Abacavir for HIV (Ziagen)

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Abacavir slows the progress of HIV infection. It is one of a number of medicines that you will need to take regularly.

You will be given an Alert Card to inform anyone treating you about sensitivity reactions - please keep this with you at all times.

Abacavir has been associated with some serious side-effects. Your doctor will discuss this with you before you start treatment.
Type of medicineA nucleoside reverse transcriptase inhibitor antiretroviral medicine
Used forHuman immunodeficiency virus (HIV) infection in adults and children
Also calledZiagen®
There are also combination tablets which contain abacavir: Kivexa® (abacavir with lamivudine); Trizivir® (abacavir with lamivudine and zidovudine); Triumeq® (abacavir with lamivudine and dolutegravir)
Available asTablets and oral liquid medicine

Abacavir is an antiretroviral medicine. It is used for human immunodeficiency virus (HIV) infection. It slows the progress of HIV infection, but it is not a cure. HIV destroys cells in the body called CD4 T cells. These cells are a type of white blood cell and are important because they are involved in protecting your body from infection. If left untreated, the HIV infection weakens your immune system so that your body cannot defend itself against bacteria, viruses and other germs. Abacavir slows down the progress of HIV infection by reducing the amount of virus in your body. It does this by stopping the virus from copying (replicating) itself.

Abacavir will be prescribed for you by a doctor who is a specialist. It belongs to a group of antiretroviral medicines known as nucleoside reverse transcriptase inhibitors (NRTIs). It is given alongside a number of other antiretroviral medicines, as part of a combination therapy. Taking three or more antiretroviral medicines at the same time is more effective than taking one alone. Some brands of abacavir contain one or more other antiretroviral medicine - these combination brands help to reduce the total number of tablets you need to take each day. Taking a combination of different medicines reduces the risk that the virus will become resistant to any individual medicine. It is vital to take your antiretroviral medicines exactly as prescribed to maintain success and to help to prevent the virus from becoming resistant to the medicines. These medicines are usually taken for life.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking abacavir it is important that your doctor knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you have any problems with the way your liver works, or if you have problems with the way your kidneys work.
  • If you drink a lot of alcohol.
  • If you are taking any other medicines. This includes any medicines which are available to buy without a prescription, as well as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine.
  • Before you start the treatment, read the manufacturer's printed information leaflet from inside your pack. It will give you more information about abacavir, and it will also provide you with a full list of the side-effects which you could experience from taking it. There will also be an Alert Card inside your pack. You should keep this with you at all times.
  • Take abacavir exactly as your doctor tells you to. The usual dose for adults and older children is 600 mg (two tablets) daily, taken either as a single dose, or divided into two doses, taken morning and evening. Your doctor will tell you how you should take the tablets. For younger children, the dose prescribed will depend upon their age. An oral liquid medicine is often prescribed for younger children - check the label on the bottle carefully to make sure that you give the correct dose.
  • It is recommended that you swallow the tablets whole with a drink of water. If you have difficulty swallowing tablets, Ziagen® brand tablets can be crushed and added to a drink or a small amount of soft food, providing that you then swallow it straightaway. Alternatively, let your doctor know you have difficulty swallowing the tablets, as the liquid medicine may be more suitable for you.
  • Try to take abacavir at the same times of day each day, as this will help you to remember to take your doses regularly. You can take abacavir either with or without food.
  • If you forget to take a dose, take it as soon as you remember (unless it is nearly time for your next dose, in which case leave out the missed dose and take the next dose as normal). Do not take two doses together to make up for a forgotten dose.
  • Keep your regular appointments with your doctor so that your progress can be monitored. You will need to have regular blood tests.
  • It is important that you continue to take abacavir and your other antiretroviral treatment regularly. This will help to prevent the HIV from becoming resistant to the medicines you are taking. Even if you miss only a small number of doses, the virus can become resistant to treatment.
  • If you develop an infection soon after you start the treatment, let your doctor know. As a result of taking abacavir, your immune system may start fighting an infection which was present before you started the treatment, but which you may not have been aware of.
  • Follow carefully any advice your doctor gives to you about making lifestyle changes to reduce any risk of damage to your heart and blood vessels. These can include stopping smoking, eating healthily and taking regular exercise.
  • Some people taking antiretroviral medicines develop changes to the way body fat is distributed in the body. This can result in changes to body image. Your doctor will discuss the possibility of this with you.
  • Although treatment with antiretroviral medicines may reduce the risk of you passing HIV to others through sexual contact, it does not stop it. It is important that you use condoms.
  • It is not uncommon for people with HIV to feel low or even depressed, especially soon after the diagnosis has been made and treatment has been started. If you have any feelings of depression, or any distressing thoughts about harming yourself then you should speak with your doctor straightaway.
  • Some people who have taken antiretroviral medicines (particularly over a long time) have developed a condition called osteonecrosis. This is a bone disease where bone tissue dies because there is a reduced blood supply to it. It leads to joint pains and stiffness, and can cause difficulties in movement. If you notice any of these symptoms, speak with your doctor.
  • If you buy any medicines, supplements or herbal remedies 'over the counter', check with a pharmacist that they are suitable to take with abacavir and your other medicines. This is because some medicines interfere with antiretrovirals and can stop them from working properly.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
  • Treatment for HIV is usually lifelong. Continue to take abacavir regularly, even if you feel well. This is to keep your immune system healthy.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with abacavir. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Common abacavir side-effects (these affect less than 1 in 10 people)
What can I do if I experience this?
HeadacheAsk your pharmacist to recommend a suitable painkiller, and speak with your doctor for further advice
Feeling or being sickAvoid fatty or spicy meals, and speak with your doctor for further advice
DiarrhoeaDrink plenty of water and speak with your doctor for further advice
Rash, high temperature (fever)Contact your doctor for advice
Loss of appetite, weight loss, feeling tiredContact your doctor for advice

Abacavir has also been associated with severe allergic reactions (hypersensitivity) and also with a condition called lactic acidosois. Hypersensitivity usually happens within the first six weeks of treatment, although it can occur at any time. Your doctor will screen you before you start treatment, to make sure you are not at high risk of allergic reactions occurring. Lactic acidosos is a condition where a substance called lactic acid builds up in your blood. If you develop any of the symptoms listed below, you must let your doctor know straightaway, as they can worsen, and may even become life-threatening.

  • The most common signs of a serious allergic reaction are fever and a skin rash. Other common symptoms are feeling sick, diarrhoea, tummy (abdominal) pain, cough or breathing difficulties, feeling weak, sore throat or mouth, headache, and muscle aches and pains.
  • The most common signs of lactic acidosis are feeling or being sick, tummy (abdominal) pain, loss of appetite, loss of weight, feeling dizzy, and fast or gasping breathing.

If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Further reading & references

  • Manufacturer's PIL, Ziagen® 300 mg film-coated tablets; ViiV Healthcare UK Ltd, The electronic Medicines Compendium. Dated April 2016.
  • British National Formulary; 71st Edition (Mar-Sep 2016) British Medical Association and Royal Pharmaceutical Society of Great Britain, London

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

Original Author:
Helen Allen
Current Version:
Peer Reviewer:
Prof Cathy Jackson
Document ID:
28497 (v2)
Last Checked:
21/07/2016
Next Review:
21/07/2019
The Information Standard - certified member

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