abacavir / lamivudine / zidovudine
Trizivir is a combination medication containing three HIV antiretrovirals (ARVs): abacavir (Ziagen), lamivudine (Epivir), and zidovudine (Retrovir). It's not used very commonly anymore.
What is Trizivir?
What is Trizivir used for?
- HIV treatment
How Trizivir works
Trizivir contains three 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 Trizivir
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
- Nausea and vomiting (19%)
- Headache (13%)
- Tiredness and fatigue (12%)
- Diarrhea (7%)
- Fevers and/or chills (6%)
- Depressed mood (6%)
Less Common Side Effects
- Muscle pain
- Rash
- Anxiety
- Cold/flu symptoms
Trizivir 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 Trizivir 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:
More common
Chills
Less common
Abdominal or stomach pain
headache
muscle weakness
numbness or tingling of the face, feet, or hands
pain in the joints
pain in the muscles
pale skin
skin rash
swelling of the feet or lower legs
unusual feeling of discomfort or illness
unusual tiredness or weakness
vomiting
yellow eyes or skin
Rare
Black, tarry stools
blood in the urine or stools
pinpoint red spots on the skin
unusual bleeding or bruising
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:
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 Trizivir
Pros
- Can be taken with or without food
- Combines 3 different HIV medications into 1 tablet
- Available as a generic, which can be more affordable
- Doesn't affect your kidneys or bone density like some other NRTIs
- Contains lamivudine, which also works against hepatitis B
Cons
- Contains 3 HIV ARVs but isn't a full HIV regimen
- Can cause serious blood and muscle problems
- 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
Pharmacist tips for Trizivir
- Take 1 tablet twice a day with or without food. Try your best to space each dose 12 hours apart from each other.
- 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 Trizivir so you know if you are having a reaction. Carry the card with you while you are taking Trizivir.
- Make sure you're also taking at least 1 other HIV ARV. Trizivir is not a full regimen on its own.
- Don't stop taking Trizivir without talking to your healthcare provider first, especially if you have hepatitis B.
- Have your labs drawn when your provider orders them. They will use your lab results to check if the medication is working and to see if you are having side effects.
Common questions about Trizivir
One tablet of Trizivir should be taken every 12 hours with or without food. Most people find it helpful to take all of their HIV ARVs together. Pay attention to the food requirements of your other HIV ARV(s), this can help you plan out your schedule.
If you forget your dose of Trizivir, take it as soon as you remember unless it's almost time for your next dose. Never double up on doses.
Changes in weight are not common with Trizivir.
ViiV Healthcare is the original maker of Trizivir and still makes the brand name product. It's now available as generic and made by a number of manufacturers.
Yes, Trizivir is still used but it's not a first choice option due to the potential side effects and toxicities of 3 NRTIs. Many people have chosen to stay on Trizivir since it works well for them and has a generic version available.
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Risks and warnings for Trizivir
Trizivir 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 Trizivir. 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 Trizivir you should never take Trizivir. Stop taking Trizivir 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
BLOOD AND BONE MARROW PROBLEMS
- Risk factors: Advanced HIV | Anemia | Neutropenia
Trizivir can cause bone marrow problems, which can lead to anemia and affect your immune system. These effects are more serious when people already have some type of low blood count or advanced HIV. Your provider will draw blood tests regularly to check your blood count. If your numbers become too low, they may lower your dose or recommend switching to a different HIV ARV.
MUSCLE PAIN AND WEAKNESS
- Risk factors: Extended use of Trizivir
Taking Trizivir for a long time can lead to muscle pain or weakness. Talk to your provider right away if you have unexplained fatigue and muscle pain or weakness all over your body.
LIVER PROBLEMS
- Risk factors: Liver disease | Women | Obesity
Although rare, NRTIs including Trizivir 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 Trizivir and go to the emergency room right away if this happens.
WORSENING OF HEPATITIS B
- Risk factors: Hepatitis B virus | Stopping Trizivir
People who have stopped taking Trizivir have had severe worsening of their hepatitis B. Don't stop taking Trizivir 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.
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 Trizivir 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 Trizivir.
HEART ATTACK
- Risk factors: High blood pressure | High cholesterol | Diabetes
People taking Trizivir 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.
FAT REDISTRIBUTION
- Risk factors: Taking HIV ARVs
Some people taking HIV ARVs, including Trizivir have noticed changes to the way fat is located in the body. This might be more fat in the abdomen and upper back, and less fat in the face, arms, legs, and buttocks. Scientists and health care providers don't really know why this happens. Switching to a different HIV ARV can help, even if the change isn't 100% reversible.
Trizivir dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 300mg/150mg/300mg | 30 tablets | $917.85 | $30.60 |
Typical dosage for Trizivir
The recommended dose is 1 tablet twice daily. Each tablet contains: 300 mg of abacavir, 150 mg of lamivudine, and 300 mg of zidovudine.
Interactions between Trizivir 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.
- Cabotegravir
- Clarithromycin
- Dapsone
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Flucytosine
- Horsetail
- Orlistat
- Pexidartinib
- Pyrazinamide
- Pyrimethamine
- Ribavirin
- Sorbitol
- Stavudine
- Vinblastine
- Vincristine
- Vincristine Sulfate Liposome
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.
- Acetaminophen
- Fluconazole
- Interferon Beta-1a
- Methadone
- Nelfinavir
- Probenecid
- Rifabutin
- Rifampin
- Rifapentine
- Tipranavir
- Valproic Acid
How much does Trizivir cost?
