II. Indications

  1. HIV Infection (combination protocols)

III. Contraindications

  1. Moderate to severe Cirrhosis (Child-Pugh Score >6)
  2. HLA-B*5701 positive state (screen in advance of starting)
    1. Associated with life-threatening Hypersensitivity

V. Precautions

  1. Do not use unless patient is negative for HLA-B5701
    1. Risk of Hypersensitivity Reaction if HLA-B5701 positive
    2. Lucas (2007) J Antimicrob Chemother 59(4):591-3 +PMID:17317695 [PubMed]

VI. Dosing

  1. Used in combination with other Retroviral agents
  2. Adult (or child weight >25 kg)
    1. Abacavir 300 mg orally twice daily
  3. Adult Hepatic Dosing in Mild Cirrhosis (Child-Pugh Score 5 to 6)
    1. Avoid Abacavir in moderate to severe Cirrhosis (Child-Pugh Score >6)
    2. Decrease dose to 200 mg orally twice daily (using 10 ml twice daily of oral solution)
  4. Child with Abacavir tablets
    1. Weight 14 to 20 kg: 150 mg orally twice daily OR 300 mg orally once daily
    2. Weight 20 to 25 kg: 150 mg qAM and 300 mg qPM orally OR 450 mg orally once daily
    3. Weight >25 kg: 300 mg orally twice daily OR 600 mg orally once daily (adult dose)
  5. Child with Abacavir oral solution (20 mg/ml, age >=3 months)
    1. Give 8 mg/kg (max 300 mg) orally twice daily OR
    2. Give 16 mg/kg (max 600 mg) orally once daily

VII. Adverse Effects

  1. Hypersensitivity (3%)
    1. Presents with Fever and Rash
    2. Associated with HLA-B*5701 positive state
    3. Mean onset 11 days after start
    4. Lethal reaction if restarted after reaction (50%)
    5. Never rechallenge Abacavir after reaction
  2. Cardiovascular Risk
    1. Unclear association with Myocardial Infarction
  3. Class Effects (with all nRTIs)
    1. Lactic Acidosis
    2. Hepatic Steatosis

VIII. Safety

  1. Avoid in Lactation
  2. Pregnancy
    1. Considered among the preferred nRTIs in pregnancy

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Related Studies

Cost: Medications

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