Abacavir + Lamivudine


Concise Prescribing Info
Indications/Uses
HIV infection.
Dosage/Direction for Use
Adult : PO Each tab contains abacavir 600 mg and lamivudine 300 mg: 1 tab once daily.
Dosage Details
Oral
HIV infection
Adult: Each tab contains abacavir 600 mg and lamivudine 300 mg: 1 tab once daily.
Renal Impairment
CrCl <50 mL/min: Not recommended.
Hepatic Impairment
Contraindicated.
Administration
May be taken with or without food.
Contraindications
Hypersensitivity. Hepatic impairment. Lactation.
Special Precautions
Patients w/ coronary heart disease, chronic hepatitis B or C, renal impairment CrCl <50 mL/min. May exacerbate hepatitis B. Prior to treatment, screening for carriage of HLA-B*5701 should be done. Pregnancy.
Adverse Reactions
Lipodystrophy, immune reactivation syndrome, osteonecrosis. Anorexia, headache, insomnia, nausea, vomiting, abdominal pain or cramps, diarrhoea, rash, urticaria, alopecia, arthralgia, peripheral neuropathy, muscle disorders, fever, fatigue, lethargy, cough, nasal symptoms, increased CPK.
Potentially Fatal: Severe hypersensitivity reactions, lactic acidosis, hepatic impairment (e.g. hepatomegaly), severe acute exacerbation of hepatitis B.
Patient Counseling Information
Advise patient to continue to practice safe sex.
MonitoringParameters
Monitor hepatic function, amylase bilirubin, blood glucose, serum creatinine kinase, haematologic parameters and triglycerides. Closely monitor for hypersensitivity reactions. Periodic LFT and markers for HBV is recommended in patients co-infected w/ hepatitis B as withdrawal of treatment may result in acute exacerbation of hepatitis.
Overdosage
Symptoms: Same as mentioned in the Adverse Reaction section. Management: Symptomatic and supportive treatment. May perform haemodialysis since lamivudine is dialysable.
Drug Interactions
Increased hepatic decompensation w/ interferon alfa. May increase the adverse effects of emtricitabine or emtricitabine-containing products. Bioavailability may decrease w/ methadone. Co-trimoxazole may increase the serum levels of lamivudine. Ribavirin may increase the risk of hepatotoxicity.
Food Interaction
Ethanol may increase abacavir serum levels and risk of toxicity.
Action
Description: Abacavir and lamivudine are both nucleoside reverse transcriptase inhibitors. Converted to their respective active triphosphate form, they have additive effect in inhibiting replication of retroviruses by interfering w/ viral RNA-directed DNA polymerase (reverse transcriptase).
Pharmacokinetics:
Absorption: Rapidly absorbed from GI tract. Bioavailability: Approx 80% (abacavir); 80-87% (lamivudine). Time to peak plasma concentration: Approx 1.5 hr (abacavir); approx 1 hr (lamivudine).
Distribution: Crosses blood-brain barrier. Lamivudine crosses the placenta and is distributed into breast milk. Plasma protein binding: Approx 50% (abacavir); up to 36% (lamivudine).
Metabolism: Abacavir and lamivudine are metabolised by intracellular kinase to carbovir triphosphate (active triphosphate form of abacavir) and lamivudine triphosphate, respectively.
Excretion: Mainly via urine as metabolites. Elimination half-life: Approx 1.5 hr (abacavir); 5-7 hr (lamivudine).
Storage
Store below 30°C.
MIMS Class
ATC Classification
J05AR02 - lamivudine and abacavir ; Belongs to the class of antivirals for treatment of HIV infections, combinations.
References
Anon. Abacavir and Lamivudine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 24/07/2014.

Buckingham R (ed). Abacavir. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com.

Buckingham R (ed). Lamivudine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 24/07/2014.

Wickersham RM. Abacavir/Lamivudine. Facts and Comparisons [online]. St. Louis, MO. Wolters Kluwer Clinical Drug Information, Inc. https://www.wolterskluwercdi.com/facts-comparisons-online/. Accessed 24/07/2014.

Disclaimer: This information is independently developed by MIMS based on Abacavir + Lamivudine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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