off-white crystalline solid. 
+
+                                                                                                                                                                                                                                                                Zidovudine: White to beige, odorless, crystalline solid </physicalDescription><furtherReading>
+
+                                                                                                                                                                                                                                                                Combivir Prescribing Information from the FDA Web site [PDF]. A more current version may be available on the manufacturer's Web site.
+                                                                                                                                                                                                                                                                Castillo SA, Hernandez JE, Brothers CH. Long-term safety and tolerability of the lamivudine/abacavir combination as components of highly active antiretroviral therapy. Drug Saf. 2006;29(9):811-26.
+                                                                                                                                                                                                                                                                Fischl MA, Burnside AE Jr, Farthing CE, Thompson MA, Bellos NC, Williams VC, Kauf TL, Wannamaker PG, Shaefer MS; ESS40005 Study Team. Twice-daily Trizivir versus Combivir-abacavir in antiretroviral-experienced adults with human immunodeficiency virus-1 infection: a formulation-switch trial. Pharmacotherapy. 2003 Nov;23(11):1432-40.
+                                                                                                                                                                                                                                                                Kumar P, Rodriguez-French A, Thompson M, Tashima K, Averitt D, Wannamaker P, Williams V, Shaefer M, Pakes G, Pappa K; ESS40002 Study Team. A prospective, 96-week study of the impact of Trizivir, Combivir/nelfinavir, and lamivudine/staviudine/nelfinavir on lipids, metabolic parameters and efficacy in antiviral-na&amp;iuml;ve patients: effect of sex and ethnicity. HIV Med. 2006 Mar;7(2):85-98.
+                                                                                                                                                                                                                                                                Matheron S, Descamps D, Boue F, Livrozet JM, Lafeuillade A, Aquilina C, Troisvallets D, Goetschel A, Brun-Vezinet F, Mamet JP, Thiaux C; CNA3007 Study Group. Triple nucleoside combination zidovudine/lamivudine/abacavir versus zidovudine/lamivudine/nelfinavir as first-line therapy in HIV-1-infected adults: a randomized trial. Antivir Ther. 2003 Apr;8(2):163-71.
+                                                                                                                                                                                                                                                                Ruane PJ, Parenti DM, Margolis DM, Shepp DH, Babinchak TJ, Van Kempen AS, Kauf TL, Danehower SA, Yau L, Hessenthaler SM, Goodwin D, Hernandez JE; COL30336 Study Team. Compact quadruple therapy with the lamivudine/zidovudine combination tablet plus abacavir and efavirenz, followed by the lamivudine/zidovudine/abacavir triple nucleoside tablet plus efavirenz in treatment-naive HIV-infected adults. HIV Clin Trials. 2003 Jul-Aug;4(4):231-43.</furtherReading></summary><summary type="Spanish"><description>El Combivir es una combinación de dos medicamentos contra el VIH: la lamivudina (Epivir) y la zidovudina (Retrovir). Ambos productos pertenecen a la clase de antirretrovirales llamados inhibidores de la transcriptasa inversa análogos de los nucleósidos (NRTI, por sus siglas en inglés). Estos medicamentos bloquean la transcriptasa inversa, una proteína que el VIH necesita para multiplicarse.</description><relatedUse>La lamivudina y la zidovudina están autorizadas independientemente por la Administración de Alimentos y Medicamentos (FDA, por sus siglas en inglés) para el tratamiento de la infección por el VIH en adultos y niños. Debido a que estos dos medicamentos con frecuencia se recetan juntos, el fabricante los ha combinado en una sola tableta. El Combivir fue aprobado por la FDA el 27 de septiembre de 1997 para empleo junto con otros antirretrovirales para el tratamiento de la infección por el VIH en adultos y niños mayores de 12 años. Este medicamento no cura ni previene la infección por el VIH o el SIDA ni reduce el riesgo de transmisión del virus a otras personas.</relatedUse><dosingInformation><dosageForm>El Combivir se fabrica en tabletas para tomarse por vía oral.</dosageForm><dailyDose>La dosis recomendada de Combivir para adultos y adolescentes de por lo menos de 12 años de edad es una tableta (150 mg de lamivudina y 300 mg de zidovudina) dos veces al día.Algunos pacientes pueden necesitar una dosis diferente de lamivudina o zidovudina. Ellos no deben tomar Combivir.</dailyDose></dosingInformation><contraindications>Las personas deben informarle al médico sobre cualquier problema médico que tengan antes de tomar este medicamento.Las advertencias y los efectos secundarios del compuesto de lamivudina/zidovudina pueden ser similares a los de cada uno de esos productos por separado. (Para más información véanse los resúmenes particulares de la lamivudina y la zidovudina.) Los niños menores de 12 años no deben tomar lamivudina/zidovudina. Las personas con enfermedad de la sangre, enfermedad de los riñones o del hígado o inflamación del páncreas deben informarle al médico antes de tomar este medicamento.</contraindications><sideEffects>Además de sus efectos deseables, el compuesto de lamivudina/zidovudina puede causar algunos efectos adversos. Los efectos secundarios graves de este medicamento incluyen: ardor, hormigueo o dolor de las manos, los brazos, los pies o las piernas; escalofrío; problemas del oído, de la nariz o de la garganta; fiebre; dolores musculares; náusea; palidez de la piel; intenso dolor de estómago; erupción de la piel; cansancio o debilidad poco comunes; vómito o amarillamiento de los ojos o la piel. Es preciso informarle al médico si padece cualquiera de estos efectos secundarios.Otros efectos secundarios pueden ser leves y disminuir o desaparecer con el uso continuo del medicamento. Entre los efectos secundarios leves de este medicamento están: tos, diarrea, mareo, dolor de cabeza, falta de apetito, cólico o dolor de estómago leve; y dificultad para dormir. Es preciso informarle  al médico si estos efectos secundarios continúan o son molestos.</sideEffects></summary></summaries><manufacturers><pharm><pharmDrug>Combivir</pharmDrug><company>GlaxoSmithKline</company><address>5 Moore Drive
+                                                                                                                                                                                                                                                                Research Triangle Park, NC 27709
+                                                                                                                                                                                                                                                                Phone: 888-825-5249</address></pharm><pharm><pharmDrug>Lamivudine/Zidovudine</pharmDrug><company>GlaxoSmithKline</company><address>5 Moore Drive
+                                                                                                                                                                                                                                                                Research Triangle Park, NC 27709
+                                                                                                                                                                                                                                                                Phone: 888-825-5249</address></pharm><pharm><pharmDrug>Lamivudine/Zidovudine</pharmDrug><company>Teva Pharmaceuticals USA</company><address>1090 Horsham Rd. P.O.B. 1090
+                                                                                                                                                                                                                                                                North Wales, PA 19454
+                                                                                                                                                                                                                                                                Phone: 888-TEVA-USA (838-2872)</address></pharm></manufacturers></drug>

data/spec/helper.rb

@@ -0,0 +1,48 @@
+$:.unshift File.expand_path('..', __FILE__)
+$:.unshift File.expand_path('../../lib', __FILE__)
+require 'simplecov'
+SimpleCov.start
+require 'aids_info'
+require 'rspec'
+
+require 'webmock/rspec'
+
+def a_delete(path)
+  a_request(:delete, 'http://aidsinfo.nih.gov/' + path)
+end
+
+def a_get(path)
+  a_request(:get, 'http://aidsinfo.nih.gov/' + path)
+end
+
+def a_post(path)
+  a_request(:post, 'http://aidsinfo.nih.gov/' + path)
+end
+
+def a_put(path)
+  a_request(:put, 'http://aidsinfo.nih.gov/' + path)
+end
+
+def stub_delete(path)
+  stub_request(:delete, 'http://aidsinfo.nih.gov/' + path)
+end
+
+def stub_get(path)
+  stub_request(:get, 'http://aidsinfo.nih.gov/' + path)
+end
+
+def stub_post(path)
+  stub_request(:post, 'http://aidsinfo.nih.gov/' + path)
+end
+
+def stub_put(path)
+  stub_request(:put, 'http://aidsinfo.nih.gov/' + path)
+end
+
+def fixture_path
+  File.expand_path('../fixtures', __FILE__)
+end
+
+def fixture(file)
+  File.new(fixture_path + '/' + file)
+end

metadata

@@ -0,0 +1,196 @@
+--- !ruby/object:Gem::Specification
+name: aids_info
+version: !ruby/object:Gem::Version
+  version: 1.0.0
+  prerelease: 
+platform: ruby
+authors:
+- Code for America
+autorequire: 
+bindir: bin
+cert_chain: []
+date: 2011-08-22 00:00:00.000000000Z
+dependencies:
+- !ruby/object:Gem::Dependency
+  name: ZenTest
+  requirement: &21264640 !ruby/object:Gem::Requirement
+    none: false
+    requirements:
+    - - ~>
+      - !ruby/object:Gem::Version
+        version: '4.5'
+  type: :development
+  prerelease: false
+  version_requirements: *21264640
+- !ruby/object:Gem::Dependency
+  name: maruku
+  requirement: &21264140 !ruby/object:Gem::Requirement
+    none: false
+    requirements:
+    - - ~>
+      - !ruby/object:Gem::Version
+        version: '0.6'
+  type: :development
+  prerelease: false
+  version_requirements: *21264140
+- !ruby/object:Gem::Dependency
+  name: rake
+  requirement: &21263680 !ruby/object:Gem::Requirement
+    none: false
+    requirements:
+    - - ~>
+      - !ruby/object:Gem::Version
+        version: '0.9'
+  type: :development
+  prerelease: false
+  version_requirements: *21263680
+- !ruby/object:Gem::Dependency
+  name: rspec
+  requirement: &21263220 !ruby/object:Gem::Requirement
+    none: false
+    requirements:
+    - - ~>
+      - !ruby/object:Gem::Version
+        version: '2.6'
+  type: :development
+  prerelease: false
+  version_requirements: *21263220
+- !ruby/object:Gem::Dependency
+  name: simplecov
+  requirement: &21262760 !ruby/object:Gem::Requirement
+    none: false
+    requirements:
+    - - ~>
+      - !ruby/object:Gem::Version
+        version: '0.4'
+  type: :development
+  prerelease: false
+  version_requirements: *21262760
+- !ruby/object:Gem::Dependency
+  name: yard
+  requirement: &21262300 !ruby/object:Gem::Requirement
+    none: false
+    requirements:
+    - - ~>
+      - !ruby/object:Gem::Version
+        version: '0.7'
+  type: :development
+  prerelease: false
+  version_requirements: *21262300
+- !ruby/object:Gem::Dependency
+  name: webmock
+  requirement: &21261840 !ruby/object:Gem::Requirement
+    none: false
+    requirements:
+    - - ~>
+      - !ruby/object:Gem::Version
+        version: '1.6'
+  type: :development
+  prerelease: false
+  version_requirements: *21261840
+- !ruby/object:Gem::Dependency
+  name: faraday
+  requirement: &21261380 !ruby/object:Gem::Requirement
+    none: false
+    requirements:
+    - - ~>
+      - !ruby/object:Gem::Version
+        version: 0.6.1
+  type: :runtime
+  prerelease: false
+  version_requirements: *21261380
+- !ruby/object:Gem::Dependency
+  name: faraday_middleware
+  requirement: &21260920 !ruby/object:Gem::Requirement
+    none: false
+    requirements:
+    - - ~>
+      - !ruby/object:Gem::Version
+        version: 0.6.3
+  type: :runtime
+  prerelease: false
+  version_requirements: *21260920
+- !ruby/object:Gem::Dependency
+  name: hashie
+  requirement: &21260460 !ruby/object:Gem::Requirement
+    none: false
+    requirements:
+    - - ~>
+      - !ruby/object:Gem::Version
+        version: 1.0.0
+  type: :runtime
+  prerelease: false
+  version_requirements: *21260460
+- !ruby/object:Gem::Dependency
+  name: multi_xml
+  requirement: &21260000 !ruby/object:Gem::Requirement
+    none: false
+    requirements:
+    - - ~>
+      - !ruby/object:Gem::Version
+        version: 0.2.2
+  type: :runtime
+  prerelease: false
+  version_requirements: *21260000
+- !ruby/object:Gem::Dependency
+  name: rash
+  requirement: &21259540 !ruby/object:Gem::Requirement
+    none: false
+    requirements:
+    - - ~>
+      - !ruby/object:Gem::Version
+        version: 0.3.0
+  type: :runtime
+  prerelease: false
+  version_requirements: *21259540
+description: A very small wrapper around the AidsInfo Drug Info database
+email: info@codeforamerica.org
+executables: []
+extensions: []
+extra_rdoc_files: []
+files:
+- .autotest
+- .gemtest
+- .gitignore
+- .rspec
+- .yardopts
+- Gemfile
+- LICENSE.md
+- README.md
+- Rakefile
+- aids_info.gemspec
+- lib/aids_info.rb
+- lib/aids_info/client.rb
+- lib/aids_info/client/api.rb
+- lib/aids_info/client/connection.rb
+- lib/aids_info/client/request.rb
+- lib/aids_info/version.rb
+- spec/aids_info/api_spec.rb
+- spec/aids_info_spec.rb
+- spec/fixtures/combivir.xml
+- spec/helper.rb
+homepage: ''
+licenses: []
+post_install_message: 
+rdoc_options: []
+require_paths:
+- lib
+required_ruby_version: !ruby/object:Gem::Requirement
+  none: false
+  requirements:
+  - - ! '>='
+    - !ruby/object:Gem::Version
+      version: '0'
+required_rubygems_version: !ruby/object:Gem::Requirement
+  none: false
+  requirements:
+  - - ! '>='
+    - !ruby/object:Gem::Version
+      version: '0'
+requirements: []
+rubyforge_project: 
+rubygems_version: 1.8.6
+signing_key: 
+specification_version: 3
+summary: A very small wrapper around the AidsInfo Drug Info database
+test_files: []