abacavir

Abacavir, in combination with other medications, is used to manage human immunodeficiency virus (HIV) infection. It belongs to a class of drugs called nucleoside reverse transcriptase inhibitors (NRTIs) and functions by reducing the concentration of HIV in the bloodstream. HIV is the virus, that if not treated, leads to acquired immune deficiency syndrome (AIDS).

Abacavir is marketed in the United States under the brand name Ziagen. It is prescribed for the treatment of HIV/AIDS. It is also available as an FDA approved generic, manufactured by a number of pharmaceutical companies. It is available in oral solid dosage form aswell as an oral solution.

The typical dosage for the treatment of HIV in an adult is 600 mg per day, administered as a single daily dose or split into two 300 mg doses. For children aged 3 months and older, the dosage is based on body weight and calculated as 8 milligrams (mg) per kilogram (kg) of body weight two times per day, or 16 mg per kg of body weight once a day.

The disadvantages of abacavir are related to the side effects. Patients who are prescribed abacavir may experience a severe allergic reaction (hypersensitivity reaction) that can be fatal. The risk of this allergic reaction significantly increases in individuals who possess a gene variation known as HLA-B*5701. Your healthcare provider can assess whether you carry this gene variation by ordering a pharmacogenomic test.

A black box warning is the FDA’s most stringent warning which alerts the public and health care providers to serious side effects, such as injury or death. Abacavir has a black box warning. To minimize the risk of a potentially life-threatening hypersensitivity reaction, cease the use of abacavir promptly if there is suspicion of such a reaction, even in cases where alternative diagnoses is plausible (e.g., sudden-onset respiratory illnesses like pneumonia, bronchitis, pharyngitis, or influenza.

The brand version of abacavir (ZIAGEN) was discontinued by ViiV as of January 1, 2024. However generic abacavir is readily available.

Abacavir can cause lipodystrophy. However a study published in the National Library of Medicine showed that abacavir has notably weaker association with lipodystrophy than its comparator stavudine which is also nucleoside reverse transcriptase inhibitors (NRTIs).

The following drugs can interact with abacavir:
Augmentin (amoxicillin/clavulanate)
Azithromycin Dose Pack (azithromycin)
Bactrim DS (sulfamethoxazole/trimethoprim)
Dextrose (glucose)
Edurant (rilpivirine)
Isentress (raltegravir)

The primary symptoms of abacavir hypersensitivity can include fever, rash, nausea, vomiting, diarrhea or abdominal pain, and fatigue along with malaise. In some cases, respiratory symptoms like tachypnea, cough, and pharyngitis may be pronounced, making the reaction resemble pneumonia.

Abacavir can be taken twice daily, as directed by the prescribing physician. For adults, the maximum daily dose is 600 mg. This can be take as one 600 mg daily dose or split as 300 mg twice daily.

Although abacavir is generally well tolerated, it can cause certain side effects such as vivid dreams, difficulty sleeping (insomnia) and lathargy and fever.

Abacavir is not an antibiotic. It is a reverse-transcriptase inhibitor (NRTI) which is indicated for the treatment of HIV. It is commonly administered as part of combination therapy alongside other HIV medications.

HIV mutations, specifically M184V, can affect the efficacy of abacavir. However, the mutation results in minimal resistance and only occurs after a prolonged period of treatment.

Abacavir is the generic name of the now discontinued brand called ZIAGEN, which was manufactured by the pharmaceutical company, ViiV. Abacavir is still available as a generic. It is a primary HIV antiretroviral (ARV) chosen, in combination with other HIV ARVs, to treat HIV.

The efficacy of Biktarvy in treating HIV was evaluated in comparison to other similar triple-drug combinations. In a particular study, individuals were assigned to either Biktarvy (comprising bictegravir sodium, emtricitabine, and tenofovir alafenamide) or Triumeq (containing abacavir, dolutegravir, and lamivudine).

The syndrome manifests with the initiation of abacavir treatment within the initial 6 weeks, presenting constitutional symptoms (fever, malaise, lethargy) often accompanied by skin involvement (rash) and/or gastrointestinal tract symptoms (nausea, vomiting, abdominal pain, diarrhea).

Abacavir is also known as abacavir sulfate. The FDA granted approval to abacavir in 1998 as an antiretroviral drug (ARV). It is also commonly known by its brand name, ZIAGEN which was marketed by ViiV, until its discontiuation in 2024. The generic version continues to be available.

Abacavir requires a genetic test for the HLA-B*5701 allele before initiation because it is associated with a potentially fatal hypersensitivity reaction. For that reason, it not recommended to be used in any PrEP regimen.

The FDA granted approval to abacavir on December 17th 1998 for the use as an antiretroviral drug (ARV).

Abacavir belongs to a class of medications called nucleoside reverse transcriptase inhibitors (NRTIs) which inhibit viral replication. The resulting therapeutic action is decreasing the amount of HIV in the blood.

If you are prescribed abacavir, your healthcare provider should have explained to you how to recognise signs of hypersensitivity, and to seek immediate medical attention if symptoms develop.

Clinical studies have shown that abacavir is effective in reducing HIV viral load and improving immune function in the majority of people when it is taken in combination with at least two other anti-HIV medications. Abacavir is active against both HIV-1 and HIV-2. It works by disrupting the activity of the HIV enzyme reverse transcriptase, which is needed to copy the genetic code of HIV into a form that can be inserted into human cells.

Several clinical studies have established a link between abacavir use and the increased risk of myocardian infarction (heart attack). In fact patients taking abacavir are 40% more likely to experience a heart attack, stroke or other serious cardiovascular event than people not taking the drug.

Abacavir can interact with the folllowing drugs: cabotegravir, levoketoconazole, methotrexate, orlistat, ribavirin and tacrolimus. These interactions are not severe and can be resolved with dose changes. However more serious interactions can occur leading to an increased risk of side effects if abacavir is taken with methadone, riociguat or tipranavir.

Abacavir induced liver toxicity is a rare event. Additionally, most cases of liver injury associated with abacavir are mild and resolve rapidly within 4 weeks of discontinuation

Abacavir is rapidly absorbed and the oral bioavailability (the proportion of a drug or other substance which enters the circulation) is 83%. Approximately 50% of the drug binds to plasma proteins. The half-life of abacavir is approximately 1.5 hours. The main routes of elimination for abacavir involve metabolism by alcohol dehydrogenase and glucuronyl transferase.

Hypersensitivity to abacavir which is the main adverse effect, is associated with the presence of the HLA-B*5701 gene allele. The reaction can present the symptoms of rash, itching or swelling (particularly of the face, tongue, or throat), pronounced dizziness, difficulty breathing, fever, profound fatigue, nausea, vomiting, diarrhea, abdominal pain, muscle aches, sore throat, or cough.