abacavir (Ziagen, ABC)
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Indications
Contraindications
- HLA-B*5701 positive patients should not be prescribed abacavir due to risk of hypersensitivity
Dosage
Tabs: 300 mg.
Adverse effects
- hypersensitivity (5%):
- fever, rash, lymphadenopathy, fatigue, GI symptoms
- generally observed within 1st 6 weeks of therapy
- may be fatal[2]
- rash (less severe allergic reaction) - 30%
- lactic acidosis[3]
- serious, sometimes fatal hypersensitivity reactions[6]
- associated with more cardiovascular deaths than tenofovir[7][8]
Laboratory
- HLA-B*5701 allele testing[5] prior to administration
- abacavir is not recommended for individuals with the HLA-B*5701 variant allele[10]
- abacavir in body fluid
Mechanism of action
- in vitro synergy with zidovudine (AZT), nevirapine (NVP), & amprenavir
- in vitro additive or synergistic effect with didanosine (DDI), lamivudine (3TC), ritonavir (RTV), stavudine (d4T), zalcitabine (ddC)
More general terms
Additional terms
Component of
- abacavir/dolutegravir/lamivudine
- abacavir/lamivudine/zidovudine (Trizivir)
- abacavir/lamivudine (Epzicom)
- emtricitabine/tenofovir (Truvada, TDF/FTC, Descovy)
References
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, Update 9/99
- ↑ 2.0 2.1 Prescriber's Letter 7(12):68 2000
- ↑ 3.0 3.1 Prescriber's Letter 9(8):47 2002
- ↑ Department of Veterans Affairs, VA National Formulary
- ↑ 5.0 5.1 Guidelines for the use of Antiretroviral agents in HIV-1 infected adults and adolescents. DHHS Panel of Antiretriviral Guidelines for Adults and Adolescents - A Working Group of the Office of AIDS Research Advisory Council (ORAC) http://aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf (corresponding NGC guideline withdrawn March 2016)
- ↑ 6.0 6.1 FDA MedWatch http://www.fda.gov/medwatch/safety/2008/safety08.htm#abacavir
- ↑ 7.0 7.1 Martin A et al Simplification of antiretroviral therapy with tenofovir- emtricitabine or abacavir-lamivudine: A randomized, 96-week trial. Clin Infect Dis 2009 Nov 15; 49:1591. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19842973
- ↑ 8.0 8.1 FDA MedWatch, 03/01/2011 Abacavir - Ongoing Safety Review: Possible Increased Risk of Heart Attack including Ziagen, Trizivir, and Epzicom http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm245190.htm
- ↑ 9.0 9.1 Zuger A Use of Antiretroviral Drugs in Pregnancy. Physician's First Watch, April 22, 2014 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission. Recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States. 2014. AIDSinfo. Clinical Guidelines Portal. March 28, 2014. http://aidsinfo.nih.gov/Guidelines/HTML/3/perinatal-guidelines/0 (corresponding NGC guideline withdrawn March 2016) - ↑ 10.0 10.1 Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline information for abacavir and HLA-B. https://www.pharmgkb.org/guideline/PA166104997