Abacavir

HIV load greater than 100,000 copies/mL; patients at high risk of cardiovascular disease (especially if 10-year cardiovascular risk greater than 20%)

About: Always check the BNF link here

• Risk of allergic reaction is much higher if you have a gene variation called HLA-B*5701

Mode of action

• Nucleoside reverse transcriptase inhibitor (NRTI class)
• It is phosphorylated to active metabolites that compete for incorporation into viral DNA
• They inhibit the HIV reverse transcriptase enzyme competitively
• Act as a chain terminator of DNA synthesis

Indications/Dose

• HIV infection in combination with other antiretroviral drugs
• Abacavir 600 mg daily in 1-2 divided doses.

Dose range:You must check with BNF or drug datasheet

Interactions

• See BNF

Cautions

• Life-threatening lactic acidosis associated with hepatomegaly and hepatic steatosis has been reported
• Hepatomegaly, hepatitis (especially hepatitis C treated with interferon alfa and ribavirin)
• LFT abnormalities and risk factors for liver disease and hepatic steatosis.
• Treatment with the NRTI should be discontinued in case of symptomatic hyperlactatemia, lactic acidosis, progressive hepatomegaly or rapid deterioration of liver function

Contraindications

• See BNF

Side effects

• Lactic acidosis, Immune reconstitution inflammatory syndrome (IRIS),
• Lipodystrophy: Changes in body fat (including gain or loss of fat).
• IHD: Increased risk of heart attack (myocardial infarction).

References

• Abacavir at BNF