HealthSearch

Health Guide

Abacavir, lamivudine, and zidovudine (Oral route)

Pronunciation:

a-BAK-a-vir SUL-fate, la-MIV-ue-deen, zye-DOE-vue-deen

Brand Names:

  • Trizivir

Dosage Forms:

  • Tablet

Warnings:

Oral route(Tablet)

Fatal hypersensitivity reactions have been reported with abacavir sulfate; discontinue if hypersensitivity reaction suspected; never restart an abacavir sulfate-containing product as potentially fatal reactions may recur within hours. Patients with HLA-B*5701 allele are at high risk for hypersensitivity to abacavir sulfate; screening for allele is recommended prior to initiating or reinitiation of therapy. Neutropenia, severe anemia, and symptomatic myopathy has been associated with zidovudine use, particularly in patients with advanced HIV disease. Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with nucleoside analogues alone or in combination with other antiretrovirals; discontinue use if lactic acidosis or pronounced hepatotoxicity is suspected. Severe acute exacerbations of hepatitis B have been reported in patients co-infected with HBV and HIV who have discontinued lamivudine; monitor hepatic function closely for several months following discontinuation of therapy .

Classifications:

Therapeutic—

Antiretroviral Agent

Pharmacologic—

Abacavir

Uses of This Medicine:

Abacavir, lamivudine, and zidovudine combination is used alone or together with other medicines to treat human immunodeficiency virus (HIV) infection. HIV is the virus that causes acquired immune deficiency syndrome (AIDS).

Abacavir, lamivudine, and zidovudine combination will not cure or prevent HIV infection or the symptoms of AIDS. This medicine helps keep HIV from reproducing, and appears to slow down the destruction of the immune system. This may help delay the development of serious health problems usually related to AIDS or HIV infection. Abacavir, lamivudine, and zidovudine combination will not keep you from spreading HIV to other people. People who receive this medicine may continue to have other problems usually related to AIDS or HIV infection.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Abacavir, lamivudine, and zidovudine combination contains a fixed amount of each medicine that cannot be decreased. Therefore, this medicine is not recommended for patients who weigh less than 40 kilograms because the amounts of abacavir, lamivudine, and zidovudine in this product cannot be adjusted for smaller body sizes.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of this medicine in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving this medicine.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Clarithromycin
  • Dapsone
  • Dasabuvir
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Flucytosine
  • Orlistat
  • Pyrazinamide
  • Pyrimethamine
  • Ribavirin
  • Stavudine
  • Vinblastine
  • Vincristine
  • Vincristine Sulfate Liposome

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acetaminophen
  • Fluconazole
  • Interferon Beta-1a
  • Methadone
  • Nelfinavir
  • Probenecid
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Tipranavir
  • Valproic Acid

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Blood problems (eg, anemia, neutropenia) or
  • Diabetes or
  • Heart attack, history of or
  • Heart disease or
  • Hepatitis B, history of or
  • Hepatitis C, history of or
  • Hyperlipidemia (high cholesterol or fats in the blood) or
  • Hypertension (high blood pressure) or
  • Myopathy (muscle weakness)—Use with caution. May make these conditions worse.
  • Genetic condition (eg, gene variation called HLA-B*5701)—This condition may increase the risk for serious and life-threatening side effects.
  • Kidney disease, severe or
  • Liver disease, moderate or severe—Should not be used in patients with these conditions.

Proper Use of This Medicine:

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. Also, do not start or stop taking abacavir, lamivudine, and zidovudine combination without checking first with your doctor.

This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

You may take this medicine with or without food.

This medicine will be given together with other medicines for HIV infection. Take all of the medicines your doctor gives you at the right time of day. These medicines work best when there is a constant amount in the blood. To help keep the amount constant, do not miss any doses. If you need help in planning the best times to take your medicines, check with your doctor.

When your supply of this medicine runs low, get more from your pharmacy or from your doctor. The amount of virus in your blood may increase if the medicine is stopped, even for a short time. The virus may develop resistance to this medicine and be harder to treat.

Only take medicine that your doctor has prescribed specifically for you. Do not share your medicine with others.

Abacavir, lamivudine, and zidovudine combination contains a fixed amount of each medicine in the tablet.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For human immunodeficiency virus (HIV) infection:
      • Adults and children who weigh at least 40 kilograms (kg)—One tablet two times per day.
      • Children who weighs less than 40 kg—Use is not recommended.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check the progress of you or your child at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Do not take any other medicine containing abacavir, emtricitabine, lamivudine, or zidovudine, such as Atripla®, Combivir®, Complera®, Emtriva®, Epivir®, Epivir-HBV®, Epzicom®, Retrovir®, Truvada®, or Ziagen®. Tell your doctor if you also use efavirenz (Sustiva®), rilpivirine (Edurant®), or tenofovir (Viread®).

This medicine may cause severe allergic reactions in some patients. These reactions usually occurs within 6 weeks after the medicine is started, but may occur at any time. If untreated, it can lead to severe low blood pressure and even death. Check with your doctor right away if you or your child notice abdominal or stomach pain, cough, diarrhea, fever, headache, nausea, numbness or tingling of the face, feet, or hands, pain in the joints, pain in the muscles, skin rash, sore throat, swelling of the feet or lower legs, unusual feeling of discomfort or illness, unusual tiredness or weakness, or vomiting.

When you or your child begin taking this medicine, you will be given a warning card which describes symptoms of severe allergic reactions that may be caused by abacavir, lamivudine, and zidovudine combination. The warning card also provides information about how to treat these allergic reactions. For your safety, you should carry the warning card with you at all times.

If you or your child must stop using abacavir because of an allergic reaction, you should never use the medicine again. Return the unused medicine to your doctor or pharmacist. A worse reaction, possibly even death, can occur if you use the medicine again. Tell your doctor right away if you have ever taken abacavir, especially if you have experienced an allergic reaction to it in the past.

Two rare but serious reactions to this medicine are lactic acidosis (too much acid in the blood) and liver toxicity. These are more common if you are female, very overweight (obese), or have been taking anti-HIV medicines for a long time. Call your doctor right away if you or your child have more than one of these symptoms: abdominal or stomach discomfort or cramping, dark urine, decreased appetite, diarrhea, general feeling of discomfort, light-colored stools, muscle cramping or pain, nausea, unusual tiredness or weakness, trouble breathing, vomiting, or yellow eyes or skin.

When you or your child start taking HIV medicines, your immune system may get stronger. If you have infections that are hidden in your body (eg, pneumonia or tuberculosis), you may notice new symptoms when your body tries to fight them. If this occurs, tell your doctor right away.

This medicine may cause you or your child to have excess body fat. Tell your doctor right away if you notice changes in your body shape, including an increased amount of body fat in the neck or upper back, face, around the chest, or stomach area. You might also lose fat from your legs, arms, or face.

This medicine may increase your risk of having a heart attack. This is more likely to occur if you smoke or already have heart disease, high blood pressure, or high cholesterol or fats in the blood. Call your doctor right away if you have chest pain or discomfort, nausea, pain or discomfort in the arms, jaw, back or neck, sweating, or vomiting. These could be symptoms of a heart attack.

This medicine will not keep you from giving HIV to your partner during sex. Make sure you understand and practice safe sex, such as using latex condoms, even if your partner also has HIV. Do not share needles, toothbrushes, and razor blades with anyone.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
Chills
Less common
Abdominal or stomach pain
cough
diarrhea
fever
headache
muscle weakness
nausea
numbness or tingling of the face, feet, or hands
pain in the joints
pain in the muscles
pale skin
skin rash
sore throat
swelling of the feet or lower legs
unusual feeling of discomfort or illness
unusual tiredness or weakness
vomiting
yellow eyes or skin
Rare
Black, tarry stools
blood in the urine or stools
pinpoint red spots on the skin
unusual bleeding or bruising

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Bone pain
loss of appetite
trouble sleeping

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 9/4/2017
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites.

Truven Health Analytics. All rights reserved.

Thomson & A.D.A.M