Ziagen vs. Triumeq for HIV Treatment: Important Differences and Potential Risks.

Key takeaways

Abacavir (Ziagen) and Triumeq (abacavir/dolutegravir/lamivudine) are both used to treat HIV, but they have some key differences. Abacavir (Ziagen) is a single medication that belongs to the nucleoside reverse transcriptase inhibitor (NRTI) class and is available in both generic and brand forms. It should be used in combination with other HIV medications. Triumeq, on the other hand, is a combination of three medications: abacavir, dolutegravir (an integrase inhibitor), and lamivudine (another NRTI). This combination makes Triumeq a complete HIV treatment in one pill, which is taken once daily. Unlike abacavir (Ziagen), Triumeq is not recommended for people with kidney or severe liver problems and has more drug interactions. Both medications require genetic testing for the HLA-B 5701 gene to avoid serious allergic reactions. Triumeq is available in tablet form for adults and children over 55 lbs. Triumeq PD is a dissolvable tablet for children between 13 lbs and 54 lbs.

Abacavir

(Ziagen)

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Triumeq

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Summary for Ziagen

Prescription only

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.

Indications for Ziagen

HIV treatment

Pros and Cons for 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)

Common Side Effects for Ziagen

Headache (7%)
Nausea (7%)
Fatigue/tireness (7%)
Diarrhea (7%)
Rash (6%)
Stomach pain (6%)
Dizziness (6%)
Muscle Pain (6%)

Warnings for Ziagen

SEVERE ALLERGIC REACTION
LIVER PROBLEMS
IMMUNE RECONSTITUTION SYNDROME
HEART ATTACK

Summary for Triumeq

Prescription only

Triumeq is a single-tablet regimen used to treat human immunodeficiency virus (HIV) infections. It contains 3 antiretrovirals (ARVs): abacavir, dolutegravir, and lamivudine. Triumeq is available as either a tablet or a dissolvable tablet for oral suspension (Triumeq PD), but the two are not the same. Before starting treatment, your provider will require you to get a genetic test to see if you're at risk for developing a serious allergic reaction to this medication.

Indications for Triumeq

Treatment of HIV infection (in people who weigh at least 13 pounds)

Pros and Cons for Triumeq

Pros

Only taken once a day for complete HIV treatment
Combines three medications into one pill for convenience
Can be taken with or without food
Available for adults and children at or over 22 lbs

Cons

Dose can't be adjusted so it's not recommended for people with kidney or liver problems
Not safe to use in severe liver problems
Requires a genetic test before starting
Interacts with a lot of medications such as St. John’s wort and oxcarbazepine (Trileptal)

Common Side Effects for Triumeq

Higher lipase levels (suggesting irritated pancreas) (up to 11%)
Higher blood sugar levels (up to 9%)
Higher creatine kinase levels in the blood (suggesting muscle damage) (up to 7%)
Higher fat levels in the blood (up to 6%)
Higher white blood cell count (up to 4%)
Abnormal liver labs (up to 3%)
Trouble sleeping (3%)
Headache (2%)
Feeling tired (2%)

Please note: The side effects listed above are from clinical trials with Tivicay (dolutegravir) and Epzicom (abacavir / lamivudine), which are all active ingredients in Triumeq and Triumeq PD