Abacavir Brand Name
Ziagen
What is Abacavir
Abacavir is an oral, synthetic guanosine nucleoside reverse transcriptase inhibitor (NRTI), indicated for use in combination with other antiretroviral medications to treat HIV.
Abacavir is associated with a hypersensitivity reaction that occurs in approximately 5% to 10% of patients.
This hypersensitivity reaction, characterized by fever, skin rash, fatigue, gastrointestinal symptoms, and, sometimes, respiratory symptoms, can be life-threatening; when a hypersensitivity reaction cannot be ruled out, abacavir treatment is permanently discontinued and rechallenge is contraindicated.
Indications
- human immunodeficiency virus (HIV)
- human immunodeficiency virus (HIV) infection
- human immunodeficiency virus (HIV) prophylaxis
NOTE: HIV guidelines recommend screening for HLA-B*5701 before initiating an abacavir-containing regimen to reduce the risk of hypersensitivity reaction. HLA-B*5701-positive patients should not be prescribed abacavir.
NOTE: HIV guidelines recommend consideration be given to avoiding the use of abacavir-containing regimens in patients at high risk for cardiovascular adverse events. Although a definitive correlation has not been established, recent (within 6 months) or current use of abacavir has been associated with an increased risk of myocardial infarction.
Side Effects
- abdominal pain
- acute respiratory distress syndrome (ARDS)
- anemia
- anxiety
- arthralgia
- azotemia
- chills
- conjunctivitis
- cough
- depression
- diarrhea
- diarrhea
- dizziness
- dyspnea
- edema
- elevated hepatic enzymes
- erythema multiforme
- fatigue
- fever
- gastritis
- headache
- hepatic failure
- hepatomegaly
- hepatotoxicity
- hyperamylasemia
- hyperglycemia
- hypertriglyceridemia
- hypotension
- infection
- insomnia
- lactic acidosis
- lethargy
- leukopenia
- lipodystrophy
- lymphadenopathy
- lymphopenia
- maculopapular rash
- malaise
- migraine
- musculoskeletal pain
- myalgia
- myocardial infarction
- nausea
- neutropenia
- nightmares
- oral ulceration
- pancreatitis
- paresthesias
- pharyngitis
- rash
- renal failure (unspecified)
- respiratory arrest
- rhabdomyolysis
- serious hypersensitivity reactions or anaphylaxis
- steatosis
- Stevens-Johnson syndrome
- thrombocytopenia
- toxic epidermal necrolysis
- urticaria
- vomiting
Monitoring Parameters
- blood glucose
- CBC with differential
- CD4+ T cell count
- hepatitis B serology
- LFTs
- plasma hepatitis C RNA
- plasma HIV RNA
- pregnancy testing
- serum bilirubin (total and direct)
- serum cholesterol
- serum lipid profile
- urinalysis
Contraindications
- abacavir hypersensitivity
- alcoholism
- autoimmune disease
- breast-feeding
- cardiac disease
- females
- geriatric
- Graves’ disease
- Guillain-Barre syndrome
- hepatic disease
- hepatitis B and HIV coinfection
- hepatitis C and HIV coinfection
- hepatotoxicity or lactic acidosis
- human immunodeficiency virus (HIV) infection resistance
- immune reconstitution syndrome
- infants
- myocardial infarction
- neonates
- obesity
- pregnancy
- serious hypersensitivity reactions or anaphylaxis
Interactions
- Adefovir
- Cabozantinib
- Echinacea
- Ethanol
- food
- Interferon Alfa-2a
- Interferon Alfa-2b
- Interferon Alfa-2b; Ribavirin
- Interferon Alfa-n3
- Interferon Alfacon-1
- Interferon Beta-1a
- Interferon Beta-1b
- Interferon Gamma-1b
- Interferons
- Methadone
- Orlistat
- Peginterferon Alfa-2a
- Peginterferon Alfa-2b
- Peginterferon beta-1a
- Ribavirin
- Tipranavir
