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What are the side effects of lamivudine/zidovudine?

A "black box warning" has been issued by the United States Food and Drug Administration for four of the most serious side effects of lamivudine-zidovudine. These include: bone marrow toxicity with low white cell and low red blood cell counts; muscle problems; high lactic acid levels and an enlarged, fatty liver; and worsening of infection with hepatitis B. If bone marrow toxicity, muscle problems and high lactic acid levels develop, the drug should be stopped immediately. The last of these potential side effects occurs in people that have both human immunodeficiency virus (HIV) and hepatitis B virus infection. The most common side effects of lamivudine-zidovudine, which occur in more than 10 percent of individuals, include: headaches, fatigue, nausea, vomiting, diarrhea, nasal symptoms, cough, insomnia, nerve problems and bone or muscle pain. Other common side effects include: fever, chills, heartburn, stomach pain or cramps, joint pain, dizziness and decreased appetite. Serious side effects include: inflammation of the pancreas, mental depression, low platelet counts, redistribution of body fat and allergic reactions.