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Generic Name:

abacavir-lamivudine, Oral tablet

All Brands

  • Epzicom
SECTION 1 of 4

Highlights for abacavir-lamivudine

Oral tablet
1
Abacavir/lamivudine is an oral medication used to treat HIV infection in combination with other drugs.
2
Each tablet of this medication contains two drugs: abacavir and lamivudine.
3
Abacavir/lamivudine is available as the brand-name drug Epzicom. It’s also available as a generic drug.
IMPORTANT INFORMATION
  • 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

Epzicom 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 Epzicom, 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 Epzicom and see a doctor immediately.

If you’ve had a hypersensitivity reaction to abacavir in the past, don’t ever take Epzicom 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 Epzicom, your healthcare provider can do a lab test to find out if you have the gene.

If you have a hypersensitivity reaction to this drug, be sure to properly dispose of any unused drug right away. This will prevent you from restarting treatment with the drug, which would be dangerous.

Lactic acidosis and severe liver enlargement have also occurred in people who take Epzicom. 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 Epzicom 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.

What is abacavir-lamivudine?

Abacavir/lamivudine is a prescription drug. It comes as an oral tablet. It’s available as the brand-name drug Epzicom. It’s also available in a generic form, which usually costs less. In some cases, the generic may not be available in every strength or form as the brand-name version.

This medication comes as a single tablet that contains two drugs: abacavir and lamivudine. It’s important to know about both drugs in the combination because each drug may affect you in a different way.

Why it's used

Abacavir/lamivudine is used to help control HIV infection. It blocks an enzyme that combines HIV with your DNA. Blocking the enzyme helps to stop HIV from multiplying. You will need to take other HIV drugs for complete treatment. This drug is not completely effective by itself at slowing down the HIV virus.

How it works

Abacavir/lamivudine 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 make copies of itself as easily.

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SECTION 2 of 4

abacavir-lamivudine Side Effects

Oral tablet

More Common Side Effects

The most common side effects that occur with this drug 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

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Hypersensitivity reactions: Symptoms can include:

    • fever
    • fatigue
    • nausea
    • vomiting
    • breathing problems
    • cough

    A rash may or may not be present. This reaction may occur in the first 6 weeks of treatment.

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

  • Heart attack: This drug increases your risk of heart-related conditions, including heart attack.

  • Liver toxicity: Symptoms can include:

    • dark urine
    • decrease in appetite
    • fatigue
    • jaundice (yellowing of the skin or eyes)
    • nausea
    • tenderness or pain if you touch your abdomen
  • Immune reconstitution syndrome: This condition happens when your immune system begins to work better. Old infections you had in the past and that 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.

  • Lactic acidosis: This is 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: Worsened virus infection symptoms can include:

    • fever
    • fatigue
    • loss of appetite
    • yellowing of your skin
    • dark urine
    • pale stools
    • pain the upper right side of you abdomen
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

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.
SECTION 3 of 4

abacavir-lamivudine May Interact with Other Medications

Oral tablet

Abacavir/lamivudine 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 abacavir/lamivudine.

Avoid alcohol when taking abacavir/lamivudine. Your body processes alcohol in the same way it processes abacavir. If you drink alcohol with abacavir/lamivudine, 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 abacavir/lamivudine 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 abacavir/lamivudine include:

  • antihepatitis medications, such as interferon or ribavirin (Copegus, Rebetol, Ribasphere, Virazole, Daklinza)
  • 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.
Drug warnings
generic warning icon
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 abacavir/lamivudine  or abacavir (one component of abacavir/lamivudine ).

liver icon
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.

kidney disease
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 woman ion
Pregnant women

There haven’t been enough studies done in humans to be certain how this drug might affect a fetus.

Research in animals has shown adverse effects to the fetus when the mother takes the drug.

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.

If you take this drug while pregnant, ask your doctor about taking part in the Antiretroviral Pregnancy Registry (APR), which tracks results of this drug usage.

breastfeeding icon
Women who are breast-feeding

Abacavir/lamivudine and HIV can pass to an infant through breast milk.

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

seniors icon
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. 

SECTION 4 of 4

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

Generic: Abacavir/lamivudine

Form: Oral tablet
Strengths: 0.5 mg, 1 mg, 2 mg

Brand: Epzicom

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

One tablet, taken once a day. Taking Taking abacavir/lamivudine 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
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

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 abacavir/lamivudine, the HIV may start multiplying in your body again.

If you start after stopping

If you start abacavir/lamivudine 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 abacavir/lamivudine 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 abacavir/lamivudine is working for you. These could include blood tests for CD4 cells (white blood cells that fight infection) and liver function tests.

abacavir/lamivudine is a long-term treatment.

You should take abacavir/lamivudine 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
take with or without food
You can take abacavir/lamivudine with or without food.
do not crush icon
The abacavir/lamivudine tablet is film-coated and should not be cut or crushed.
storage icon
This drug should be stored at room temperature: 68–77°F (20–25°C)
See Details
refillable prescription
Prescription is refillable
clinical monitoring icon
Clinical monitoring
See Details
not usually stocked icon
Not every pharmacy stocks this drug, so call ahead
See Details
hidden costs
Hidden costs
See Details
insurance icon
Insurance
See Details

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.

Insurance

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.


Show Sources

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

Medically reviewed by University of Illinois-Chicago, Drug Information Group on June 15, 2017

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.
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