Abacavir & Lamivudine

Abacavir/lamivudine treats HIV infection. This medication may cause a build-up of acid in the blood.

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Pharmacist Trey Robinson, PharmD overviews the uses and common side effects of Abacavir and lamivudine
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Abacavir and Lamivudine
Abacavir and Lamivudine
Pharmacist Trey Robinson, PharmD overviews the uses and common side effects of Abacavir and lamivudine
Antivirals
Antivirals
Pharmacist Steve Lozano, PharmD summarizes the uses, common side effects, and warnings for the Antivirals class of medications

Abacavir & Lamivudine Overview

Updated: 

Abacavir/lamivudine is a prescription medication used to treat human immunodeficiency virus (HIV) infection in adults. Abacavir/lamivudine belongs to a group of drugs called nucleoside reverse transcriptase inhibitors (NRTIs), which help decrease the amount of HIV in your blood.

This medication comes in tablet form and is taken once a day, with or without food. 

Common side effects of abacavir/lamivudine include trouble sleeping, depression, and headache.

 

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Uses of Abacavir & Lamivudine

Abacavir/lamivudine is a prescription medication used to treat human immunodeficiency virus (HIV) infection in adults.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Abacavir & Lamivudine Brand Names

Abacavir & Lamivudine may be found in some form under the following brand names:

Abacavir & Lamivudine Drug Class

Abacavir & Lamivudine is part of the drug class:

Side Effects of Abacavir & Lamivudine

Abacavir/lamivudine can cause the following serious side effects:

  • Serious allergic reaction that can cause death.
  • Lactic acidosis with liver enlargement (hepatomegaly) that can cause death.
  • Worsening of HBV infection. 
  • Changes in immune system. When you start taking HIV medicines, your immune system may get stronger and could begin to fight infections that have been hidden in your body, such as pneumonia, herpes virus, or tuberculosis. If you have new symptoms after starting your HIV medicines, be sure to tell your doctor.
  • Changes in body fat. These changes have happened in patients taking antiretroviral medicines like abacavir/lamivudine. The changes may include an increased amount of fat in the upper back and neck (“buffalo hump”), breast, and around the back, chest, and stomach area. Loss of fat from the legs, arms, and face may also happen. The cause and long-term health effects of these conditions are not known.

Some HIV medicines including abacavir/lamivudine may increase your risk of heart attack. If you have heart problems, smoke, or suffer from diseases that increase your risk of heart disease such as high blood pressure, high cholesterol, or diabetes, tell your doctor.

The most common side effects with abacavir/lamivudine are:

  • trouble sleeping
  • depression
  • headache
  • tiredness
  • dizziness
  • nausea
  • diarrhea
  • rash
  • fever
  • stomach pain
  • abnormal dreams
  • anxiety

Most of these side effects did not cause people to stop taking abacavir/lamivudine.

This list of side effects is not complete. Ask your doctor or pharmacist for more information.

Abacavir & Lamivudine Interactions

Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take any of the following medicines:

This is not a complete list of abacavir/lamivudine drug interactions. Ask your doctor or pharmacist for more information.

Abacavir & Lamivudine Precautions

  • Serious Allergic Reaction to Abacavir. Patients taking abacavir/lamivudine may have a serious allergic reaction (hypersensitivity reaction) that can cause death. Your risk of this allergic reaction is much higher if you have a gene variation called HLA-B*5701 than if you do not. Your doctor can determine with a blood test if you have this gene variation.
    • If you stop abacavir/lamivudine because of an allergic reaction, NEVER take abacavir/lamivudine or any other abacavir-containing medicine again. If you take abacavir/lamivudine or any other abacavir-containing medicine again after you have had an allergic reaction, WITHIN HOURS you may get life-threatening symptoms that may include very low blood pressure or death.
    • If you stop abacavir/lamivudine for any other reason, even for a few days, and you are not allergic to abacavir/lamivudine, talk with your doctor before taking it again. Taking abacavir/lamivudine again can cause a serious allergic or life-threatening reaction, even if you never had an allergic reaction to it before. If your doctor tells you that you can take abacavir/lamivudine again, start taking it when you are around medical help or people who can call a doctor if you need one.
  • Lactic Acidosis. Some human immunodeficiency virus (HIV) medicines, including abacavir/lamivudine, can cause a rare but serious condition called lactic acidosis with liver enlargement (hepatomegaly). Nausea and tiredness that don't get better may be symptoms of lactic acidosis. In some cases this condition can cause death. Women, overweight people, and people who have taken HIV medicines like abacavir/lamivudine for a long time have a higher chance of getting lactic acidosis and liver enlargement. Lactic acidosis is a medical emergency and must be treated in the hospital.
  • Worsening of hepatitis B virus (HBV) infection. Patients with HBV infection, who take abacavir/lamivudine and then stop it, may get “flare-ups” of their hepatitis. “Flare-up” is when the disease suddenly returns in a worse way than before. If you have HBV infection, your doctor should closely monitor your liver function for several months after stopping abacavir/lamivudine. You may need to take anti-HBV medicines.
  • Use with interferon- and ribavirin-based regimens. Worsening of liver disease (sometimes resulting in death) has occurred in patients infected with both HIV and hepatitis C virus who are taking anti-HIV medicines and are also being treated for hepatitis C with interferon with or without ribavirin. If you are taking abacavir/lamivudine as well as interferon with or without ribavirin and you experience side effects, be sure to tell your doctor.

Abacavir/lamivudine can have other serious side effects.

Do not take abacavir/lamivudine if you:

  • have ever had a serious allergic reaction (a hypersensitivity reaction) to abacavir/lamivudine or any other medicine that has abacavir as one of its ingredients.
  • have a liver that does not function properly.
  • are less than 18 years of age.

Abacavir & Lamivudine Food Interactions

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of abacavir/lamivudine there are no specific foods that you must exclude from your diet when receiving abacavir/lamivudine.

Inform MD

Before starting abacavir/lamivudine tell your doctor about all of your medical conditions, including if you:

  • have been tested and know whether or not you have a particular gene variation called HLA-B*5701.
  • are pregnant or planning to become pregnant. We do not know if abacavir/lamivudine will harm your unborn child. You and your doctor will need to decide if abacavir/lamivudine is right for you. If you use abacavir/lamivudine while you are pregnant, talk to your doctor about how you can be on the Antiviral Pregnancy Registry for abacavir/lamivudine.
  • are breastfeeding. Some of the ingredients in abacavir/lamivudine can be passed to your baby in your breast milk. It is not known if they could harm your baby. Also, mothers with HIV should not breastfeed because HIV can be passed to the baby in the breast milk.
  • have liver problems including hepatitis B virus infection.
  • have kidney problems.
  • have heart problems, smoke, or suffer from diseases that increase your risk of heart disease such as high blood pressure, high cholesterol, or diabetes.

Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. 

Abacavir & Lamivudine and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Abacavir/lamivudine falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

If you take abacavir/lamivudine while you are pregnant, talk to your healthcare provider about how you can take part in the Pregnancy Registry for abacavir/lamivudine. The purpose of the pregnancy registry is to collect information about the health of you and your baby.

Abacavir & Lamivudine and Lactation

Tell your doctor if you are breastfeeding or plan to breastfeed. The Centers for Disease Control and Prevention recommend that HIV-1-infected mothers not breastfeed their infants to avoid risk of HIV-1 transmission. Both medicines in abacavir/lamivudine may be excreted in human breast milk. Because of both the potential for HIV-1 transmission and the potential for serious adverse reactions in nursing infants, your doctor advise you not to breastfeed while taking abacavir/lamivudine.

Abacavir & Lamivudine Usage

  • Take abacavir/lamivudine by mouth exactly as your doctor prescribes it. The usual dose is 1 tablet once a day. Do not skip doses.
  • You can take abacavir/lamivudine with or without food.
  • If you miss a dose of abacavir/lamivudine, take the missed dose right away. Then, take the next dose at the usual time.
  • Do not let your abacavir/lamivudine run out.
  • Starting abacavir/lamivudine again can cause a serious allergic or life-threatening reaction, even if you never had an allergic reaction to it before. If you run out of abacavir/lamivudine even for a few days, you must ask your doctor if you can start abacavir/lamivudine again. If your doctor tells you that you can take abacavir/lamivudine again, start taking it when you are around medical help or people who can call a doctor if you need one.
  • If you stop your anti-HIV drugs, even for a short time, the amount of virus in your blood may increase and the virus may become harder to treat.
  • If you take too much abacavir/lamivudine, call your doctor or poison control center right away.

Abacavir & Lamivudine Dosage

Take abacavir/lamivudine exactly as your doctor prescribes it. Follow the directions on your prescription label carefully.

The recommended dose of abacavir/lamivudine in adults is one tablet daily, along with other antiretroviral medicines.

Abacavir & Lamivudine Overdose

If you take too much abacavir/lamivudine seek emergency medical attention or call your local Poison Control Center right away.

If abacavir/lamivudine is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Forms of Medication

Abacavir/lamivudine tablets contain 600 mg of abacavir sulfate and 300 mg of lamivudine.

Other Requirements

  • Store abacavir/lamivudine at room temperature between 59° to 86°F (15° to 30°C).
  • Keep abacavir/lamivudine and all medicines out of the reach of children.

Abacavir & Lamivudine FDA Warning

WARNING: RISK OF HYPERSENSITIVITY REACTIONS, LACTIC ACIDOSIS AND SEVERE HEPATOMEGALY, AND EXACERBATIONS OF HEPATITIS

Hypersensitivity Reactions: Serious and sometimes fatal hypersensitivity reactions have been associated with abacavir sulfate, a component of this medication (abacavir sulfate and lamivudine).

Hypersensitivity Reactions: Serious and sometimes fatal hypersensitivity reactions have been associated with abacavir sulfate. Hypersensitivity to abacavir is a multi-organ clinical syndrome usually characterized by a sign or symptom in 2 or more of the following groups: 

(1) fever,
(2) rash,
(3) gastrointestinal (including nausea, vomiting, diarrhea, or abdominal pain),
(4) constitutional (including generalized malaise, fatigue, or achiness), and
(5) respiratory (including dyspnea, cough, or pharyngitis).
  • Discontinue this medication as soon as a hypersensitivity reaction is suspected.

Patients who carry the HLA-B*5701 allele are at high risk for experiencing a hypersensitivity reaction to abacavir. Prior to initiating therapy with abacavir, screening for the HLA-B*5701 allele is recommended; this approach has been found to decrease the risk of hypersensitivity reaction. Screening is also recommended prior to reinitiation of abacavir in patients of unknown HLA-B*5701 status who have previously tolerated abacavir. HLA-B*5701-negative patients may develop a suspected hypersensitivity reaction to abacavir; however, this occurs significantly less frequently than in HLA-B*5701-positive patients.

Regardless of HLA-B*5701 status, permanently discontinue this medication if hypersensitivity cannot be ruled out, even when other diagnoses are possible.

Following a hypersensitivity reaction to abacavir, NEVER restart this medication or any other abacavir-containing product because more severe symptoms can occur within hours and may include life-threatening hypotension and death.

Reintroduction of this medication or any other abacavir-containing product, even in patients who have no identified history or unrecognized symptoms of hypersensitivity to abacavir therapy, can result in serious or fatal hypersensitivity reactions. Such reactions can occur within hours.

Lactic Acidosis and Severe Hepatomegaly: Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues alone or in combination, including abacavir, lamivudine, and other antiretrovirals

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, which is one component of this medication. Hepatic function should be monitored closely with both clinical and laboratory follow-up for at least several months in patients who discontinue this medication and are co-infected with HIV-1 and HBV. If appropriate, initiation of anti-hepatitis B therapy may be warranted.