Lamivudine Abacavir

Lanier ER, Hazen R, Ross L, Freeman A, Harvey R (2005) Lack of antagonism between abacavir, lamivudine, and tenofovir against wild-type and drug-resistant HlV-1, J Acquir Immune Defic Syndr 39 519-522... 

Tenofovir + Emtricitabine Zidovudine + Lamivudine Abacavir + Lamivudine Efavirenz or Nevirapine Lopinavir/r or Atazanavir/r or Eosamprenavir/r or Saquinavir/r... 

Combination therapy Lamivudine/zidovudine and abacavir/lamivudine/zidovudine are combination product tablets that contain zidovudine as one of their components. Do not administer zidovudine concomitantly with lamivudine/zidovudine or abacavir/lamivudine/zidovudine. 

Consult the complete prescribing information for each agent, abacavir. lamivudine. and zidovudine, prior to administration of abacavir/lamivudine/zidovudine combination tablets. 

Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs alone or in combination, including abacavir, lamivudine, zidovudine, and other antiretrovirals (see Warnings). 

Pharmacokinetics Following oral administration, abacavir, lamivudine, and zidovudine are rapidly absorbed and extensively distributed. Binding of abacavir to human plasma proteins is about 50% binding of lamivudine and zidovudine to plasma proteins is low. 

Abacavir/lamivudine/zidovudine tablets are contraindicated in patients with previously demonstrated hypersensitivity to any of the components of the product (see Warnings). 

Hypersensitivity reactions Serious and sometimes fatal hypersensitivity reactions have been associated with abacavir, a component ot Epzicom. Discontinue abacavir/lamivudine as soon as a hypersensitivity reaction is suspected. Permanently discontinue abacavir/lamivudine if hypersensitivity cannot be ruled out, even when other diagnoses are possible. 

Following a hypersensitivity reaction to abacavir, never restart abacavir/lamivudine 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/lamivudine 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. 

Dose adjustment Do not prescribe abacavir/lamivudine to patients requiring dosage adjustment such as those with Ccr less than 50 mL/min, those with hepatic impairment, or those experiencing dose-limiting adverse events. 

Renal function impairment Lamivudine requires dose adjustment in the presence of renal insufficiency abacavir/lamivudine is not recommended for use in patients with Ccr less than 50mL/min. 

Liver function /mpa/rmenf.-Abacavir is contraindicated in patients with moderate to severe hepatic impairment, and dose reduction is required in patients with mild hepatic impairment. Because abacavir/lamivudine is a fixed-dose combination and cannot be dose adjusted, abacavir/lamivudine is contraindicated for patients with hepatic impairment. 

The present NRTIs available for the treatment of HIV are zidovudine (azidothymidine, AZT), stavu-dine (d4T), didanosine (ddl), lamivudine (3TC), dideoxycytidine (ddC, zalcitabine) and abacavir, emtricitabine and tenofovir disoproxil. Combination formulations are abcavir combined with zidovudine and lamivudine and the abacavir-lamivudine combination. 

Alternative regimen Nevirapine Atazanavir Fosamprenavir Fosamprenavir + ritonavir Fopinavir/ ritonavir Abacavir/ lamivudine Didanosine/ lamivudine... 

A 44-year-old African-American developed vertigo, tinnitus in both ears, headache behind the eyes, and left ear pain and hearing loss soon after starting to take abacavir, lamivudine, and stavudine. There was... 

Katlama C, Fenske S, Gazzard B, Lazzarin A, Clumeck N, MaUolas J, LafeuiUade A, Mamet JP, Beauvais L AZL30002 European study team. TRIZAL study switching from successful HAART to Trizivir (abacavir-lamivudine-zidovudine combination tablet) 48 weeks efficacy, safety and adherence results. HTV Med 2003 4(2) 79-86. 

Staszewski S, Keiser P, Montaner J, Raffi F, Gathe J, Brotas V, Hicks C, Hammer SM, Cooper D, Johnson M, TorteU S, CutreU A, Thorborn D, Isaacs R, Hetherington S, Steel H, Spreen W CNAAB3005 International Study Team. Abacavir-lamivudine-zidovudine vs indinavir-lamivudine-zidovudine in antiretroviral-naive HIV-infected adults A randomized equivalence trial. JAMA 2001 285(9) 1155-63. 

Nuctane, Somese, Somniton, Songar, Trialam Trizivir zidovudine, abacavir, lamivudine... 

NRTIs are faulty version reverse transcriptase. Reproduction of HIV is stalled when HIV uses NRTI instead of the normal reverse transcriptase. Dmgs within this category include Abacavir (Ziagen, ABC), Abacavir, Lamivudine (Epzicom), Abacavir, Lamivudine, Zidovudine (Trizivir), Didanosine (Videx, ddl, Videx EC), Emtricitabine (Emtriva, FTC, Coviracil), Emtricitabine, Tenofovir DF (Truvada), Lamivudine (Epivir, 3TC), Lamivudine, Zidovudine (Combivir), Stavudine (Zerit, d4T), Tenofovir DF (Viread, TDF), Zalcitabine (Hivid, ddC), and Zidovudine (Retrovir, AZT, AZV). 

A single 300-mg dose of zidovudine was given with abacavir 600 mg to 13 mV-positive subjects. The pharmaeokinetics of abacavir were not significantly affected. The zidovudine maximum plasma level deereased by 20%, but the AUC was unchanged. This ehange is not thought to be elin-ically significant and so no dose alteration would seem neeessaty on eon-current use. These results were eonfirmed in a steady-state study in which 79 mV-positive subjects received 8 weeks of treatment with abacavir 600 mg to 1.8 g daily, in divided doses, and zidovudine 600 mg daily, in divided doses. The triple NRTI eombination of abacavir, lamivudine and zidovudine may also be considered if protease inhibitors or NNRTIs cannot be used. ... 

R526 B. Young, T. Vanig, E. DeJesus, T. Hawkins, M. Clair, B. Standi and B. Ha, 96-Week Results of a Pilot Study of Abacavir/Lamivudine and Raltegravir in Antiretroviral - Naive HIV-1-Infected Patients The SHIELD Trial , HIV Clin. Trials, 2011, 12, 228. 

Hematologic Neutropenia (neutrophil count 80 X 10 /1) occurred in a 38-year-old woman who took abacavir - - lamivudine with lopina-vir -I- ritonavir for 3 weeks [93 ]. She had a fever and mild erythema and edema on the face, trunk, and arms. She was positive for HLA-B 5701. Subsequent therapy with teno-fovir -I- emtricitabine and lopinavir - - ritonavir was uneventful. 

Yuen, G.J. Lou, Y. Thompson, N.P. Otto, V.R. Allsup, T.L. Mahony, W.B. Hutman, H.W. Abacavir/lamivudine/zidovudine as a combined formulation tablet Bioequivalence compared with each component administered concurrently and the effect of food on absorption, J.Clin.Pharmacol., 2001, 41, 277-288. 

Trottier B, Machouf N, Thomas R, Gallant S, Longpre D, Vezina S, et al. Abacavir/lamivudine fixed-dose combination with ritonavir-boosted darunavir a safe and efficacious regimen for HIV therapy. HIV Clin Trials 2012 13(6) 335-42. 

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