Name Abacavir + Lamivudine + Zidovudine
Classes Antiinfective Agent
Antiviral Agent
Antiviral Combination
Diseases HIV
Infectious Disease

Abacavir + Lamivudine + Zidovudine

Abacavir + Lamivudine + Zidovudine is a combination of anti retroviral drug belonging to the class nucleoside reverse transcriptase inhibitor. They are incorporated to the viral DNA during replication and inhibit the process terminating viral replication. 

Abacavir + Lamivudine + Zidovudine is indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection. 

  • Before initiating Abacavir + Lamivudine + Zidovudine, screen for the HLA-B*5701 allele because Abacavir + Lamivudine + Zidovudine contains abacavir.
  • Adults and pediatric patients weighing at least 40 kg: 1 tablet twice daily. 
  • Because Abacavir + Lamivudine + Zidovudine is a fixed-dose tablet and cannot be dose adjusted, Abacavir + Lamivudine + Zidovudine is not recommended in patients requiring dosage adjustment or patients with hepatic impairment.

The most commonly reported adverse reactions were-

  • nausea
  • headache
  • malaise
  • fatigue
  • vomiting
  • Hypersensitivity Reactions:
    • Serious and sometimes fatal hypersensitivity reactions have occurred with abacavir-containing products. Hypersensitivity to abacavir is a multi-organ clinical syndrome. 
    • Patients who carry the HLA-B*5701 allele are at a higher risk of experiencing a hypersensitivity reaction to abacavir. 
    • Abacavir + Lamivudine + Zidovudine is contraindicated in patients with a prior hypersensitivity reaction to abacavir and in HLA-B*5701-positive patients.
    • Discontinue Abacavir + Lamivudine + Zidovudine as soon as a hypersensitivity reaction is suspected. Regardless of HLA-B*5701 status, permanently discontinue Abacavir + Lamivudine + Zidovudine if hypersensitivity cannot be ruled out, even when other diagnoses are possible. 
    • Following a hypersensitivity reaction to Abacavir + Lamivudine + Zidovudine, NEVER restart Abacavir + Lamivudine + Zidovudine or any other abacavir-containing product. 
  • Hematologic Toxicity:  Hematologic toxicity, including neutropenia and anemia, has been associated with the use of zidovudine, a component of Abacavir + Lamivudine + Zidovudine.
  • Myopathy: Symptomatic myopathy associated with prolonged use of zidovudine. 
  • Lactic Acidosis and Severe Hepatomegaly with Steatosis: Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues. 
  • Exacerbations of Hepatitis B: Severe acute exacerbations of hepatitis B have been reported in patients who are co-infected with hepatitis B virus (HBV) and human immunodeficiency virus (HIV-1) and have discontinued lamivudine, a component of Abacavir + Lamivudine + Zidovudine. Monitor hepatic function closely in these patients and, if appropriate, initiate anti-hepatitis B treatment.
  • In HIV-1/HCV co-infected patients receiving combination antiretroviral therapy and interferon alfa with or without ribavirin, hepatic decompensation, some fatal, has occurred. Discontinue Abacavir + Lamivudine + Zidovudine as directed by your doctor, and consider reducing or discontinuing interferon alfa, ribavirin, or both.
  • Anemia has been reported to worsen in HIV-1/HCV co-infected patients receiving ribavirin and zidovudine. Ribavirin and zidovudine should not be taken together.
  • In patients receiving combination antiretroviral therapy, immune reconstitution syndrome and redistribution/accumulation of body fat have been reported.

Contraindication

Contraindicated in patients with prior hypersensitivity reaction to-

Contraindicated in patients with-

  • Presence of HLA-B*5701 allele
  • Moderate or severe hepatic impairment