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Precautions and Warnings With Abacavir/Lamivudine/Zidovudine

Talking to your healthcare provider about the precautions and warnings with abacavir/lamivudine/zidovudine before starting treatment can help minimize risks. It is important to know that the drug is not a cure for HIV or AIDS and that you should always practice safe sex. Make sure to tell your healthcare provider if you have liver or kidney disease, hepatitis B, or anemia before taking abacavir/lamivudine/zidovudine.

Abacavir/Lamivudine/Zidovudine: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking abacavir/lamivudine/zidovudine (Trizivir®) if you have:
 
  • Anemia, neutropenia, or any other low blood count or blood disorder
  • Liver disease, such as liver failure or cirrhosis
  • Kidney disease, such as kidney failure (renal failure
  • Hepatitis B
  • Any allergies, including allergies to food, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:

 

  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
You should also be sure to tell your healthcare provider about all other medicines you are taking, including prescription and prescription medicines, vitamins, and herbal supplements.
 

Specific Warnings and Precautions for Abacavir/Lamivudine/Zidovudine

Warnings and precautions to be aware of prior to taking abacavir/lamivudine/zidovudine include the following:
 
  • Abacavir (one of the components of abacavir/lamivudine/zidovudine) often causes allergic reactions. These reactions can be extremely dangerous. Stop taking abacavir/lamivudine/zidovudine and contact your healthcare provider immediately if you develop symptoms from two or more of the following groups of symptoms:

 

    • Group 1 -- Fever
    • Group 2 -- Rash
    • Group 3 -- Nausea, vomiting diarrhea, or abdominal pain (stomach pain)
    • Group 4 -- Extreme fatigue, a general ill feeling (malaise), or achiness
    • Group 5 -- Shortness of breath, cough, or a sore throat.
If you have ever had an allergic reaction to abacavir, you should never take abacavir/lamivudine/zidovudine (or any other medication containing abacavir) ever again.
  • People with a certain gene known as HLA-B*5701 are much more likely to have serious allergic reactions to this medication. It is recommended that you be tested for this gene before starting this medication or before restarting it (even if you did not have problems in the past).

In general, this medication is not recommended for people with this gene. It should be noted that serious allergic reactions can still occur in people that do not have this gene.  

  • Abacavir/lamivudine/zidovudine can rarely cause a condition called lactic acidosis and hepatic steatosis. It is caused by damage to the liver and can be very dangerous. You are at higher risk for this side effect if you are obese or have liver disease.

 

  • Abacavir/lamivudine/zidovudine can cause bone marrow depression, which means that it can decrease the bone marrow's ability to produce blood cells. This can lead to a variety of problems, such as anemia, frequent infections, or bleeding. Your healthcare provider should check your blood counts frequently while you are taking abacavir/lamivudine/zidovudine.
     
  • Abacavir/lamivudine/zidovudine can cause muscle problems. Let your healthcare provider know if you develop muscle weakness or pain.
     
  • Studies of lamivudine (one of the components of abacavir/lamivudine/zidovudine) for treating hepatitis B have suggested that hepatitis B may worsen after lamivudine is stopped. If you have hepatitis B and you stop taking abacavir/lamivudine/zidovudine, your healthcare provider may need to monitor you more closely. Abacavir/lamivudine/zidovudine has not been studied in people who are infected with both HIV and hepatitis B.

 

  • One study suggested that abacavir (one of the components of this medication) may increase the risk of a heart attack. Although further analysis (using the data from several studies) did not confirm this risk, your healthcare provider should take measures to identify and treat (if possible) any possible heart disease risk factors.

  

  • Abacavir/lamivudine/zidovudine can change the distribution of fat on your body. You may gain fat in areas that are not typical for you, such as in the abdomen or at the back of the neck (a "buffalo hump"), and may lose weight in other areas.
     
  • Abacavir/lamivudine/zidovudine is not a cure for HIV or AIDS. If you have HIV or AIDS, you should always use safer sex practices, whether or not you are taking medications.
     
  • As will all HIV medications, it is important that you take abacavir/lamivudine/zidovudine exactly as prescribed. Missing doses may increase the chance of the virus becoming resistant to HIV medications.

 

  • When you first start taking this medication and your immune system begins to recover, a group of problems known as immune reconstitution syndrome may occur. Your immune system may start aggressively reacting to any infections you may have and may cause extreme inflammation. There have even been cases of autoimmune disorders (such as Graves' disease, polymyositis, and Guillain-Barré syndrome) possibly caused by this problem. 

 

  • The kidneys help remove abacavir/lamivudine/zidovudine from the blood. Therefore, check with your healthcare provider before taking abacavir/lamivudine/zidovudine if you have kidney disease.
     
  • Abacavir/lamivudine/zidovudine can interact with a number of different medications (see Drug Interactions With Abacavir/Lamivudine/Zidovudine for more information).
     
  • Abacavir/lamivudine/zidovudine is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not known (see Trizivir and Pregnancy).
     
  • Abacavir/lamivudine/zidovudine passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Trizivir and Breastfeeding). It is important to understand that the HIV virus can be transmitted through breast milk and that breastfeeding is usually not recommended in women with HIV or AIDS.
     

Abacavir/Lamivudine/Zidovudine for HIV

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