Abacavir and Lamivudine (Oral)

Abacavir and Lamivudine is an antiretroviral medication commonly marketed under the brand name Epzicom, and it is one of the most miraculous drugs to have been developed to combat HIV and AIDS.

Overview

A combination of Abacavir and Lamivudine is one of many antiretroviral medications used in the course of treatment for patients who are suffering from human immunodeficiency virus (HIV) infection or acquired immune deficiency syndrome (AIDS). An Abacavir and Lamivudine combination prescription will not serve as a cure or a preventive measure against HIV infection or advanced symptoms that are a consequence of AIDS. The purpose of this medicine is to keep the HIV from reproducing itself and to delay the degradation of the immune system that is the virus' most devastating effect. This can significantly delay the most serious health problems that are related to HIV infection. This is not a viral suppressant and will not prevent transmission of the virus to another person through the typical vectors of transition such as sexual intercourse or sharing needles. Those who take this medicine may continue to have certain problems that are related to AIDS or HIV infection. This medication is only available by prescription.

Conditions Treated

  • HIV
  • AIDS

Type of Medicine

  • Nucleoside reverse transcriptase inhibitor (NRTIs).

Side Effects

As with any medication of this kind, Abacavir and Lamivudine may come with a number of side effects that will vary from individual to individual. Unwanted side effects will not necessarily occur at all, but those that have been observed may require immediate medical attention as a result of their severity. The side effects may be caused primarily by Abacavir and Lamivudine or as a result of interaction with other substances that the patient comes in to contact with.

If any of the following common side effects occur, report them to a physician immediately:

Less Common Side-Effects Include

  • Bloating
  • Blisters
  • Nerve Pain
  • Chills
  • Chest Pain
  • Convulsions
  • Constipation
  • Loss of Appetite
  • Difficulty Swallowing
  • Dark Urine
  • Light-Colored Stools
  • Rapid Heartbeat
  • Dizziness
  • Hives
  • Incontinence
  • Muscle Spasms
  • Cramps
  • Back or Side Pain
  • Pale Skin
  • Swelling of the Facial Area
  • Redness and Irritation of the Eyes
  • Skin Lesions
  • Sores Around the Mouth or Tongue
  • Loss of Consciousness
  • Swollen Lymph Glands
  • Loss of Balance
  • Unexplained Bleeding or Bruising
  • Unusual Weakness
  • Jaundice

In addition, some side effects usually will not require medical attention and may be reduced or eliminated as the body adjusts to the medication. You may be initially warned about these side effects on the warning card that will come with your first dose as these side effects could be expected. Check with your medical professional for methods that may prevent or reduce the side effects until that time. If the side effects persist you should bring them to the attention of your primary care physician.

The more common of this lesser tier of side effects include:

Other side effects have been reported by patients or during clinical trials, but their incidence is not known. These side effects include:

  • Blurred vision
  • Dry mouth
  • Bad breath
  • Wheezing
  • Excessive weight gain
  • Hair loss
  • Excessive sweating
  • Dry skin
  • Increased hunger and thirst
  • Increased urination
  • Unexplained weight loss
  • Inflammation of the mouth

Dosage

Abacavir and Lamivudine should only be taken exactly as directed by your doctor. Do not take it more or less often than indicated or for a longer duration than is authorized in the doctor's orders. Never take this medication without the approval of your primary care provider. Read and heed the instructions in the medication guide that comes with this medicine. If you have any questions or any instruction is unclear to you please ask your doctor before proceeding. Abacavir and Lamivudine can be taken with or without food. When the supply of this medication runs low order more from your doctor or the pharmacy to prevent running out at a crucial time. If the dosage is stopped altogether the amount of HIV virus can increase significantly even in a very short period of time. The virus may also develop resistance to the medicine and become more difficult to treat in the future.

Abacavir and Lamivudine are given in combination with other medical treatments including pharmaceuticals meant to combat HIV infection. Patients that are prescribed this as a part of their regimen need to take everything that they are prescribed in the exact dosage indicated at the right time of day. The medications work most effectively when there is a constant amount in the bloodstream. Missed doses may jeopardize the constant effective level required.

The expected dosage of Abacavir and Lamivudine will vary by patient depending upon their individual medical condition. The doctor's orders regarding dosage listed on the label should always be followed. Although the following outlines common dosages for this medication, these are only averages and should not be followed in contravention of the dosage determined by your physician. This dosage can be determined by a number of factors including the strength of the medicine, the number of times per day it is taken, and the length of time you have been affected by symptoms of HIV and AIDS.

  • The adult dosage is 1 tablet per day consisting of 600 mg of abacavir and 300 mg of lamivudine.
  • Children weighing at least 55 pounds take 1 tablet per day.
  • Children weighing less than 55 pounds must take a reduced dose determined by a pediatrician.

Children need to be further assessed by a pediatrician for their ability to swallow tablets prior to prescribing Abacavir and Lamivudine. If a dose is missed for any reason, take the dose as soon as possible but do not double dose. Rather, skip to the next dose if it is nearly time for the next dose to re-establish the regular dosing schedule. It is more important to maintain as constant a level in the bloodstream as possible than it is to make up for a missed dose. Attempting a double dose may cause a more dangerous condition than the missed dose would have.

Drug Interactions

There are certain medicines that should never be used together, but in other cases, different medications may be used together even if there is a significant chance of a drug interaction. This is the difficult decision that physicians need to make when faced with a condition as life-threatening as HIV/AIDs. Doctors may change or alter the dosage of certain medications as a precaution when there is a danger of serious drug interactions. In addition, substitutions for treatments of other co-existing conditions can be prescribed to prevent adverse drug interactions. Inform your physician of all drugs being taken at all times, including over-the-counter medication or medication that is being used for off-brand purposes. The following include some drugs with a significant chance of interactions and is not intended as an all-inclusive or complete list. Although the use of the following drugs is not recommended they may be required depending upon your medical condition. If they are prescribed together, your doctor may seek out alternative pharmaceutical solutions.

  • Dasabuvir
  • Orlistat
  • Ribavirin
  • Methadone
  • Tipranavir

In addition, the medication may or may not be used around mealtimes as certain types of food or drink could cause interactions. If you have any questions regarding what kind of food or drink should be avoided, please ask your primary care provider or the doctor who prescribed you Abacavir and Lamivudine. Use of alcohol or tobacco may also be a cause for concern as they may interact poorly with the medication. Discuss this with your physician before beginning a drug regimen that includes Abacavir and Lamivudine.

Warnings

There are a number of warnings that must be heeded before beginning a regimen of Abacavir and Lamivudine. For children, it is imperative that physicians regularly check progress at regular intervals to ensure that the medication is working as intended. Any unwanted effects need to be accounted for and blood tests may be able to ascertain whether they are caused by the medication. Allergic reactions are possible and this medicine may cause a severe allergic reaction within 6 weeks of beginning the regimen. If left untreated, this allergic reaction can be fatal. Symptoms of the allergy include severely low blood pressure, a sudden fever, rashes, abdominal pain, vomiting, and flu-like symptoms. Before taking this drug please regard the warning card that comes with the initial dose that outlines what symptoms may indicate an allergic reaction to Abacavir and Lamivudine. If an allergic reaction occurs of sufficient severity, stop using the medication - it should never be used again and all unused medicine should be permanently disposed of or returned to your doctor or pharmacist. If it is prescribed to you again, tell your doctor right away that you have had a previous allergic reaction associated with the drug.

Two rare but very serious reactions that have been reported when taking Abacavir and Lamivudine include lactic acidosis and liver toxicity. These severe allergic reactions associated with the circulatory system may be indicated by the presence of more than one of the following symptoms:

  • Light-colored stools
  • Diarrhea
  • Nausea
  • Vomiting
  • Dark urine
  • Jaundice
  • Muscle Cramps
  • Difficulty Breathing

These symptoms may be more common in women and those who are suffering from obesity. Those who have been taking other anti-HIV meds for a long period of time may also be at a heightened risk. Some symptoms may be a consequence of your immune system getting stronger and fighting back previously undetected infections such as pneumonia or tuberculosis. Your physician must be appraised of all symptoms as they occur so that further testing can be performed to determine their cause.

Abacavir and Lamivudine are not intended to keep you from transmitting HIV to your partner. Make sure to adhere to safe sex guidelines and other precautions (such as not sharing personal injectables or hygiene equipment) in order to prevent transmission even if your partner also has HIV.

Taking this medicine may result in weight gain with a growing body fat percentage. Inform your physician if you notice changes in your body type. Excess fat may cause additional health problems other than those associated with the medication or the condition that it is treating. Taking Abacavir and Lamivudine could increase your risk of heart disease or make heart failure more likely if you have already been diagnosed with heart disease. High blood pressure, high cholesterol, or smoking may exacerbate this condition.

Do not take any other medications - including vitamins, supplements, or herbal remedies - that have not been discussed with your doctor. Even over the counter medication may have adverse effects on you when combined with Abacavir and Lamivudine.

Your doctor's decision to prescribe Abacavir and Lamivudine to you may depend on other health problems that you suffer from. Keep your physician appraised of all medical problems in your history, including but not limited to the following conditions:

  • Heart Disease
  • Diabetes
  • Hepatitis B or C
  • High Blood Pressure
  • High Cholesterol
  • Kidney Disease
  • Liver disease
  • Genetic Conditions

Storage

Great care must be taken in the storage of these medications. Abacavir and Lamivudine should be stored at room temperature in a tightly closed container away from high heat or direct sunlight. Storage recommended temperatures range between 59°F and 86°F (15°C to 30°C). It should not be either refrigerated or frozen under any circumstances. It should be stored in a place where it cannot be accessed by children and should be disposed of when it has passed its expiration date. Disposal is also recommended if, for any reason, it is no longer prescribed or needed. Seek direction from your primary care physician regarding dispossession of discontinued prescriptions.

Summary

Abacavir and Lamivudine are commonly marketed under the brand name Epzicom, a prescription medicine approved by the FDA for the treatment of HIV and AIDs primarily in adults and children who weigh more than 55 pounds. It is intended to be used in combination with other HIV treatments. Its dual active ingredients are combined in one pill. Abacavir and Lamivudine both belong to a type of HIV medication called a nucleoside reverse transcriptase inhibitor (NRTI). They block the HIV enzyme called reverse transcriptase, which is a protein that increases the speed of chemical reactions within the body. The effect is to prevent the HIV from multiplying and reduce the HIV count of the body in order to stave off the development of AIDs. It is not a cure for the condition, but when taken in combination with other treatments in a HIV regimen it helps patients lead longer and healthier lives. Although it may reduce the chances of HIV transmission by reducing the HIV count in the body, it does not prevent transmission and all precautions must be taken as if the drug was not a factor.

There are certain pieces of information that your physician will need to know before prescribing Abacavir and Lamivudine. You should tell your doctor if you have ever had an allergic reaction to any medication, especially HIV Medicines. Certain gene variations (specifically called HLA-B*5701) should be tested for prior to prescription. Liver problems or hepatitis infections are something that needs to be taken into consideration, as are prior kidney problems. Lifestyle must also be considered, including drinking or smoking as well as other activities that may contribute to heart problems. If you have any history of diabetes it is something you need to discuss with your doctor and could require a blood test. All medications you are currently taking need to be disclosed.

While Abacavir and Lamivudine have not been associated with an increased risk of birth defects, women who are pregnant or plan to become pregnant should talk to their physician about other possible risks. Women should not breastfeed if they have HIV or are taking Abacavir and Lamivudine. If you are using hormone-based birth control while taking Abacavir and Lamivudine your doctor will have more information about birth control and NRTIs. Your doctor will need to know about all nonprescription medicines, supplements, vitamins, and herbal products that you take or are planning to take. Medications that are intended to treat other conditions such as hepatitis or other HIV medications must be approved. Abacavir and Lamivudine can affect how other medications work or have adverse reactions when combined with them. In rare cases, combining Abacavir and Lamivudine with certain medications or products can cause life-threatening side effects.

Despite the risks of side effects and adverse drug interactions, these NRTIs are one of the most-prescribed treatments for HIV and AIDs patients. When used as directed as part of a HIV regimen, Abacavir and Lamivudine are one of the most powerful ways to prevent HIV from developing into AIDS and one of the most effective treatments preventing AIDs symptoms from worsening or becoming fatal.

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Last Reviewed:
December 10, 2017
Last Updated:
April 05, 2018
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