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Drugs reference index «abacavir»

abacavir (Oral route)

a-BAK-a-vir

Oral routeTabletSolution

Serious and sometimes fatal hypersensitivity reactions have been associated with abacavir sulfate.

Hypersensitivity to abacavir is a multi-organ clinical syndrome usually characterized by a sign or symptom in 2 or more of the following groups: 1) fever, 2) rash, 3) gastrointestinal (including nausea, vomiting, diarrhea, or abdominal pain), 4) constitutional (including generalized malaise, fatigue, or achiness), and 5) respiratory (including dyspnea, cough, or pharyngitis). Discontinue abacavir sulfate as soon as a hypersensitivity reaction is suspected.

Patients who carry the HLA-B*5701 allele are at high risk for experiencing a hypersensitivity reaction to abacavir. Prior to initiating therapy with abacavir, screening for the HLA-B*5701 allele is recommended; this approach has been found to decrease the risk of hypersensitivity reaction. Screening is also recommended prior to reinitiation of abacavir in patients of unknown HLA-B*5701 status who have previously tolerated abacavir. HLA-B*5701-negative patients may develop a suspected hypersensitivity reaction to abacavir; however, this occurs significantly less frequently than in HLA-B*5701-positive patients.

Regardless of HLA-B*5701 status, permanently discontinue abacavir sulfate if hypersensitivity cannot be ruled out, even when other diagnoses are possible.

Following a hypersensitivity reaction to abacavir, NEVER restart abacavir sulfate or any other abacavir-containing product because more severe symptoms can occur within hours and may include life-threatening hypotension and death.

Reintroduction of abacavir sulfate or any other abacavir-containing product, even in patients who have no identified history or unrecognized symptoms of hypersensitivity to abacavir therapy, can result in serious or fatal hypersensitivity reactions. Such reactions can occur within hours.

Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues alone or in combination, including abacavir sulfate and other antiretrovirals .

Serious hypersensitivity reactions, lactic acidosis, severe hepatomegaly with steatosis (including fatal cases) have been reported. Risk is increased in patients carrying the HLA-B*5701 allele. Discontinue if hypersensitivity reaction is suspected and do not restart .

Commonly used brand name(s):

In the U.S.

  • Ziagen

Available Dosage Forms:

  • Tablet
  • Solution

Therapeutic Class: Antiretroviral Agent

Pharmacologic Class: Nucleoside Reverse Transcriptase Inhibitor

Uses For abacavir

Abacavir is used, in combination with other medicines, in the treatment of the infection caused by the human immunodeficiency virus (HIV). HIV is the virus that causes acquired immunodeficiency syndrome (AIDS).

Abacavir will not cure or prevent HIV infection or AIDS; however, it helps keep HIV from reproducing and appears to slow down the destruction of the immune system. This may help delay the development of problems usually related to AIDS or HIV disease. Abacavir will not keep you from spreading HIV to other people. People who receive abacavir may continue to have other problems usually related to AIDS or HIV disease.

abacavir is available only with your doctor's prescription.

Before Using abacavir

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 abacavir, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to abacavir 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.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of abacavir in infants below 3 months of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of abacavir 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 of dosage in patients receiving abacavir.

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.

Interactions with Medicines

Using abacavir 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.

  • Ribavirin

Using abacavir 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.

  • Methadone
  • Tipranavir

Interactions with Food/Tobacco/Alcohol

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 abacavir. Make sure you tell your doctor if you have any other medical problems, especially:

  • Diabetes or
  • Heart disease or
  • High blood pressure or
  • High cholesterol—Use with caution. May make these conditions worse.
  • Genetic condition (e.g., gene variation called HLA-B*5701)—This condition may increase the risk for serious and life-threatening side effects.
  • Liver problems, moderate or severe—Abacavir has not been studied in patients with moderate or severe liver problems, so it should not be used in patients with this condition.
  • Risk factors for liver disease such as:
  • Being overweight or
  • Taking other HIV medicines for long periods of time—Serious side effects could occur; caution should be used.

Proper Use of abacavir

Take abacavir exactly as directed by your doctor. 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 without checking with your doctor first.

It is important to take abacavir together in combination with other HIV medicines. Take all other medicines your doctor prescribed at the right time of the day. This will make your medicines work better.

When your abacavir supply 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 abacavir and be harder to treat.

You may take abacavir with or without food.

Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.

abacavir should come with a Medication Guide. Read and follow these instructions carefully. Read it again each time you refill your prescription in case there is new information. You should talk to your doctor if you have any questions.

Dosing

The dose of abacavir 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 abacavir. 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 (solution or tablets):
    • For HIV infection:
      • Adults and teenagers 16 years of age and older—300 milligrams (mg) two times a day or 600 mg once a day. abacavir can be taken with or without food.
      • Children 3 months to 16 years of age—Dose is based on body weight and must be determined by your child's doctor. The usual dose is 8 mg per kilogram (kg) (3.6 mg per pound) of body weight two times a day.
      • Infants below 3 months of age—Use and dose must be determined by your child's doctor.

Missed Dose

If you miss a dose of abacavir, 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 the bottle closed when you are not using it. Store it at room temperature, away from light and heat. Do not freeze.

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 abacavir

It is very important that your doctor check your progress at regular visits to make sure that abacavir is working properly. Blood tests may be needed to check for unwanted effects.

abacavir may cause a severe allergic reaction in some patients. This reaction 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. Stop taking abacavir and check with your doctor immediately if you notice sudden fever, skin rash, diarrhea, nausea, stomach pain, vomiting, or a feeling of unusual tiredness or illness, cough, shortness of breath, or sore throat.

When you begin taking abacavir, you will be given a warning card which describes symptoms of severe allergic reactions that may be caused by abacavir. 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.

Do not stop using abacavir unless your doctor tells you to do so. If you stop taking abacavir for any reason, do not start taking it again without talking to your doctor first.

If you 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 abacavir are lactic acidosis (too much acid in the blood) and liver toxicity, which includes an enlarged liver. 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 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 start taking HIV medicines, your immune system may get stronger. If you have certain infections that are hidden in your body, such as pneumonia or tuberculosis, you may notice new symptoms when your body tries to fight them. If this occurs, tell your doctor right away.

You should not breastfeed if you have HIV or AIDS, because you may give the infection to your baby through your breast milk.

abacavir 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.

abacavir may cause you to have excess body fat. Tell your doctor if you notice changes in your body shape, such as an increased amount of fat in the upper back and neck, or around the chest and stomach area; or a loss of fat from the legs, arms, and face.

abacavir Side Effects

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:

Less common
  • Abdominal or stomach pain
  • cough
  • diarrhea
  • difficult or labored breathing
  • fever
  • headache
  • joint or muscle pain
  • nausea
  • numbness or tingling of hands, feet, or face
  • redness and soreness of eyes
  • shortness of breath
  • skin rash
  • sore throat
  • sores in mouth
  • swelling of feet or lower legs
  • vomiting
  • unusual feeling of discomfort or illness
  • unusual tiredness
Rare
  • Abdominal swelling
  • decreased appetite
  • fast, shallow breathing
  • sleepiness
Incidence not known
  • Blistering, peeling, or loosening of skin
  • chills
  • dark urine
  • itching
  • light-colored stools
  • red, irritated eyes
  • red skin lesions, often with a purple center
  • sores, ulcers, or white spots in mouth or on lips
  • unusual weakness
  • upper right abdominal pain
  • yellow eyes and skin

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
  • Headache
Less common
  • Trouble in sleeping
Incidence not known
  • Breast enlargement
  • buffalo hump
  • central obesity
  • facial wasting
  • peripheral wasting

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.

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  • abacavir Concise Consumer Information (Cerner Multum)
  • Abacavir MedFacts Consumer Leaflet (Wolters Kluwer)
  • Ziagen Prescribing Information (FDA)
  • Ziagen Detailed Consumer Information (PDR)

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