Infectious Disease Compendium

Abacavir (Ziagen®)

Other formulations

Trizavir ® is abacavir + zidovudine + lamivudine is dosed 1 po bid.

Dosing

CrCl Formula

For up-to-date information, go to http://hivinsite.ucsf.edu/.

CrCl > 80: 300 bid or 600 qd.

CrCl 80-50: No dosage adjustment.

CrCl 50-10: No dosage adjustment.

CrCl < 10: No dosage adjustment.

Liver disease

Mild (Child-Pugh A); 200 mg q12hr.

Moderate-to severe (Child-Pugh B or C): Contraindicated.

Important side effects

3% get a hypersensitivity reaction especially white males with HLA B5701: 50-70%.

Also, if genotyping of HIV shows a mutation at codon 245 have a very high chance of being HLA B5701 (PubMed, PubMed).

Testing for HLA (and it is becoming standard of care) can prevent the reaction (PubMed)): rash, increased LFT's cytopenia's, nausea.

Rechallenge can KILL, as can continuing the drug. Lactic acidosis and hepatomegaly with steatosis.

Important drug interactions

Increases amprenavir effect and toxicity; with ribavirin increases the risk of lactic acidosis; decreases methadone effect.

Rants and Screeds

Pearls

The prevalence HLA B5701 is 3.4 to 5.8 percent of Europeans, 17.6 percent in native Americans, 3.0 percent of Hispanic Americans, and 1.2 percent in Chinese Americans. There is variability in African populations. but is around 1.0 percent on average

Treatment of choice

Use for

HIV.

Class

Nucleoside reverse transcriptase inhibitor.

Last Update: 03/25/19.