Abacavir, Lamivudine, and Zidovudine

Abacavir, lamivudine, and zidovudine is a compound medication used to treat human immunodeficiency virus, or HIV infection.

Overview

Abacavir, lamivudine, and zidovudine, sold as Trivizir, contains drugs which are all nucleotide reverse transcriptase inhibitors, or NRTIs. These drugs block reverse transcriptase, a HIV enzyme that injects viral biological code into healthy cells. This serves to reduce, halt, and reverse the viral spread of HIV, preventing the viruses from multiplying.

HIV medications can't cure HIV or AIDS, but taking prescribed HIV medications regularly can reduce viral load, strengthening the immune system, and preventing dangerous infections. Abacavir, lamivudine, and zidovudine can be taken alone to reduce and manage viral load, or as part of a combination or regimen of HIV and AIDS medications. HIV medicines can also help reduce the risk of HIV transmission.

Conditions treated:

  • HIV (Human immunodeficiency virus)

Type of Medicine:

  • NRTI (Nucleotide reverse transcriptase inhibitor)

Side Effects

Abacavir, lamivudine, and zidovudine can cause some unwanted effects in the body in addition to its desired effects. Not all of these side effects may occur in all patients. If you experience any side effects from abacavir, lamivudine, and zidovudine, inform your physician immediately.

Mild Side Effects

Abacavir, lamivudine, and zidovudine can have some mild side effects that are not necessarily dangerous. These effects are usually a result of your body adjusting to the treatment and are likely to subside over the course of your treatment. Inform your doctor about any and all side effects you experience from abacavir, lamivudine, and zidovudine, as they may be able to tell you about ways to treat or prevent these side effects. Tell your doctor if your side effects do not subside, do not respond to treatment, or become more serious. When taking abacavir, lamivudine, and zidovudine, patients may experience some bone pain, loss of appetite, and trouble sleeping or sleeplessness.

Serious Side Effects

Abacavir, lamivudine, and zidovudine can have side effects that can cause serious health problems, or that may be symptoms of health problems within the body. If you experience these side effects while taking abacavir, lamivudine, and zidovudine, check with your doctor immediately and seek medical help if necessary.

Patients taking abacavir, lamivudine, and zidovudine may experience gastrointestinal problems such as abdominal pain or stomach pain, nausea, diarrhea, vomiting, black and tarry stools, or blood in the urine or stools. Patients may experience respiratory problems such as a cough, shortness of breath, or a sore throat. You may experience chills or fever, pain in the joints or pain in the muscles, swelling of the feet or lower legs, muscle weakness, headaches, an unusual feeling of illness or discomfort, unusual tiredness or weakness, and numbness or tingling in the feet, hands, or face. Watch out for unusually pale skin, a skin rash, yellow eyes or skin, pinpointed red spots on the skin, or unusual bruising or bleeding. All of these side effects can be signs of serious health problems.

Abacavir Side Effects

Medications containing abacavir can cause side effects of abacavir in some patients. Abacavir can cause unusual patterns of weight gain, loss, or movement in a small percentage of patients. You may experience weight gain in the breasts or chest area, central obesity, facial wasting or peripheral wasting, buffalo hump or fat deposits behind the shoulders, and weight gain around the neck, upper back, breast, face, or waist.

Some side effects of abacavir can cause serious health problems, or may be symptoms of serious health problems. If you experience these side effects while taking medications with abacavir, check with your doctor immediately or seek medical help. You may experience abdominal or stomach swelling, a decreased appetite, and pain in the upper right abdominal area. You may experience difficult or labored breathing, fast or shallow breathing, chest pain or discomfort, or sweating. You may experience redness and soreness of the eyes, red or irritated eyes, or yellow eyes and skin, along with blistering, peeling, or loosening skin, sores, ulcers or white spots in the mouth or lips, red skin lesions that may have a purple spot in the center, or unusual swelling of the feet or lower legs.

Lamivudine Side Effects

Medications containing lamivudine can cause side effects of lamivudine in some patients. Some of these side effects are a result of your body adjusting to the medication and may subside over the course of treatment. Let your doctor know if you experience these side effects. Your doctor may be able to help you prevent, treat, or reduce many of these side effects. Let your doctor know immediately if these side effects do not subside, become stronger over time, or become bothersome. You may experience gastrointestinal effects such as an acid or sour stomach, belching, heartburn, indigestion, and stomach discomfort or upset. You may experience dry mouth, increased hunger or thirst, increased urination, flushed and dry skin, or a fruit-like breath odor. Some patients will experience hair loss or thinning of the hair, and some may have trouble breathing with exertion, depression, or sweating.

Some side effects of lamivudine will need medical attention, as they may cause serious health problems or may be symptoms of serious health problems. Check with your doctor immediately or seek medical assistance if you experience bleeding gums, blood in the urine or stools, constipation, darkened urine, black and tarry stools, light-colored stools, indigestion, bloating, or constipation. You may experience a fast heartbeat, chills, fast and shallow breathing, a general feeling of discomfort or tiredness and weakness, unusual sleepiness, tightness in the chest, muscle pain or stiffness, or fever. Consult your doctor immediately if you experience skin rash, hives, or itching, pinpoint red spots on the skin, pains in the stomach or side that radiate to the back, right upper abdominal stomach pain or unusual fullness, tightness in the chest, unusual bleeding or bruising, or dizziness.

Zidovudine Side Effects

Medications containing zidovudine can cause side effects of zidovudine in some patients. Some of these side effects are a result of your body's adjustment to the medication and may subside over your course of treatment. Let your doctor know about all side effects you experience while taking medications with zidovudine. Your doctor may be able to help you find ways to treat or reduce some of these side effects. Tell your doctor if your side effects do not subside, become worse, or become seriously bothersome. You may experience gastrointestinal problems such as constipation, vomiting, acid or sour stomach, belching, heartburn, stomach cramps or pain, or indigestion. You may experience headaches, muscle soreness, muscle or bone pain, a sensation or pins or needles, or lack or loss of strength. You may experience trouble sleeping, weight loss, changes in skin color, yellow eyes or skin, or a burning, tingling, or numbness in the extremities. Watch for bluish-brown colored bands on thumbnails or fingernails.

Some side effects of zidovudine can be more serious and require medical attention as they may point to underlying health problems. Check with your doctor immediately if you experience loss of appetite, fast or shallow breathing, shortness or breath, fever or chills, pale skin, a sore throat, mood or mental changes, sleepiness, or seizures or convulsions.

Dosage

Abacavir, lamivudine, and zidovudine comes in tablets which contain 300 mg of abacavir as abacavir sulfate, 150 mg of lamivudine, and 300 mg of zidovudine. This tablet is to be taken orally twice daily, with or without food.

The standard dosage and directions of abacavir, lamivudine, and zidovudine is provided by the manufacturer. Precise directions given to you by your doctor regarding your course of abacavir, lamivudine, and zidovudine may vary. When in doubt, always refer to your doctor's directions regarding this medication. Consult your doctor before changing your dosage or frequency of abacavir, lamivudine, and zidovudine.

Major Drug Interactions

Abacavir, lamivudine, and zidovudine can interact with other medications, drugs, or supplements you are taking. These interactions can increase your risk for unwanted or serious side effects, change the way your medications work or the effectiveness of your medications, or cause other problems. Any substance may interact with abacavir, lamivudine, and zidovudine, even if not listed here. Keep a list of the medications, drugs, and supplements you take consistently, whether they are prescribed to you or taken over the counter. Your doctor or pharmacist can help identify potential drug interactions with abacavir, lamivudine, and zidovudine.

Abacavir, lamivudine, and zidovudine have been known to interact with orlistat, probenecid, ribavirin, and stavudine. This medication may interact with drugs that may lower blood cell counts or decrease bone marrow function, such as ganciclovir or trimthoprim, or cancer chemotherapy including drugs such as doxorubicin. This medication may interact with drugs that may affect the kidneys, such as NSAIDS, including ibuprofen, naproxen, or aspirin. Patients taking clarithromycin should take this medication at least two hours before or after your clarithromycin dose. Ask your doctor for further details.

Some medications can alter the way your body gets rid of zidovudine, which can affect the way your medication works. Drugs with this effect include rifampin and valproic acid. Do not take other products that contain abacavir, lamivudine, or zidovudine when taking this medication. An overdose of any of these drugs can have serious side effects. Drugs with very similar effects, such as emtricitabine, should not be taken with this medication. Check with your doctor to avoid taking redundant medications.

Abacavir Interactions

Abacavir does not undergo hepatic metabolism and therefore does not have many of the same interactions other drugs may have. However, there are substances that can alter the effectiveness of abacavir, and may decrease or alter the effectiveness of your other drugs or medication. Patients taking medications with abacavir are advised to take caution and consult with a physician when taking these medications.

Protese inhibitors, such as ritonovir or tipranavir, can decrease the concentration of abacavir in the body, reducing its therapeutic effects. Other drugs that can have this effect are orlistat. Methadone can also diminish the effect of abacavir on the body, while abacavir can decrease the serum concentration of methadone in the body and therefore its effectiveness in treating pain and addiction. Ethanol or alcohol substances can result in increased levels of abacavir, as abacavir is metabolized by alcohol. Patients are advised to check with their doctor to see whether the consumption of alcohol is advised while taking this medication.

Lamivudine Interactions

Lamivudine is eliminated in the urine and may interact with other drugs which are eliminated via active renal secretion (kidneys and urine system). Drugs with lamivudine may interact with drugs, such as trimethoprim, that are eliminated via urine.

Medications or supplements with sorbitol may result in a dose-dependent reduction with lamivudine exposure, meaning that the effectiveness of lamivudine may be reduced when it's taken with a medication including sorbitol. Take caution and consult a doctor when using or taking medications with sorbitol at the same time you are taking medications with lamivudine. If co-administration of sorbitol and medications with lamivudine cannot be avoided, your doctor may choose to monitor your HBV viral load more frequently to avoid serious interactions or unwanted side effects.

Lamivudine may interact with other drugs, medications, or supplements. If you experience a new or heightened side effect of a drug or medication you are taking while you consume a medication with lamivudine, contact your doctor immediately.

Zidovudine Interactions

Zidovudine is removed from the body by the kidneys after chemical modification in the liver and may interact in unwanted ways with other medications that are removed from the body in a similar fashion. Patients who take drugs with the same mechanics may need to adjust their dose of medications containing zidovudine, or may need to adjust their dosage or other medications.

Patients taking rifampicin or phenytoin should be advised that taking these medications with zidovudine can alter the levels of these medications in the body. Drugs such as probenecid, atovaquone, and valproic acid can affect the metabolism of zidovudine, leading to increased levels of zidovudine in the body and an increased risk or severity of side effects. Patients taking amphotericin, flucytosine, interferon alfa, systematic pentamidine, vinblastine, or vincristine should be monitored closely in case of kidney problems or blood problems.

Low white blood cell counts may increase in patients taking ganciclovir, doxorubicin, trimextrate, or cotrimoxazole. Patients taking pyrimethamine and sulphadiazine may see an increased risk of anemia.

Patients taking zidovudine are advised to take aspirin, codeine, isoprinosine, lorezepam, morphone, naproxen, oxazepam, or dapsone with caution.

Warnings

Hypersensitivity Reaction

Abacavir, lamivudine, and zidovudine can cause a hypersensitivity reaction or allergic reaction in some individuals, especially those with the HLA-B*5701 gene variation. Your doctor may screen you for this gene before you begin taking this medication. There are five groups of symptoms that indicate you may be having a hypersensitive or allergic reaction to this medication. If you experience symptoms from two or more of these groups, contact your doctor immediately for medical assistance and further directions:

Group 1 Symptoms: Fever

Group 2 Symptoms: Skin rash

Group 3 symptoms: Gastrointestinal symptoms include abdominal or stomach pain, nausea, vomiting and diarrhea

Group 4 Symptoms: Extreme tiredness, achiness, a general ill feeling

Group 5 Symptoms: Respiratory symptoms include a cough, a sore throat, or shortness of breath

Lactic Acidosis

Abacavir, lamivudine, and zidovudine can cause lactic acidosis in some individuals. Contact your healthcare provider immediately if you have symptoms such as weakness or tiredness, unusual muscle pain, a fast or irregular heartbeat, a cold feeling in the arms or legs, trouble breathing, stomach pain with nausea and vomiting, or dizziness and lightheadedness.

Liver Problems

Abacavir, lamivudine, and zidovudine can cause some liver problems or liver malfunction. Contact your health care provider and get medical help if you begin to manifest signs of liver problems such as dark-colored urine, light-colored bowel movements, unusual yellowing of the skin or whites of the eyes, nausea, loss of appetite for several days or longer, and pain, tenderness, or aching on the right side of your stomach and abdomen.

Hepatitis B

Abacavir, lamivudine, and zidovudine may not be safe for patients infected with chronic hepatitis B. Some hepatitis B variants can be resistant to lamivudine. Hepatitis B symptoms or conditions may be exacerbated after this medication is stopped or discontinued. Patients discontinuing this medication should be monitored closely for signs and symptoms of hepatitis B.

Other Health Problems

Abacavir, lamivudine, and zidovudine can cause or aggravate hematologic toxicity, or a toxic concentration or lack of concentration of substances in the bloodstream, such as anemia and neutropenia. Patients, especially patients with advanced HIV-1, should be monitored carefully for these problems. Patients who have compromised bone marrow or low hemoglobin counts should use this medication with caution. Patients with HIV-1 should be monitored closely. Consistent or frequent blood counts may be needed in some patients to treat or prevent these conditions.

Storage

Abacavir, lamivudine, and zidovudine are blue-green, ovaloid, film-coated, and imprinted with the code GX LL1. They come in a count of 60 tablets per bottle. The ideal storage temperature is at 77°F. Store this medication at room temperature, between 59° to 86°F.

Summary

Abacavir, lamivudine and zidovudine is a compound medication used to treat HIV. These drugs prevent HIV from multiplying in the body and can reduce the risk of HIV transmission. They come in blue-green tablets which contain 300 mg of abacavir as abacavir sulfate, 150 mg of lamivudine, and 300 mg of zidovudine, and are to be taken twice daily and stored at room temperature.

Consult your physician before taking abacavir, lamivudine and zidovudine with any prescription or over-the-counter drugs or medications. This medication may interact with other HIV drugs, other drugs that contain any of its components, and sorbitol. This medication may interact with drugs that may lower blood cell counts or decrease bone marrow function. Some components of this medication may interact with other drugs that are eliminated in the urine, or drugs that affect the kidneys. Take painkillers and NSAIDs such as codeine, aspirin, lorazepam, naproxen, or morphine with caution.

Abacavir, lamivudine, and zidovudine may decrease or increase the serum concentration of other drugs in the body, such as rifampin, valproic acid, and protease inhibitors. Its concentration in the body may increase or decrease when exposed to alcohol or methadone, which can cause reduced effect or overdose. This medication may cause a necessary dosage adjustment for other drugs. Check with your doctor for any and all dosage adjustment.

Abacavir, lamivudine, and zidovudine can cause lactic acidosis, liver problems, or aggravation of hepatitis B symptoms in the body. These medications can also cause or aggravate various forms of hematologic toxicity. Patients with compromised bone marrow or low hemoglobin counts should be monitored closely. Patients taking this medication should undergo consistent blood counts and tests as needed to check for these problems.

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Last Reviewed:
December 10, 2017
Last Updated:
December 22, 2017
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