abacavir / lamivudine
Epzicom is a combination medication containing two HIV antiretrovirals (ARVs), abacavir (Ziagen) and lamivudine (Epivir). It's used with other HIV ARVs for the treatment of HIV.
What is Epzicom?
What is Epzicom used for?
- HIV treatment
How Epzicom works
Epzicom contains two nucleoside reverse transcriptase inhibitors (NRTIs). They insert themselves into the virus' DNA and stop the DNA-making process. When this happens, the HIV virus can't make copies of itself.
Drug facts
Side effects of Epzicom
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%)
- Tiredness and fatigue (6%)
- Dizziness (6%)
- Nausea (5%)
- Diarrhea (5%)
- Rash (5%)
- Fever (5%)
Less Common Side Effects
- Stomach pain
- Anxiety
Epzicom 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
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Pros and cons of Epzicom
Pros
- Contains 2 first choice HIV ARV options
- Convenient dosing (1 tablet, once a day, with or without food)
- Same dose for everyone weighing more than 55 lbs (25 kg)
- Contains lamivudine, which also works against hepatitis B
- Available as a generic, which can be more affordable
Cons
- Dose can't be adjusted so it's not recommended for people with kidney or liver problems
- Requires a genetic test called HLA-B 5701 because the allergic reaction can be fatal
- Not a good option for people with heart problems
- People taking methadone might need a higher dose of methadone after starting Epzicom
- People with hepatitis B can have worsened hepatitis B if they suddenly stop taking Epzicom
Pharmacist tips for Epzicom
- Try to take your tablet at the same time every day. This will help keep the amount of medication in your body consistent.
- 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 Epzicom so you know if you are having a reaction. Carry the card with you while you are taking Epzicom.
- If you have an allergic reaction to Epzicom, 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.
- Don't stop taking Epzicom without talking to your healthcare provider first, especially if you have hepatitis B.
- If you forget to take Epzicom, or run out of medication for more than a few days, talk to your healthcare provider before starting it again.
Common questions about Epzicom
If you forget your dose of Epzicom, take it as soon as you remember unless it has been more than 12 hours. If it's been longer than 12 hours go ahead and skip the dose. Never double up on doses.
Epzicom can be taken at any time of the day. The most important thing is that you keep the time consistent. Many people prefer to take all of their HIV ARVs at the same time. Pay attention to dosing instructions and food requirements of your other HIV ARVs.
Changes in weight are not common with Epzicom.
Yes, Epzicom is still used by many people throughout the world. It's not as commonly used as it was before, since there are newer HIV ARV combination tablets that are full regimens.
ViiV Healthcare is the original maker of Epzicom and still makes the brand name product. It's now available as generic and made by a number of manufacturers.
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Risks and warnings for Epzicom
Epzicom 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 Epzicom. 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 Epzicom you should never take Epzicom. Stop taking Epzicom 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
WORSENING OF HEPATITIS B
- Risk factors: Hepatitis B virus | Stopping Epzicom
People who have stopped taking Epzicom have had severe worsening of their hepatitis B. Don't stop taking Epzicom unless instructed by your healthcare provider. If you are instructed to stop the medication or switch to a different antiviral medication, make sure you get your labs drawn regularly. This is how your provider will monitor your liver and HBV.
LIVER PROBLEMS
- Risk factors: Obesity | Women | History of liver problems
Although rare, NRTIs including Epzicom 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 Epzicom 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 Epzicom 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 Epzicom.
HEART ATTACK
- Risk factors: High blood pressure | High cholesterol | Diabetes
People taking Epzicom 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.
Epzicom dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 600mg/300mg | 90 tablets | $108.81 | $1.21 |
Typical dosage for Epzicom
The recommended dose is 1 tablet once daily. Each tablet contains 600 mg of abacavir and 300 mg of lamivudine.
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