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Precautions and Warnings With Abacavir/Lamivudine

There are numerous precautions and warnings with abacavir/lamivudine to be aware of before starting treatment. Before taking abacavir/lamivudine, tell your healthcare provider if you have kidney disease, anemia, or neutropenia. You should not take abacavir/lamivudine if you are allergic to any components of the medication or have decreased kidney function. It is important to know that abacavir/lamivudine is not a cure for HIV or AIDS.

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

You should talk with your healthcare provider prior to taking abacavir/lamivudine (Epzicom™) if you have:
 
  • Hepatitis B
  • Liver disease, such as liver failure or cirrhosis
  • Kidney disease, such as kidney failure (renal failure)
  • Anemia, neutropenia, or any other low blood count or blood disorder
  • 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 non-prescription medicines, vitamins, and herbal supplements.
 

Specific Warnings and Precautions for Abacavir/Lamivudine

Warnings and precautions to be aware of prior to taking abacavir/lamivudine include the following:
 
  • Abacavir (one of the components of abacavir/lamivudine) often causes allergic reactions. These reactions can be extremely dangerous. Stop taking abacavir/lamivudine 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 (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.
  • Studies of lamivudine (one of the components) for treating hepatitis B have suggested that the condition may worsen after lamivudine is stopped. If you have hepatitis B and you stop taking abacavir/lamivudine, your healthcare provider may need to monitor you more closely. This drug has not been studied in people infected with both HIV and hepatitis B.
 
  • Abacavir/lamivudine 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 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.
     
  • Abacavir/lamivudine 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.
 
  • 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 measure to identify and treat (if possible) any possible heart disease risk factors.
 
  • Abacavir/lamivudine is not a cure for HIV or AIDS. If you have HIV or AIDS, you should always use safer sex practices, regardless of whether you are taking 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. 

 

  • As will all HIV medications, it is important that you take abacavir/lamivudine exactly as prescribed. Missing doses may increase the chance of the virus becoming resistant to HIV medications.
     
  • The kidneys help remove abacavir/lamivudine from the blood. Therefore, check with your healthcare provider before taking abacavir/lamivudine if you have kidney disease.
     
  • Abacavir/lamivudine can interact with a number of different medications (see Drug Interactions With Abacavir/Lamivudine for more information).
     
  • Abacavir/lamivudine 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 Epzicom and Pregnancy).
     
  • Abacavir/lamivudine 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 Epzicom 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 for HIV/AIDS

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