Abacavir/lamivudine: Difference between revisions
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*Dosage Forms: TAB 600mg, 300mg | *Dosage Forms: TAB 600mg, 300mg | ||
*Routes of Administration: Oral | *Routes of Administration: Oral | ||
*Common Trade Names: Epzicom | *Common Trade Names: Epzicom, APO, Auro, Kivexa, MYLAN, PMS, TEVA | ||
*Administered W/WO food. | |||
==Adult Dosing== | ==Adult Dosing== | ||
===[[HIV]] infection=== | ===[[HIV]] infection=== | ||
*1 tab PO daily | *1 tab PO daily (abacavir 600 mg and lamivudine 300 mg) | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
| Line 66: | Line 67: | ||
*Anxiety | *Anxiety | ||
*Hyperamylasemia | *Hyperamylasemia | ||
===Disease-related concerns=== | |||
*Coronary heart disease: Use associated with increased risk of MI in some cohort studies (Elion 2018; HHS 2017) | |||
*Chronic hepatitis B: Severe acute exacerbations of hepatitis B have been reported in patients who are co-infected with hepatitis B virus (HBV) and HIV-1 and have discontinued lamivudine, which is one component of abacavir/lamivudine. | |||
==Pharmacology== | ==Pharmacology== | ||
| Line 86: | Line 91: | ||
==See Also== | ==See Also== | ||
*Elion RA, Althoff KN, Zhang J, et al; American AIDS Cohort Collaboration on Research and Design of IeDEA. Recent abacavir use increases risk of type 1 and type 2 myocardial infarctions among adults with HIV. J Acquir Immune Defic Syndr. 2018;78(1):62-72. doi: 10.1097/QAI.0000000000001642. [PubMed 29419568] | |||
*Epzicom (abacavir and lamivudine) [prescribing information]. Research Triangle Park, NC: GlaxoSmithKline; April 2018. | |||
*HHS Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf. Updated October 17, 2017. Accessed October 18, 2017. | |||
*Kivexa (abacavir and lamivudine) [product monograph]. Laval, Quebec, Canada: ViiV Healthcare ULC; December 2018. | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] [[Category:ID]] | ||
Latest revision as of 16:29, 19 September 2019
Administration
- Type: Antiviral
- Dosage Forms: TAB 600mg, 300mg
- Routes of Administration: Oral
- Common Trade Names: Epzicom, APO, Auro, Kivexa, MYLAN, PMS, TEVA
- Administered W/WO food.
Adult Dosing
HIV infection
- 1 tab PO daily (abacavir 600 mg and lamivudine 300 mg)
Pediatric Dosing
HIV infection
- >25kg: 1 tab PO daily
Special Populations
Pregnancy Rating
- Abacavir: Benefits outweigh risks during pregnancy
- Lamivudine: Benefits outweigh risks during pregnancy
Lactation risk
- Avoid breastfeeding
Renal Dosing
- Adult:
- CrCl <50: Avoid use
- Pediatric:
- CrCl <50: Avoid use
Hepatic Dosing
- Adult:
- Child-Pugh Class A: Avoid use
- Child-Pugh Class B or C: Contraindicated
- Pediatric:
- Child-Pugh Class A: Avoid use
- Child-Pugh Class B or C: Contraindicated
Contraindications
- Allergy to class/drug
- HLA-B*5701 Positive pts
- Hepatic impairment
Adverse Reactions
Serious
- Hypersensitivity reaction
- Anaphylaxis
- Stevens-Johnson syndrome
- Toxic epidermal necrolysis
- Erythema multiforme
- MI
- Lactic acidosis
- Hepatomegaly w/ steatosis
- Pancreatitis
- HBV exacerbation, post-treatment
- Peripheral neuropathy
- Anemia, severe
- Rhabdomyolysis
- Immune reconstitution syndrome
- Autoimmune disorders
Common
- Insomnia, depression, fatigue, abnormal dreams
- Headache, dizziness
- Nausea, diarrhea, abdominal pain,
- Rash
- Fever
- Anxiety
- Hyperamylasemia
- Coronary heart disease: Use associated with increased risk of MI in some cohort studies (Elion 2018; HHS 2017)
- Chronic hepatitis B: Severe acute exacerbations of hepatitis B have been reported in patients who are co-infected with hepatitis B virus (HBV) and HIV-1 and have discontinued lamivudine, which is one component of abacavir/lamivudine.
Pharmacology
- Half-life:
- Abacavir: 1.5h
- Lamivudine: 5-7h
- Metabolism:
- Abacavir: Liver
- Lamivudine: Intracellular; active metabolite
- Excretion:
- Abacavir: Urine 82.2% (1.2% unchanged), feces 16%
- Lamivudine: Urine (primarily unchanged)
Mechanism of Action
Both drugs inhibit reverse transcriptase and incorporates into viral DNA, resulting in chain termination
Comments
See Also
- Elion RA, Althoff KN, Zhang J, et al; American AIDS Cohort Collaboration on Research and Design of IeDEA. Recent abacavir use increases risk of type 1 and type 2 myocardial infarctions among adults with HIV. J Acquir Immune Defic Syndr. 2018;78(1):62-72. doi: 10.1097/QAI.0000000000001642. [PubMed 29419568]
- Epzicom (abacavir and lamivudine) [prescribing information]. Research Triangle Park, NC: GlaxoSmithKline; April 2018.
- HHS Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf. Updated October 17, 2017. Accessed October 18, 2017.
- Kivexa (abacavir and lamivudine) [product monograph]. Laval, Quebec, Canada: ViiV Healthcare ULC; December 2018.