II. Indications
- HIV Infection (combination protocols)
III. Contraindications
- Moderate to severe Cirrhosis (Child-Pugh Score >6)
- HLA-B*5701 positive state (screen in advance of starting)
- Associated with life-threatening Hypersensitivity
IV. Mechanism
V. Precautions
- Do not use unless patient is negative for HLA-B5701
- Risk of Hypersensitivity Reaction if HLA-B5701 positive
- Lucas (2007) J Antimicrob Chemother 59(4):591-3 +PMID:17317695 [PubMed]
VI. Dosing
- Used in combination with other Retroviral agents
- Adult (or child weight >25 kg)
- Abacavir 300 mg orally twice daily
- Adult Hepatic Dosing in Mild Cirrhosis (Child-Pugh Score 5 to 6)
- Avoid Abacavir in moderate to severe Cirrhosis (Child-Pugh Score >6)
- Decrease dose to 200 mg orally twice daily (using 10 ml twice daily of oral solution)
- Child with Abacavir tablets
- Weight 14 to 20 kg: 150 mg orally twice daily OR 300 mg orally once daily
- Weight 20 to 25 kg: 150 mg qAM and 300 mg qPM orally OR 450 mg orally once daily
- Weight >25 kg: 300 mg orally twice daily OR 600 mg orally once daily (adult dose)
- Child with Abacavir oral solution (20 mg/ml, age >=3 months)
- Give 8 mg/kg (max 300 mg) orally twice daily OR
- Give 16 mg/kg (max 600 mg) orally once daily
VII. Adverse Effects
-
Hypersensitivity (3%)
- Presents with Fever and Rash
- Associated with HLA-B*5701 positive state
- Mean onset 11 days after start
- Lethal reaction if restarted after reaction (50%)
- Never rechallenge Abacavir after reaction
-
Cardiovascular Risk
- Unclear association with Myocardial Infarction
- Class Effects (with all nRTIs)
- Lactic Acidosis
- Hepatic Steatosis
IX. Resources
Images: Related links to external sites (from Bing)
Related Studies
abacavir (on 11/23/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
ABACAVIR 300 MG TABLET | Generic | $0.61 each |
ABACAVIR-LAMIVUDINE 600-300 MG | Generic | $2.58 each |
Ontology: abacavir (C0663655)
Definition (NCI) | A nucleoside reverse transcriptase inhibitor analog of guanosine. This agent decreases HIV viral loads, retards or prevents the damage to the immune system, and reduces the risk of developing AIDS. |
Definition (CSP) | carbocyclic nucleoside with anti-HIV activity. |
Concepts | Pharmacologic Substance (T121) , Nucleic Acid, Nucleoside, or Nucleotide (T114) |
MSH | C106538 |
SnomedCT | 391696008, 387005008, 116084008 |
LNC | LP21306-3, MTHU013841 |
English | abacavir, abacavir [Chemical/Ingredient], AVACAVIR, 2-Cyclopentene-1-methanol, 4-(2-amino-6-(cyclopropylamino)-9H-purin-9-yl)-, (1S,4R)-, Abacavir - chemical (substance), Abacavir - chemical, ABACAVIR, Abacavir (product), Abacavir (substance), Abacavir |
Spanish | abacavir (producto), abacavir (sustancia), abacavir |
Ontology: Ziagen (C0724476)
Concepts | Pharmacologic Substance (T121) , Nucleic Acid, Nucleoside, or Nucleotide (T114) |
MSH | C106538 |
English | Ziagen, GSK brand of abacavir sulfate, ziagen |