Details About Generic Salt ::  Abacavi1

Main Medicine Class:: Antiretroviral combination   

(ab-ah-KAV-ear SULL-fate/la-MIH-view-deen/zie-DOE-view-DEEN)
Trizivir
Tablets: 300 mg abacavir sulfate/150 mg lamivudine/300 mg zidovudine
Class: Antiretroviral combination

 

Drugs Class ::

 Action Inhibits replication of HIV by incorporation into HIV DNA and producing incomplete, nonfunctional DNA.

Indications for Drugs ::

 Indications Use alone and in combination with other antiretroviral agents for the treatment of HIV-1 infection.

Drug Dose ::

 Route/Dosage

Adults and Adolescents (40 kg or greater): PO 1 tablet bid.

Contraindication ::

 Contraindications Abacavir has been associated with fatal hypersensitivity reactions and should not be restarted following a hypersensitivity reaction to abacavir; hypersensitivity to any component of the product.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: HIV-infected mothers should not breastfeed their infants. Zidovudine: Excreted in breast milk. Abacavir and Lamivudine: Undetermined. Children: Safety and efficacy not established in children weighing less than 40 kg. Elderly: Select dose with caution, reflecting greater frequency of decreased hepatic, renal, or cardiac function and comorbidity. Bone marrow suppression: Use with caution in patients who have bone marrow compromise evidenced by granulocyte count less than 1000 cells/mm3 or hemoglobin less than 9.5 g/dL. Hypersensitivity: Fatal hypersensitivity reactions have been associated with abacavir use and have occurred within hours after reintroduction of abacavir in patients who have no identified history or unrecognized symptoms of hypersensitivity. If hypersensitivity cannot be ruled out, do not restart therapy. Renal function impairment Because this is a fixed-dose tablet, do not use for patients requiring dosage adjustments (eg, Ccr less than 50 mL/min or patients experiencing dose-limiting adverse effects). Lactic acidosis/Severe hepatomegaly: Steatosis have been reported.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CARDIOVASCULAR: Cardiomyopathy. CNS: Loss of appetite; anorexia; insomnia; sleep disorders; headache; malaise; fatigue; neuropathy; dizziness; depression; paresthesia; peripheral neuropathy; seizures. DERMATOLOGIC: Skin rash; alopecia; Stevens-Johnson syndrome; toxic epidermal necrolysis; erythema multiforme. EENT: Nasal signs and symptoms. GI: Nausea; vomiting; diarrhea; pancreatitis; abdominal pain; dyspepsia; stomatitis; oral mucosal pigmentation. GU: Gynecomastia. HEMATOLOGIC: Neutropenia; anemia; thrombocytopenia; aplastic anemia; lymphadenopathy; pure red cell aplasia; splenomegaly. HEPATIC: Increased ALT, AST, and bilirubin; hepatic steatosis; posttreatment exacerbation of hepatitis. METABOLIC: Redistribution of body fat; hyperglycemia. RESPIRATORY: Cough; abnormal breath sounds; wheezing. OTHER: Hypersensitivity; fever; chills; musculoskeletal pain; myalgia; arthralgia; vasculitis; weakness; muscle weakness; CPK elevation; rhabdomyolysis.

Drug Mode of Action ::  

 Action Inhibits replication of HIV by incorporation into HIV DNA and producing incomplete, nonfunctional DNA.

Drug Interactions ::

 Interactions

Doxorubicin, ribavirin, stavudine: Antagonistic relationship has been demonstrated between these agents and zidovudine. Ganciclovir, interferon-alpha, other bone marrow suppressive or cytotoxic agents: May increase the hematologic toxicity of zidovudine. Trimethoprim/sulfamethoxazole: Serum concentrations of lamivudine may be elevated, increasing the pharmacologic and adverse effects. Zalcitabine: Lamivudine and zalcitabine may inhibit the intracellular phosphorylation of each other.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note patient’s weight and history of renal impairment (Ccr less than 50 mL/min) or liver impairment.
  • Ensure that patient is not receiving abacavir, lamivudine, or zidovudine in other dose forms.
  • Do not administer to patient weighing less than 90 lbs.
  • Ensure that CBC is obtained prior to starting and periodically during therapy.
  • Monitor patient for signs of lactic acidosis. If patient develops profound weakness or tiredness, unexpected stomach discomfort, feeling cold, dizzy, or lightheaded, or slow or irregular heartbeat, withhold drug and contact health care provider.
  • Monitor patient for signs/symptoms of allergic reaction to abacavir. Discontinue use and notify health care provider immediately if skin rash or 1 or more symptoms from at least 2 of the following groups are noted: fever; nausea, vomiting, diarrhea, abdominal pain; fatigue, muscle aches, malaise; sore throat; shortness of breath; cough. If hypersensitivity reaction is documented then ensure that reaction is reported to Abacavir Hypersensitivity Register as noted in the package insert.
  • Assess for evidence of peripheral neuropathy (eg, numbness, tingling, burning or pain in hands or feet) or evidence of opportunistic infections. Notify health care provider if these occur.
  • Monitor patient for evidence of CNS, GI, musculoskeletal, and general body side effects. If noted and significant, inform health care provider.
OVERDOSAGE: SIGNS & SYMPTOMS
  Nausea, vomiting, headache, dizziness, drowsiness, lethargy, confusion

Drug Storage/Management ::

 Administration/Storage

  • Administer twice daily without regard to meals.
  • Administer with food if GI upset occurs.
  • Store tablets at controlled room temperature (59° to 86° F).

Drug Notes ::

 Patient/Family Education

  • Explain name, dose, action, and potential side effects of drug.
  • Advise patient to review Medication Guide before starting therapy and with each refill of the medication.
  • Advise patient to take drug twice daily without regard to meals but to take with food if GI upset occurs.
  • Instruct patient that if a dose is missed to take as soon as remembered then take the next dose at the usual scheduled time.
  • Instruct patient to continue taking other HIV medications as prescribed by health care provider.
  • Instruct patient to discontinue use and notify health care provider immediately if skin rash or 1 or more symptoms from at least 2 of the following groups are noted: fever; nausea, vomiting, diarrhea, abdominal pain; fatigue, muscle aches, malaise; sore throat; shortness of breath; cough.
  • Instruct patient to report the following symptoms immediately to health care provider: profound weakness or tiredness; feeling cold, dizzy or lightheaded; slow or irregular heartbeat; pain or tingling in the hands or feet; muscle or joint pain.
  • Advise patient to carry Warning Card at all times.
  • Inform patient that drug does not completely eliminate HIV virus and therefore does not reduce risk of transmitting HIV. Appropriate precautions must still be followed.
  • Advise patient that drug is not a cure for HIV infection and that he/she may continue to acquire illnesses associated with HIV infection, including opportunistic infections and to remain under a health care provider’s care.
  • Instruct patient to not take any prescription or OTC medications or dietary supplements unless advised to do so by their health care provider.
  • Instruct women to notify health care provider if pregnant, planning to become pregnant, or breastfeeding.
  • Remind patient that examinations and laboratory tests will be required to monitor therapy and to keep appointments.

Disclaimer ::

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