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HIV NUTRITION UPDATE
VOLUME 9, ISSUE 3
MEDWATCH: Epzicom® (Abacavir and Lamivudine)
By  Stuart Katsh, MS, RD

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Editor's Note: Research Pharmacist James D. Scott, PharmD, and Sophea Tim, PharmD Candidate co-wrote this issue's article.

Epzicom is a combination drug used in the treatment of HIV infection or AIDS.  The product was approved by the Food and Drug Administration on August 2, 2004. It contains two drugs:  abacavir (Ziagen®, ABC) and lamivudine (Epivir®, 3TC).  When used in combination, the two drugs help to lower the amount of HIV in the blood.  Epzicom is usually used in combination with other antivirals from a different class, such as Protease Inhibitors or non-nucleoside reverse transcriptase inhibitors, but not in combination with other nucleoside reverse transcriptase inhibitors.
 

Pharmacologic Classification

  •  Nucleoside Reverse Transcriptase Inhibitors (NRTIs):  abacavir and lamivudine
Indication

Epzicom, in combination with other antiretroviral agents, are indicated for the treatment of HIV-1 infection.

  • Check prior medical history for previous exposure and hypersensitivity to abacavir.
Dosage Forms

Epzicom is available as a tablet with:

  • 600 mg of abacavir as abacavir sulfate and 300 mg of lamivudine.
Dosage
  • The recommended dose is one tablet daily, in combination with other antiretroviral agents.
  • Patients who need dose adjustments for renal or hepatic disease should not take the fixed dose tablet form.
 

 
 
 
 


 
 
 

 

 
 
 
 

Pharmacology and Pharmacokinetics
 
  • There is minimal metabolism of abacavir and lamivudine through the cytochrome P450 enzymes, so there are less drug interactions than other antiviral medications.
  • Both medications are readily absorbed and widely distributed throughout the body.
  • Food does not decrease the extent of exposure to the medications, but it does decrease the body’s ability to rapidly absorb the medications verses a fasting state.


Adverse Reactions

  • BLACK BOX WARNING:  A serious hypersensitivity  can occur when starting on this medication (this is often stated as an allergic reaction, but it is not a true allergy). If the patient had a previous reaction to abacavir, then restarting the patient on this medication can lead to life-threatening consequences.  Some of the signs and symptoms of a hypersensitivity reaction are: fever, skin rash, stomach cramping and discomfort, flu-like symptoms, sore throat, shortness of breath or difficulty breathing, closing of the throat, swelling of the lips, tongue, or face, or hives.



 
 
 
 
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2/15/2005