abacavir
Abacavir (Ziagen) is a first choice HIV antiretroviral (ARV) used in combination with other HIV ARVs for the treatment of HIV. It requires a genetic test before you start taking it because it can cause a severe allergic reaction.
What is Abacavir (Ziagen)?
What is Abacavir (Ziagen) used for?
- HIV treatment
How Abacavir (Ziagen) works
Abacavir (Ziagen) is a nucleoside reverse transcriptase inhibitor (NRTI). It inserts itself into the virus' DNA by pretending to be a DNA building block, but actually stops the DNA making process. When this happens, the HIV virus can't make copies of itself.
Drug facts
| Common Brands | Ziagen |
|---|---|
| Drug Class | HIV ARV |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
Side effects of Abacavir (Ziagen)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Headache (7%)
- Nausea (7%)
- Fatigue/tireness (7%)
- Diarrhea (7%)
- Rash (6%)
- Stomach pain (6%)
- Dizziness (6%)
- Muscle Pain (6%)
Less Common Side Effects
- Cough
- Vomiting
Abacavir (Ziagen) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
Symptoms from 2 or more of the following groups:
- Fever
- Rash
- Nausea, vomiting, diarrhea, stomach pain
- Tiredness, achiness, feeling ill
- Shortness of breath, cough, sore throat
The following Abacavir (Ziagen) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Abdominal or stomach pain
difficult or labored breathing
headache
joint or muscle pain
numbness or tingling of the hands, feet, or face
redness and soreness of the eyes
skin rash
sores in the mouth
swelling of the feet or lower legs
unusual feeling of discomfort or illness
unusual tiredness
vomiting
Rare
Abdominal or stomach swelling
decreased appetite
fast, shallow breathing
sleepiness
Incidence not known
Blistering, peeling, or loosening of the skin
chest pain or discomfort
chills
dark urine
light-colored stools
pain or discomfort in the arms, jaw, back, or neck
red, irritated eyes
red skin lesions, often with a purple center
sores, ulcers, or white spots in the mouth or on the lips
sweating
unusual weakness
upper right abdominal or stomach pain
yellow eyes and skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Headache
Less common
Trouble sleeping
Incidence not known
Breast enlargement
buffalo hump
central obesity
facial wasting
gaining weight around your neck, upper back, breast, face, or waist
peripheral wasting
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Abacavir (Ziagen)
Pros
- It's the only NRTI that can be used safely at the same dose in people with severe kidney problems
- Available in many other HIV ARV combination tablets
- Not many drug interactions
- Can be used in children aged 3 months and older
- Available as a tablet and oral solution
Cons
- Requires a genetic test called HLA-B 5701 because the allergic reaction can be fatal
- Cannot be taken by anyone who has ever had an allergic reaction to abacavir (Ziagen)
- Not a good option for people with heart problems
- Can't be used in people with severe liver problems
- People taking methadone might need a higher dose of methadone after starting abacavir (Ziagen)
Pharmacist tips for Abacavir (Ziagen)
- Take abacavir (Ziagen) at the same time(s) everyday. It can be taken with or without food.
- Your medication will come with a warning card that lists all the symptoms of an allergic reaction. Make sure you read this card before you take abacavir (Ziagen) so you know if you are having a reaction. Carry the card with you while you are taking abacavir (Ziagen).
- If you have an allergic reaction to abacavir (Ziagen), get rid of any remaining tablets. You should never take it again. Make sure you let your provider and pharmacist know your allergies so they put it in your medical record.
- If you stop taking abacavir (Ziagen) for more than a few days, talk to your healthcare provider before starting it again.
- The oral solution can be kept at room temperature. You can also store it in the fridge if you want to, but don't freeze it.
Risks and warnings for Abacavir (Ziagen)
Abacavir (Ziagen) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
SEVERE ALLERGIC REACTION
- Risk factors: Positive genetic test (HLA B5701)
Life-threatening allergic reactions to have happened to people taking abacavir (Ziagen). This usually happens in the first 6 weeks after starting the medication. Your healthcare provider will do a genetic test before you start the medication to review your risk of having a reaction. If the test is positive, or you have a history of an allergic reaction to abacavir (Ziagen) you should never take abacavir (Ziagen). This includes HIV ARV combination tablets containing abacavir (Ziagen), such as Epzicom or Triumeq. Stop taking abacavir (Ziagen) and seek medical help right away if you have symptoms from 2 or more of the following groups.
- Fever
- Rash
- Nausea, vomiting, diarrhea, stomach pain
- Tiredness, achiness, feeling ill
- Shortness of breath, cough, sore throat
LIVER PROBLEMS
- Risk factors: Obesity | Women | History of liver problems
Although rare, NRTIs including abacavir (Ziagen) can cause a life-threatening liver problem called lactic acidosis with hepatic steatosis. Most of the cases have been in women. Symptoms include appetite loss, stomach pain, muscle pain, fast and shallow breathing, extreme tiredness, and sudden weakness. Stop taking abacavir (Ziagen) and go to the emergency room right away if this happens.
IMMUNE RECONSTITUTION SYNDROME
- Risk factors: Weakened immune system | Current untreated infection
HIV attacks your immune system. Over time, if the virus isn't treated your body may become defenseless against bacterial and fungal infections. Your HIV medications are very good at killing the virus, and when the number of viruses goes down, your immune system gets started making more cells. Once your immune system gets better, it will start to fight off any infections you might have, which can lead to a lot of inflammation. Even though it's a good thing that your immune system is getting better, too much inflammation can be bad. Your healthcare provider might check for underlying infections (sometimes called opportunistic infections) before starting abacavir (Ziagen) especially if it is your first time taking HIV medications. Call your provider if you experience fever, difficulty breathing, or sudden changes to your health after starting abacavir (Ziagen).
HEART ATTACK
- Risk factors: High blood pressure | High cholesterol | Diabetes
People taking abacavir (Ziagen) might be at a higher risk for having a heart attack, especially if you have high blood pressure, high cholesterol, or diabetes. Talk to your HIV provider about all the medications you are taking and let them know if you have a history of heart problems.
Abacavir (Ziagen) dosage
Interactions between Abacavir (Ziagen) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Methadone
- Tipranavir
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