Abacavir (Ziagen)

Abacavir slows the progress of HIV infection.

It is one of a number of medicines that you will need to take regularly.

You will be given an Alert Card - keep this with you at all times.

Abacavir has been associated with some serious side-effects. Your doctor will discuss these with you before you start treatment.

About abacavir

Type of medicine An antiretroviral medicine (a nucleoside reverse transcriptase inhibitor)
Used for Human immunodeficiency virus (HIV) infection in adults and children
Also called Ziagen®
Kivexa® (abacavir with lamivudine)
Trizivir® (abacavir with lamivudine and zidovudine)
Available as Tablets and oral liquid medicine

Abacavir is an antiretroviral medicine. It is used for human immunodeficiency virus (HIV) infection. It slows the progress of HIV infection, but it is not a cure. HIV destroys cells in the body called CD4 T cells. These cells are a type of white blood cell and are important because they are involved in protecting your body from infection. If left untreated, the HIV infection weakens your immune system so that your body cannot defend itself against bacteria, viruses and other germs.

Abacavir belongs to a group of antiretroviral medicines known as nucleoside reverse transcriptase inhibitors (NRTIs). Some brands of abacavir contain one or more other NRTIs also. Abacavir is given alongside a number of other antiretroviral medicines, as part of a combination therapy. Taking three or more antiretroviral medicines at the same time is more effective than taking one alone. Taking a combination of different medicines also reduces the risk that the virus will become resistant to any individual medicine.

Abacavir slows down the progress of HIV infection by reducing the amount of virus in your body. This helps improve your immune system and reduces the risk of you developing the complications associated with HIV infection. It will be prescribed for you by a doctor who is a specialist.

Before taking abacavir

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking abacavir it is important that your doctor or pharmacist knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you have a problem with the way your liver works.
  • If you have severe kidney problems.
  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine. It is particularly important that you tell your doctor if you have ever taken abacavir before and had a bad reaction to it.

How to take abacavir

  • Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about the specific brand of abacavir you have been given, and a full list of side-effects which you may experience from taking it. There will also be an Alert Card inside your pack. You should keep this with you at all times.
  • Take abacavir exactly as your doctor has told you. You may be asked to take one or two doses each day. Your doctor will tell you how many tablets to take for each dose, or if you are taking liquid medicine, how much of the medicine to take. Your dose will also be on the label of the pack to remind you.
  • It is recommended that you swallow the tablets whole with a drink of water. If you are taking Ziagen® and have difficulty swallowing the tablets, you can crush them and then add them to a drink or a small amount of soft food, providing you swallow it straightaway. Alternatively, let your doctor know you have difficulty swallowing the tablets, as the liquid medicine may be more suitable for you.
  • Try to take abacavir at the same times each day, as this will help you to remember to take it. You can take abacavir before or after meals.
  • If you forget to take a dose, take it as soon as you remember. If it is time to take your next dose when you remember, skip the missed dose and just take the dose that is due. Do not take two doses together to make up for a forgotten dose.

Getting the most from your treatment

  • Keep your regular appointments with your doctor so that your progress can be monitored. You are likely to need regular blood tests to check how well your medicines are working.
  • It is important that you continue to take abacavir and your other antiretroviral treatment regularly. This will help to prevent the HIV virus from becoming resistant to the medicines you are taking. Even if you miss only a small number of doses, the virus can become resistant to treatment.
  • If you develop any infection soon after you start this treatment, let your doctor know. As a result of taking abacavir, your immune system may start fighting an infection which was present before you started the treatment, but which you may not have been aware of.
  • Follow carefully any advice your doctor gives to you about making some lifestyle changes to reduce the risk of damage to your heart and blood vessels. These may include stopping smoking, eating healthily and taking regular exercise.
  • Abacavir has been associated with serious side-effects in some people who have taken it. These include severe hypersensitivity (an allergic reaction), and a problem known as lactic acidosis (where there is too much lactic acid in the blood). The symptoms associated with these side-effects are listed in the next section 'Can abacavir cause problems?'. Your doctor will screen you before you start treatment to make sure you are not at high risk of these reactions occurring. If you do however develop any of the symptoms listed below, you must let your doctor know straightaway, as they can worsen, and may even become life-threatening.
  • Although treatment with antiretroviral medicines may reduce the risk of you passing HIV to others through sexual contact, it does not stop it. It is important that you use condoms.
  • It is not uncommon for people with HIV to feel low or even depressed, especially soon after the diagnosis has been made. If you have any feelings of depression then you should speak with your doctor.
  • Some people who have taken antiretroviral medicines (particularly over a long time) have developed a condition called osteonecrosis. This is where some bone tissue dies because there is a reduced blood supply to it. It can cause joint aches and pains, and lead to difficulties in movement. If you notice any of these symptoms, speak with you doctor.
  • If you buy any medicines, check with a pharmacist that they are safe to take with abacavir and your other medicines.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
  • Treatment for HIV is lifelong. Continue to take abacavir unless you are advised otherwise, even if you feel well. This is to keep your immune system healthy.

Can abacavir cause problems?

Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. You should, however, speak with your doctor if you develop any of the following side-effects. This is because many of the common side-effects of abacavir are similar to the symptoms of more serious problems.

Common abacavir side-effects - these affect less than 1 in 10 people who take this medicine
What can I do if I experience this?
Headache Ask your pharmacist to recommend a suitable painkiller, and speak with your doctor for further advice
Feeling or being sick Avoid rich and spicy meals, and speak with your doctor for further advice
Diarrhoea Drink plenty of water and speak with your doctor for further advice
Rash, fever Contact you doctor for advice straightaway
Loss of appetite, weight loss, feeling tired Contact you doctor for advice straightaway

Your doctor will discuss with you the possibility of serious allergic reactions occurring. The most common signs of this are fever and a skin rash. Other common symptoms are feeling sick, diarrhoea, abdominal pain, cough or breathing difficulties, weakness, sore throat or mouth, headache, and muscle aches and pains. Let your doctor know straightaway if you develop these symptoms.

The symptoms of lactic acidosis are feeling or being sick, abdominal pain, loss of appetite, loss of weight, and fast or gasping breathing. You must contact your doctor straightaway if this happens to you.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store abacavir

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.