POZ IRELAND
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POZ IRELAND
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ABACAVIR (ABC) Other names: Ziagen®
Approved for use in HIV infection in combination with other antiviral drugs.
ADULT / Adolescent DOSE: 300 mg twice a day, 12 hours apart. With or without food. Paediatric DOSE (3months - 12 yrs): 8 mg/kg BID (max - 300 mg BID). Liquid formulation available. Neonates: Not approved for infants less than 3 months of age. In infants between 1 and 3 months, a dose of 8 mg/kg BID is under investigation.
SIDE EFFECTS: When you start any antiviral treatment, you may have temporary side effects such as headaches, high blood pressure, or a general sense of feeling ill. These side effects usually get better or disappear over time. The most common side effects of abacavir are headache, nausea and vomiting.
HYPERSENSIVITY REACTION: About 3-5% of people who take abacavir have an allergic reaction. This usually develops within two weeks of starting abacavir. However, it can appear up to six weeks or more after starting. People have had the following symptoms:
If you ever stopped abacavir for any reason (for example, because you ran out), talk to your doctor before you start again. In rare cases, people who thought they weren't allergic had serious reactions when re-starting abacavir. If an acute illness cannot be clearly differentiated from a hypersensitivity reaction, abacavir must be permanently discontinued. Serious HSR symptoms have occurred from within three days up to a month after starting therapy. Rash may not initially be present. The constitutional symptoms worsen with continued dosing and usually lead to discontinuation of therapy. SEVERE AND FATAL HYPERSENSITIVITY REACTIONS CAN APPEAR WITHIN HOURS AFTER ABACAVIR REINTRODUCTION -- EVEN IN PEOPLE WHO HAD NO HISTORY OR UNRECOGNISED SYMPTOMS OF HYPERSENSITIVITY REACTION TO ABACAVIR AT THE TIME OF DISCONTINUATION. IF ABACAVIR HAS BEEN DISCONTINUED FOR REASONS OTHER THAN SYMPTOMS OF HYPERSENSITIVITY, EXTREME CAUTION SHOULD BE EXERCISED BEFORE REINTRODUCING ABACAVIR.
Other side effects include dizziness, palpitations and photophobia; nausea and/or vomiting occurred. Laboratory abnormalities included one case of neutropenia, one raised LFT, decreased platelets in one patient and hypoglycaemia in another. Enlarged fatty liver and lactic acidosis have been reported in patients taking nucleoside analogues.
RESISTANCE: There is considerable cross resistance among the nucleoside analogues (3TC, ddI, ddC). Abacavir maybe effective against HIV that has low level resistance to some other NRTIs.
INTERACTIONS: It has been noted that Abacavir with methadone caused a slight increase in the oral clearance rate of methadone. Alcohol increases the blood levels of Abacavir by 41%. Interaction studies with ganciclovir and co-trimoxazole are continuing.
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