Abacavir & Lamivudine

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.

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

• Epzicom

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.

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:

• hepatitis medicines such as interferon or ribavirin
• methadone
• HIVID (zalcitabine, ddC)
• Epivir or Epivir-HBV (lamivudine, 3TC), Atripla (efavirenz/emtricitabine/and tenofovir disoproxil fumarate), Ziagen (abacavir sulfate), Combivir (lamivudine and zidovudine), Complera (emtricitabine/rilpivirine/tenofovir disoproxil fumarate), Emtriva (emtricitabine), Truvada (emtricitabine/tenofovir disoproxil fumarate) or Trizivir (abacavir sulfate, lamivudine, and zidovudine)
• alcohol

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

• 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.

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.

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. 

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.

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.

• 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.

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.

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.

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

• 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.

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