Generic Name:

abacavir-lamivudine, Oral tablet

All Brands

  • Epzicom
SECTION 1 of 4

Highlights for abacavir-lamivudine

Oral tablet

Epzicom is given with other human immunodeficiency virus (HIV) drugs. Though it’s made up of two drugs, it’s not a complete treatment by itself. It’s not effective on its own to control HIV.


A rash or breathing problems can be a sign of a dangerous reaction. Your healthcare provider may test you for a gene that increases your risk for a potentially deadly rash and hypersensitivity reaction. See a doctor right away if you have a rash with Epzicom.


Epzicom is a tablet that you take once a day. You can take your dose before bed to reduce how much you feel its side effects.


Take Epzicom as prescribed every day. If you don’t, your HIV infection and symptoms may worsen.


Epzicom interacts with alcohol and other medications. Combining it with other substances can lead to toxic effects.

  • warning icon

    FDA warning See Details

  • heart icon

    May increase your risk of a heart attack.

  • infections

    May cause immune reconstitution syndrome See Details

FDA warning

This drug has a Black Box Warning. This is the most serious warning from the U.S. Food and Drug Administration (FDA). Though the medication can still be sold and used, a Black Box Warning alerts doctors and patients to potentially dangerous problems.

Warning: Abacavir, one of the drugs in this drug, can cause a potentially fatal hypersensitivity reaction, which often starts with a skin rash.  Symptoms of this reaction may also include:

  • fever
  • nausea
  • vomiting
  • diarrhea
  • stomach pain
  • fatigue
  • difficulty breathing

Symptoms usually happen during the first 6 weeks that you take the drug. If you have these symptoms, stop taking this drug and see a doctor immediately.

If you’ve had a hypersensitivity reaction to abacavir in the past, don’t ever take this drug or abacavir again. The reaction can be much more serious the second time.

The risk of this reaction is highest for people who have a gene called HLA-B*5701.  Before you take this drug, your healthcare provider can do a lab test to find out if you have the gene. 

Lactic acidosis and severe liver enlargement have also occurred in people who take this drug. Symptoms may include:

  • stomach pain
  • diarrhea
  • shallow breathing
  • muscle pain
  • weakness

If you experience these symptoms, see a doctor right away.

Warning for people with hepatitis B virus infection. If you take this drug and then stop taking it, your hepatitis B virus infection can become much more severe. Your healthcare provider would need to monitor you very carefully if this happens.

May cause immune reconstitution syndrome

In this condition, an improved immune system begins working against old, inactive infections in your body, causing them to get worse. These can include fungal infections, pneumonia, or tuberculosis.

Drug features

This drug is a prescription drug. It is available as an oral tablet.

This drug is a combination drug, which means that it is a combination of two or more drugs in a single form. It is important to know about all the drugs in the combination because they each may have unique traits.

Why it's used

This drug is given to help control HIV infection. It blocks an enzyme that combines HIV with your DNA. Blocking the enzyme helps to stop HIV from multiplying.

This drug is given with other HIV drugs to form a complete treatment for HIV infection. It’s not completely effective by itself at slowing down the HIV virus.

How it works

This drug belongs to a class of medications known as nucleoside reverse transcriptase inhibitors (NRTIs). These medications work by blocking the effectiveness of an enzyme present in HIV known as reverse transcriptase. Without access to the enzyme, HIV can’t replicate as easily.

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abacavir-lamivudine Side Effects

Oral tablet

Most Common Side Effects

The most common side effects that occur with Epzicom may include:

  • changes in the distribution of body fat, such as an increasing amount of fat on or around the neck

  • depression

  • diarrhea

  • dizziness

  • fever

  • headache

  • nausea or vomiting

  • rash. Some people have a mild rash that disappears within a few weeks. If you have a mild rash and it starts getting worse, stop taking the drug and see a doctor immediately. It could develop into a potentially serious hypersensitivity reaction.

  • tiredness

  • inability to sleep or unusual dreams

  • anxiety

  • abdominal pain

Most of these side effects will be reduced or disappear over time.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life-threatening, or if you think you’re experiencing a medical emergency, call 9-1-1.

  • symptoms of hypersensitivity reactions, including fever, fatigue, nausea, vomiting, breathing problems, and cough. A rash may or may not be present. This reaction may occur in the first 6 weeks of treatment.

  • symptoms of heart attack. Epzicom increases your risk for heart-related conditions, including heart attack.

  • symptoms of liver toxicity, including dark urine, decrease in appetite, fatigue, jaundice (yellowing of the skin or eyes), nausea, and tenderness or pain if you touch your abdomen.

  • symptoms of immune reconstitution syndrome. This condition happens when your immune system begins to work better. Old infections you had in the past, and have been almost unnoticeable, may reoccur. Symptoms include:

    • coughing (from tuberculosis or pneumonia)
    • extreme fatigue (from cytomegalovirus)
    • skin or lung infections (from fungal infections) 

    If you have these or any other symptoms that remind you of past infections you have had, see a doctor right away.

  • symptoms of lactic acidosis, a condition that causes excess amounts of acid to build up in your blood. Symptoms include:

    • weakness
    • tiredness
    • difficulty breathing
    • stomach pain
    • feeling cold or dizzy
  • worsening hepatitis B virus infection symptoms, including:

    • fever
    • fatigue
    • loss of appetite
    • yellowing of your skin
    • dark urine
    • pale stools
    • pain in the upper right side of your abdomen
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug does not cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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abacavir-lamivudine May Interact with Other Medications

Oral tablet

Epzicom can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Alcohol Interaction

Avoid alcohol when taking Epzicom.

Your body processes alcohol in the same way it processes abacavir, one of the drugs in Epzicom. If you drink alcohol with Epzicom, the drug can stay in your body longer than it normally would. This increases your risk for toxic side effects from the drug.

Medications That Might Interact with This Drug

Other HIV Drugs

Some other HIV medications that can have interactions with Epzicom include:

  • efavirenz/emtricitabine/tenofovir disoproxil fumarate (Atripla)
  • lamivudine/zidovudine (Combivir)
  • emtricitabine/rilpivirine/tenofovir disoproxil fumarate (Complera)
  • emtricitabine (Emtriva)
  • lamivudine (Epivir or Epivir-HBV) — also treats hepatitis B virus infection
  • abacavir sulfate/lamivudine/zidovudine (Trizivir)
  • abacavir sulfate (Ziagen)

Other Drugs

Other drugs that can adversely interact with Epzicom include:

  • antihepatitis medications, such as interferon or ribavirin (Copegus, Rebetol, Ribasphere, Virazole)
  • methadone
  • trimethoprim (found in combination antibiotics containing sulfamethoxazole)

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with HLA-B*5701 gene positivity

If you have this gene and take the drug, you are at higher risk for a potentially deadly hypersensitivity reaction, which often starts with a skin rash. Other symptoms of this reaction may include:

  • fever
  • nausea
  • vomiting
  • diarrhea or stomach pain
  • fatigue
  • difficulty breathing

Symptoms usually happen during the first six weeks that you take the drug.  

A test can determine if you have the gene called HLA-B*5701. You may need to be tested before taking Epzicom or abacavir (one component of Epzicom).

People with liver disease

If you have liver disease, your doctor will decide whether to give you this drug. Whether you take the drug depends on how severe your disease is. The drug comes in one strength only, so it’s not possible to lower the dose.

People with kidney disease

If you have kidney disease, your doctor will decide whether to give you this drug. If your kidney function is slow (less than 50 mL per minute), you shouldn’t take the drug. Your kidney function can be checked with a lab test that checks how well your kidneys are functioning.

Pregnant women

This drug is a pregnancy category C drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans. 

Pregnant women should only use this drug if the benefits to the mother outweigh the risks to the baby.  If you’re pregnant or plan to become pregnant, discuss this drug with your doctor before taking it.

Women who are breast-feeding

This drug and HIV can pass to an infant through breast milk.

Because of the potential for HIV transmission and the potential for adverse reactions in nursing infants, you shouldn’t breastfeed while taking this drug. 

For seniors

If you’re age 65 or older, your doctor may need to evaluate your general health with lab tests before giving you this drug.

Older adults may process drugs more slowly. A normal adult dose may cause levels of the drug to be higher than normal. If you’re a senior, you may need a lower dose, or you may need a different schedule. 

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How to Take abacavir-lamivudine (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Human immunodeficiency virus (HIV) infection
Form: Oral tablet
Strength: 600 mg abacavir/300 mg lamivudine
Adult dosage (ages 18 years and older)

One tablet, taken once a day. Taking Epzicom at bedtime may reduce your reaction to its side effects.

Child dosage (ages 0–17 years)

Dosage for people younger than 18 years has not been established.

Special considerations

Liver Disease: If you have severe liver disease, this drug isn’t recommended. Your liver may not be able to process the drug well or consistently. The drug could build up in the body causing toxic side effects.

If you have mild liver disease, your healthcare provider may still give you this drug.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug will help control the HIV in your body. It’s most effective if you take it every day.

If you skip doses or stop taking it

If you skip doses or stop taking this drug, the HIV may start multiplying in your body again.

If you start after stopping

If you start this drug after stopping, you should be very careful to watch for rash or hypersensitivity reactions. This reaction can be extremely serious and potentially fatal. Just because you took this drug safely before doesn’t lower the chance of a serious reaction. Symptoms usually occur during the first six weeks you take the drug.

If you miss a dose

If you forget to take your dose, take it as soon as you remember.  If it’s just a few hours before your next dose, take it at the usual time.

Take just one tablet at a time. Never try to catch up by taking two tablets at once. This could result in toxic side effects.

How can I tell if the drug is working?

Your healthcare provider will do tests to see how well this drug is working for you. These could include blood tests for CD4 cells (white blood cells that fight infection) and liver function tests.

This drug is a long-term treatment.

You should take this drug every day as a long-term treatment. Stop taking it only if your doctor tests you and decides to change your treatment.

Important considerations for taking this drug

This drug should be stored at room temperature: 68–77°F (20–25°C)

Keep the bottle tightly closed and away from heat, light, and moisture.

Note: Bathrooms tend to be filled with moisture. To keep drugs away from moisture, store them some place other than your bathroom.

Clinical monitoring

This drug will require occasional lab tests to be sure your body is healthy enough to continue taking it, including:

  • CD4 blood test (CD4 cells are white blood cells that fight infection.)
  • liver function blood tests
  • kidney function blood tests

This drug requires a special genetic test before you start taking it. You need to be tested for the HLA-B*5701 gene. If you have this gene, you are at higher risk for a potentially fatal hypersensitivity reaction. This reaction can include:

  • rash
  • fever
  • nausea
  • vomiting
  • diarrhea or stomach pain
  • fatigue
  • difficulty breathing

Not every pharmacy stocks this drug, so call ahead

If you only need a few tablets, you should call and ask if your pharmacy dispenses only a small number of tablets. Some pharmacies can’t dispense only part of a bottle.

This drug is often available from specialty pharmacies through your insurance plan. These pharmacies operate like mail order pharmacies and ship the drug to you.

In larger cities, there will often be HIV pharmacies where you can have your prescriptions filled. Ask your doctor if there’s a local HIV pharmacy in your area.

Hidden costs

Before you can take this drug, you’ll need a gene test for the HLA-B*5701 gene. This test will determine if you have high risk of hypersensitivity from this drug.


Many insurance companies will require a prior authorization before they approve the prescription and pay for this drug.

Are there any alternatives?

There are several drugs and combinations to treat HIV infection. Talk to your doctor about alternatives.

What does the pill look like?

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Content developed in collaboration with Susan J. Bliss, RPh, MBA

Medically reviewed by Alan Carter, PharmD and Stacey Boudreaux, PharmD on January 22, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.