Standard Dose: Two 300 mg tablets once-a-day (or one 300 mg tablet twice-a-day), no food restrictions (may be taken with or without food). A strawberry/banana flavored liquid is available. Take missed dose as soon as possible, but do not double up on your next dose.

AWP: $472.14 / month

Manufacturer contact: GlaxoSmithKline,
www.treathiv.com, 1 (888) 825–5249

AIDSInfo:1 (800) HIV–0440 (448–0440), www.aidsinfo.nih.gov

Approximately 8% of people taking abacavir experienced hypersensitivity reaction (HSR, an allergic-like reaction) during clinical trials. People who think they are experiencing HSR must be evaluated by an experienced HIV provider as soon as possible before they stop taking abacavir. Be very careful, especially in the first two months of treatment. Symptoms worsen with every dose, but very slowly. If treatment is stopped because of this serious reaction, they can never take abacavir, Epzicom or Trizivir again (called “re-challenging”) because of life-threatening and potentially fatal reaction. (This does not apply to missed doses, when there’s no HSR, but watch for symptoms if you’ve stopped the drug for at least a few days). This reaction usually occurs during the second week of treatment, but may take as long as six weeks to appear, but can occur anytime during treatment. It gets progressively worse and resolves quickly (24–48 hours) after permanent discontinuation. Symptoms usually, but not always, include some combination of sudden fever, muscle ache, severe nausea, vomiting or abdominal pain, severe tiredness, respiratory symptoms (cough, difficulty breathing and sore throat) and possibly mild rash. Symptoms are listed on the patient information sheet and warning card that you receive each time you fill your prescription. Always keep the warning card with you. HSR might be confused with flu during flu season, but remember that it worsens with every dose. See Epzicom tips. Check with your doctor if you have any side effects after taking this medicine—don’t just stop! More common side effects include nausea, vomiting, diarrhea, fatigue, headache, fever, rash, anorexia (loss of appetite), and potentially high blood sugar and high triglyceride levels (fat in the blood). Rare but potentially fatal toxicity with all NRTIs is hepatomegaly (enlarged liver) with steatosis and lactic acidosis (accumulation of lactate in the blood and abnormal acid-base balance). Lactic acidosis has been seen in patients taking NRTIs but is more severe in women, people who are obese and people who have been taking nukes for a long time; and more common in people with liver disease, but can occur in people without a history of liver damage. Symptoms include persistent fatigue, abdominal pain or distension, nausea/vomiting, and difficulty breathing or shortness of breath; and enlarged, fatty liver (called hepatomegaly with steatosis).

This is a potent NRTI, but the potential hypersensitivity reaction (HSR) does warrant the U.S. HIV treatment guidelines not recommending Ziagen as first-line treatment. It is important to remember that HSR occurs in 5–8% of people and is not fatal unless ignored, and to communicate any and all symptoms to your healthcare provider. Do not stop Ziagen until you have discussed this with your healthcare provider. You don’t want to burn through a potent and tolerable HIV drug. The manufacturer recommends that people with symptoms of acute respiratory disease consider HSR even if other diagnosis such as pneumonia, bronchitis or flu is possible. An analysis of 8,000 patients found a reduced risk of HSR in blacks and in men.