Abamune-L Tablet (Abacavir + Lamivudine)

Abamune-L Tablet (Abacavir + Lamivudine) is a two-in-one antiretroviral drug used in combination with HIV therapy.

Epzicom is an abacavir lamivudine combination tablet, an antiretroviral medication used to treat HIV infection in adults and some children. It is taken orally as a tablet.

It contains two antiretroviral agents: abacavir (marketed as Ziagen) and lamivudine (marketed as Epivir). To ensure complete viral suppression, Epzicom is taken in conjunction with at least one other antiretroviral drug.

The Food and Drug Administration (FDA) approved Epzicom for use in 2004. Epzicom may cause severe and potentially life-threatening side effects in some people, despite its ease of use and proven efficacy.

In the United States, several generic versions of Epzicom are available. sold simply as "abacavir + lamivudine" or "abacavir/lamivudine."

abacavir and lamivudine tablets' brand names are Epzicom and Abamune-L

Uses of Abamune-L Tablet (Abacavir + Lamivudine)/Epzicom

Epzicom's two antiretroviral agents are classified as nucleoside reverse transcriptase inhibitors (NRTIs). They work by preventing the virus from replicating or making copies of itself, by blocking a stage of the virus's life cycle.

Epzicom, when combined with other antiretroviral drugs, can reduce viral load to undetectable levels. NRTIs inhibit reverse transcriptase, an enzyme used by the virus to convert viral RNA into DNA, which is then integrated into the nucleus of the host cell to turn it into an HIV-producing factory. 1

NRTIs were the first class of drugs that could stop the virus's replication cycle. They remain an important component of combination antiretroviral therapy.

Epzicom has been approved by the FDA for use in adults and children weighing at least 55 pounds. Epzicom cannot be used in people whose abacavir or lamivudine dose needs to be adjusted because it is a fixed-dose tablet. Individual prescriptions would be required for these people.

Epzicom has no off-label applications.

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Before Taking Epzicom / Abamune-L Tablet (Abacavir + Lamivudine)

Epzicom can be used as a first-line HIV treatment, but it is more commonly used as a backup to preferred first-line agents. If abacavir and lamivudine are used, they are more likely to be combined in the HIV drug Triumeq (abacavir + dolutegravir + lamivudine).

Pretreatment Evaluation

Your healthcare provider will order a series of tests to evaluate the characteristics of your virus if you have been diagnosed with HIV or if your treatment has changed. HIV is ultimately made up of a plethora of genetic variants within the "viral pool," some of which may be drug resistant.

Because drug resistance can be passed from person to person, drug resistance testing is critical in determining which drugs will be most effective in combating the virus in its current form within your body.

Among the tests are:

Genetic resistance testing: This blood test, also known as genotyping or genotypic testing, detects genetic mutations that are known to confer resistance.
Phenotypic testing: This test, also known as phenotyping, is more commonly used after treatment failure and exposes the virus directly to all available antiretroviral drugs to determine which are best able to fully suppress the virus.
People who test positive for this variant are at a high risk of developing a severe hypersensitive reaction to abacavir and should avoid taking abacavir or any abacavir-containing medication.

Precautions and Contraindications of Abamune-L Tablet (Abacavir + Lamivudine)

Epzicom should be avoided or used with caution in certain situations. This could be due to abacavir, lamivudine, or both.

Epzicom should be avoided not only in people who test positive for the HLA-B*5701 allele but also in anyone who has previously had a hypersensitive reaction to abacavir or lamivudine. Some hypersensitive reactions, especially those associated with abacavir, can result in anaphylaxis, multi-organ failure, and death. 4

Furthermore, in people with preexisting liver disease, lamivudine can cause potentially severe liver complications, including liver failure. People with moderate to severe liver disease (Child-Pugh score 7-15) should never take Epzicom because the dosage of each drug cannot be adjusted with fixed-dose combination drugs.

Even people with mild liver impairment (Child-Pugh score 5-6) may need to avoid Epizicom unless they have no other options. To avoid liver toxicity and injury in such cases, frequent liver function tests are required.

Because Epzicom is excreted through both the kidneys and the liver, people with severe kidney impairment (defined as a creatinine clearance of less than 50 milliliters per minute) should avoid the drug as well.

Other NRTIs
There are three other antiretroviral drugs classified as nucleoside reverse transcriptase inhibitors, as well as six fixed-dose combination drugs containing abacavir and/or lamivudine:

• Emtriva (lamivudine)
• Combivir (lamivudine + zidovudine)
• Delstrigo (doravirine + lamivudine + tenofovir disproxil fumarate)
• Dovato (lamivudine + dolutegravir)
• Retrovir (AZT, zidovudine)
• Symfi (efavirenz + lamivudine + tenofovir disoproxil fumarate)
• Symfi Lo (efavirenz + lamivudine + tenofovir disoproxil fumarate)
• Triumeq (abacavir + dolutegravir + lamivudine)
• Viread (tenofovir disoproxil fumarate)

Epzicom's recommended dosage is as follows:

• Adults should take one tablet daily, with or without food.
• Children weighing 55 pounds or more: Take one tablet daily, with or without food.

Epzicom is never used alone. It must be used in conjunction with at least one other antiretroviral medication of a different class. For first-line therapy, an integrase inhibitor such as Tivicay (dolutegravir) is typically used.

How to Take and Store

To ensure complete viral suppression, Epzicom must be taken on a daily basis. The therapeutic concentration of the drug in the bloodstream can be reduced if doses are skipped or missed. Not only does this allow the viral population to grow, but it may also hasten the development of drug resistance.

If you miss a dose, take it as soon as you remember. If your next dose is approaching, skip the first one and continue as usual. Take no more than one dose at a time.

Food has no effect on Epizcom blood concentration. Crushing or splitting the tablet, on the other hand, can slow down absorption and should be avoided. If you or your child has trouble swallowing tablets, notify your doctor so that alternative forms can be prescribed.

Epzicom can be safely stored at temperatures around 77 degrees Fahrenheit. Although short-term exposure to higher temperatures is acceptable, prolonged exposure should be avoided.

This includes the tablets' storage.

The tablets should be stored in their original light-resistant container in a cool, dry cabinet or drawer. Always keep track of the expiration date and avoid taking expired or deteriorated tablets.

In the event of an overdose, seek emergency care because it can result in lactic acidosis, a potentially fatal complication, or other potential harm.

Side Effects of Abamune-L Tablet (Abacavir + Lamivudine)

All medications have side effects, and the majority of those associated with Epzicom are mild and transient or pass quickly. In rare cases, serious side effects may occur, some of which may appear soon after treatment begins and others as a result of prolonged use.

Common Side Effects

Abacavir and lamivudine are independently associated with a number of common side effects, some of which overlap. The most common, occurring in around 5%–10% of users, include:

• Abacavir
• Stuffy nose
• Sneezing
• Sinus pain
• Headache
• Ear pain
• Insomnia
• Unusual dreams
• Loss of appetite
• Lamivudine
• Stuffy or runny nose
• Headache
• Dizziness
• Cough
• Feeling tired
• Insomnia
• Nausea
• Diarrhea

Many of these side effects are transient and will go away as your body adjusts to the treatment. Inform your healthcare provider if side effects persist or become intolerable. However, never discontinue treatment without first consulting your healthcare provider.

Severe Side Effects

Epzicom has a number of potentially serious and even life-threatening side effects. Although uncommon, they may necessitate the immediate discontinuation of the drug as well as, in some cases, emergency medical intervention. These are some examples:

• Abacavir hypersensitivity: Symptoms include fever, rash, nausea, vomiting, diarrhea, abdominal pain, fatigue, and pneumonia-like symptoms, which typically occur within six weeks of starting treatment. If symptoms are not treated, they can worsen and lead to death.
• Lipodystrophy: Long-term NRTI use has been linked to lipodystrophy or the abnormal redistribution of body fat. The symptoms range from mild to severe and are usually progressive
• Lactic acidosis: The abnormal buildup of lactic acid with abacavir and lamivudine is less common than with older-generation antiretrovirals. It can still happen, and symptoms include stomach pain, loss of appetite, diarrhea, muscle cramps, unusual sleepiness, and rapid, shallow breathing (tachypnea). Lactic acidosis has a 50% mortality rate in severe cases.
• Hepatomegaly: Epzicom can cause abnormal liver enlargement in people who have HIV and hepatitis C. Aside from abdominal swelling, other symptoms include red hands, enlarged blood vessels beneath the skin's surface, and skin and eye yellowing (jaundice).

According to some studies, abacavir may increase the risk of a heart attack. Although research is ongoing, if you have a heart condition, consult with your doctor.

Warnings and Interactions with Abamune-L Tablet (Abacavir + Lamivudine)

The FDA has issued several black box warnings informing consumers and healthcare professionals about Epzicom's potentially serious risks. The warnings are based on prior experience with abacavir and lamivudine among HIV patients over a 20-year period.

Abacavir hypersensitivity in people with the HLA-B*5701 allele, lactic acidosis, and severe hepatomegaly are among the black box warnings. Furthermore, the FDA warns that Epzicom may aggravate liver-related symptoms in people infected with both HIV and hepatitis B.

Epzicom is generally thought to be safe during pregnancy. Despite animal studies indicating a risk of fetal harm, data from the Antiretroviral Pregnancy Registry show no difference in the rate of miscarriage and birth defects between mothers taking abacavir or lamivudine and women in the general population.

Those who are pregnant or may become pregnant should, however, consult with their healthcare providers to fully understand the benefits and risks of Epzicom. Breastfeeding is also discouraged for HIV-positive mothers to reduce the risk of transmission to their children.

Abacavir and lamivudine can interact with a variety of medications. These interactions may increase or decrease the concentration of abacavir or lamivudine in some cases while increasing or decreasing the concentration of the coadministered drug in others.

Not all interactions necessitate a dose change or substitution. Nonetheless, it is critical to inform your healthcare provider about any medications you are taking, whether prescription, over-the-counter, herbal, nutritional, or recreational.

Abacavir

The rate at which abacavir is excreted from the body can be slowed by alcohol. This can result in increased blood concentrations and, as a result, a higher risk of side effects such as headache, loss of appetite, and nausea. Reduced alcohol consumption can help to mitigate this effect.

On the other hand, abacavir can lower methadone concentrations in people receiving methadone maintenance therapy for opioid addiction. Having said that, the Epzicom dose rarely necessitates a change in the methadone dose.

Lamivudine

Sorbitol, an artificial sweetener, can lower the concentration of lamivudine in the bloodstream. The effect appears to be dose-dependent, with higher sorbitol intake resulting in greater lamivudine loss in the bloodstream. When possible, avoid taking sorbitol (or sorbitol-containing laxatives) at the same time as Epzicom.

The combination of the antibiotics trimethoprim and sulfamethoxazole (TMP-SMX) may increase lamivudine concentrations, but usually not to a level that is considered problematic.

Other commonly used medications can raise lamivudine levels by inhibiting organic cation transporters (OCTs), which aid in the excretion of substances through the kidneys. Examples include:

• Benadryl (diphenhydramine)
• Glucophage (metformin)
• Prozac (fluoxetine)
• Tagamet (cimetidine)
• Verelan (verapamil)
• Zovirax (acyclovir)
  
  

Frequently asked questions about Abacavir

Abacavir + Lamivudine

Q. Is Abacavir + Lamivudine safe during pregnancy?

Abacavir should only be used if the potential benefits justify the potential risk to the baby. Please follow your doctor's advice regarding its use.

Q. Is it safe to use Abacavir + Lamivudine during breastfeeding?

Abacavir is not safe for the baby and should not be used by women who are breastfeeding.

Q. What is Abacavir + Lamivudine/ what is Abacavir + Lamivudine used for/ what is Abacavir + Lamivudine / what is abacavir-lamivudine/ what does abacavir treat?

Abacavir or abacavir sulfate is used to treat HIV infection along with other medications. Abacavir-lamivudine is a combination drug used to treat HIV infection.

Q. How does Abacavir + Lamivudine work/ how does Abacavir + Lamivudine interfere with reverse transcriptase?

Abacavir works by blocking the function of reverse transcriptase, which inhibits the replication of HIV thereby decreasing its level in the blood.

Q. What is Abacavir + Lamivudine hypersensitivity reaction/ what is Abacavir + Lamivudine hypersensitivity?

Abacavir may cause a serious or life-threatening allergic or hypersensitivity reaction. Hypersensitivity reaction symptoms usually include fever and skin rash, nausea, vomiting, diarrhea, abdominal pain, loss of appetite, severe tiredness, headache, joint or muscle pain, swelling of the neck, shortness of breath, sore throat, cough, and occasionally inflammation of the eye (conjunctivitis), mouth ulcers, low blood pressure, tingling or numbness of the hands or feet. Consult your doctor immediately if you experience one or more such symptoms and stop taking abacavir immediately.

Q. Is Abacavir + Lamivudine a protease inhibitor?

Abacavir is not a protease inhibitor. It inhibits the activity of reverse transcriptase.

Q. Is Abacavir + Lamivudine generic?

Abacavir is a generic name.

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