Abacavir/lamivudine/zidovudine is a combination formulation of the Nucleotide and Nucleoside Reverse Transcriptase Inhibitors (NRTIs), indicated for the treatment of HIV-1 infection, in combination with other antiretroviral drugs.
Dosing & Administration
Abacavir/lamivudine/zidovudine is indicated for the treatment of HIV-1 infection in adults and adolescents weighing 40 Kg or more. The dose is one tablet orally twice a day, with or without food. Because some components require dose adjustments in patients with liver or kidney dysfunction, this formulation is not recommended for use in these patients.
Abacavir/lamivudine/zidovudine is contraindicated in patients with a hypersensitivity to any of the components should not take this drug, and in patients with very low neutrophil or hemoglobin levels.
Abacavir/lamivudine/zidovudine is associated with serious side effects, as described below. As well, it may cause myopathy/myositis, headache, fatigue/weakness, nausea/vomiting, dizziness, loss of appetite, and diarrhea. A detailed list of potential adverse events is available in the product monograph.
Patients should be screened for HLA-B*5701 prior to starting abacavir/lamivudine/zidovudine, due to the risk of serious hypersensitivity reaction to abacavir.
Abacavir/lamivudine/zidovudine may cause bone marrow suppression, and should be used with caution in patients with baseline bone marrow suppression, or those at risk. Therapy with abacavir/lamivudine/zidovudine requires frequent monitoring of laboratory indices of bone marrow function in all patients, as detailed in the product monograph.
Abacavir/lamivudine/zidovudine should not be used in patients with liver dysfunction due to risk of hepatotoxicity or lactic acidosis. Recommendations for screening and monitoring are outlined in the product monograph.
Discontinuation of lamivudine (a component of Abacavir/lamivudine/zidovudine) in patients co-infected with HIV and Hepatitis B virus (HBV) may lead to HBV exacerbation. Fatal cases have been reported. Monitoring recommendations for co-infected patients who discontinue Abacavir/lamivudine/zidovudine are listed in the product monograph.
Abacavir/lamivudine/zidovudine should be used with caution in patients requiring dental work due to the risk of myelosuppression and infection.
All patients who test positive for HIV infection should be screened for comorbid HBV and Hepatitis C virus (HCV) infection. Co-infected patients should be started on an antiretroviral regimen targeting co-infected viruses, regardless of CD4 counts or viral loads. Current HIV treatment guidelines outline drug regimens and prescribing considerations.
Abacavir/lamivudine/zidovudine is associated with a large number of drug-drug and herbal interactions. A complete list is provided in the product monograph.
Pregnancy & Lactation
Highly active retroviral combination treatment should be used in all pregnant women. Data from the Antiretroviral Pregnancy Registry do not show that any of the components of abacavir/lamivudine/zidovudine cause major birth defects above baseline. Components of abacavir/lamivudine/zidovudine are excreted in breast milk. The CDC recommends that all HIV positive women, treated or untreated, avoid breastfeeding to prevent vertical transmission of the virus.
There is no known treatment specific for abacavir/lamivudine/zidovudine overdose. Patients should be closely monitored and provided with supportive care. None of the components of abacavir/lamivudine/zidovudine appear to be removed by hemodialysis.
Alternative Brand Names
Abacavir/lamivudine/zidovudine 300/150/300mg is available under the brand name Trizivir.
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