Epzicom: Side Effects, Dosage, Information

Written by Rachel Nall, RN, BSN | Published on October 3, 2014
Medically Reviewed by Susan J. Bliss, RPh, MBA on October 3, 2014

What Is Epzicom?

Brand Name: Epzicom
Generic Name: ABC/3TC, abacavir sulfate/lamivudine

Epzicom is a medication physicians prescribe to treat HIV. The medication has two components: 600 milligrams (mg) of abacavir sulfate and 300 mg of lamivudine.

Read the FDA description of Epzicom.

What Does Epzicom Do?

Epzicom belongs to a class of medications known as nucleoside reverse transcriptase inhibitors (NRTIs). These medications block the effectiveness of an enzyme present in HIV known as reverse transciptase. As a result, HIV cannot replicate as easily. Epzicom is not a cure for HIV.

What Are the Typical Doses of Epzicom?

The adult dosage is one tablet daily (abacavir 600 mg and lamivudine 300 mg). Epzicom is taken with or without food. Since Epzicom is a fixed dose combination drug, it’s not appropriate for patients with kidney disease who need a dose adjustment. The dose for children aged 3 months to 12 years is based on weight. 

This information is a summary. Before starting this medication, discuss questions with your healthcare provider and make sure you understand dosage instructions.

Before Taking Epzicom

Your doctor will probably perform genetic screening for the HLA-B*5701 allele.  A positive test for this gene puts you at an increased risk for a hypersensitivity reaction, which is a risk in about 8 percent of the population. These reactions can be fatal. 

Tell your doctor if you:

  • have an allergy to abacavir, lamivudine, or other HIV treatment medications
  • are breastfeeding or are planning on breastfeeding
  • are pregnant or are thinking of becoming pregnant
  • have been told you have the gene HLA-B*5701; this must be confirmed or you may need re-testing before taking Epzicom or abacavir (one component of Epzicom).
  • have heart-related conditions, such as heart disease, high blood pressure, or high cholesterol
  • have kidney problems
  • have a history of liver disease, such as hepatitis B or hepatitis C

What Medications May Interact with Epzicom?

Always tell your physician about any prescription medications or herbal remedies you are taking.

Some of the medications that can adversely interact with Epzicom include:

  • anti-hepatitis medications, such as interferon or ribavirin (Copegus, Rebetol, Ribasphere, Vilona, Virazole)
  • efavirenz/emtricitabine/tenofovir disoproxil fumarate (Atripla)
  • lamivudine and zidovudine (Combivir)
  • emtricitabine/rilpivirine/tenofovir disoproxil fumarate (Complera)
  • emtricitabine (Emtriva)
  • lamivudine (Epivir or Epivir-HBV)
  • methadone
  • abacavir sulfate, lamivudine and zidovudine (Trizivir)
  • abacavir sulfate (Ziagen)
  • trimethoprim (found in combination antibiotics containing sulfamethoxazole)
  • Alcohol slows down the passage of abacavir (one ingredient of Epzicom) from the body and may increase risk of toxicity. Avoid alcohol when taking Epzicom. 

Possible Side Effects of Epzicom

Possible Adverse and Emergency Side Effects

The following are severe and emergent side effects of Epzicom. Report to your medical provider immediately if you experience the following.

  • hypersensitivity reactions: Despite genetic testing, some patients may still have hypersensivity reactions. Fever, fatigue, nausea, vomiting, breathing problems, and cough are symptoms and a rash may or may not be present. This reaction occurs in the first six weeks of treatment. Contact the physician immediately if hypersensitivity is suspected.
  • heart-related conditions: Epzicom increases your risk for a heart attack.
  • hepatotoxicity, such as hepatomegaly with steatosis, that affects your liver functioning. Symptoms of this condition include dark urine, decrease in appetite, fatigue, jaundice or yellowing, nausea, and tenderness over the liver.
  • immune reconstitution syndrome, a condition that causes an inflammatory response in viruses in the blood, such as pneumonia or tuberculosis
  • lactic acidosis, a condition that causes excess amounts of acid to build up in your blood. This causes symptoms such as weakness, tiredness, difficulty breathing, stomach pain, feeling cold, or feeling dizzy.
  • worsening of hepatitis B symptoms. A doctor should closely monitor a patient with hepatitis B and HIV for liver function.

Possible Nonemergency Side Effects

The following side effects may occur, but do not usually represent an emergency. Discuss them with your doctor if they continue or are bothersome:

  • changes in the distribution of body fat, such as an increasing amount of fat on the neck
  • depression
  • diarrhea
  • dizziness
  • fever
  • headache
  • nausea or vomiting
  • rash (see hypersensitivity warning above).  Some patients have rash only, which is mild and disappears within a few weeks. 
  • tiredness

This list may not describe all possible side effects. Call your doctor or healthcare provider for advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Where Should I Keep Epzicom?

Epzicom should be stored at room temperature — between 59 and 86 degrees Fahrenheit (15 to 30 degrees Celsius).

Important FDA Warnings

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

FDA WARNING: EPZICOM CARRIES A BLACK BOX WARNING DUE TO A RISK FOR EXPERIENCING HYPERSENSITIVITY SKIN REACTIONS THAT CAN PROVE DEADLY. EXAMPLES OF HYPERSENSITIVITY SYMPTOMS INCLUDE FEVER, RASH, STOMACH UPSET, STOMACH PAIN AND DIFFICULTY BREATHING. THIS RISK IS HIGHER FOR THOSE WITH THE HLA-B*5701 GENE. A PHYSICIAN CAN USE A BLOOD TEST TO DETERMINE IF A PATIENT HAS THIS GENE. A PHARMACIST WILL GIVE YOU A WARNING CARD WITH A LIST OF SYMPTOMS TO BE AWARE OF. 

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