Drug Index


Mechanism :

Abacavir is a carbocyclic synthetic nucleoside analogue. Abacavir is converted by cellular enzymes to the active metabolite, carbovir triphosphate (CBV-TP), an analogue of deoxyguanosine-5’-triphosphate (dGTP). CBV-TP inhibits the activity of HIV-1 reverse transcriptase (RT) both by competing with the natural substrate dGTP and by its incorporation into viral DNA. Abacavir is also a weak inhibitor of cellular DNA polymerases (alpha, beta, and gamma).

Indication :

  • HIV infection

Contraindications :

Contraindicated in patients with previously demonstrated hypersensitivity to abacavir or any other component of the products. Patients testing positive for the presence of the HLA-B*5701 allele are at a significantly increased risk for hypersensitivity reactions. Fatal rechallenge reactions have been associated with re-administration of abacavir to patients with a prior history of a hypersensitivity reaction to abacavir. Contraindicated in patients with moderate or severe hepatic impairment.

Dosing :

>3 months-18 years:
8 mg/kg BDS OR 16 mg/kg per day. Max: 300 mg BDS.

Adverse Effect :

Fever/chills, redistribution/accumulation of body fat, lactic acidosis, hepatic steatosis, rash, Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), erythema multiforme, insomnia, headache, malaise, fatigue, anxiety, depression, hyperglycemia, hypertriglyceridemia, nausea, vomiting, diarrhea, anorexia; pancreatitis (rare), asthenia, musculoskeletal pain, cough, thrombocytopenia, hypersensitivity reaction.

Interaction :

Ethanol: Decreases the elimination of abacavir causing an increase in overall exposure.
Ganciclovir-Valganciclovir: May enhance the adverse/toxic effect of Reverse Transcriptase Inhibitors (Nucleoside). Hematologic toxicity is of specific concern.
Protease Inhibitors: May decrease the serum concentration of Abacavir.
Ribavirin: May enhance the hepatotoxic effect of Reverse Transcriptase Inhibitors (Nucleoside). Lactic acidosis may occur.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Dose as in normal renal function

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnknown dialysability. Dose as in normal renal function
HDUnlikely to be dialysed. Dose as in normal renal function
HDF/High fluxNot dialysed. Dose as in normal renal function
CAV/VVHDUnknown dialysability. Dose as in normal renal function

Hepatic Dose :

Mild hepatic impairment: Use with caution. Decrease the dose if required.
Moderate to severe hepatic impairment: Avoid using as efficacy and pharmacokinetic parameters are not known.
01/24/2024 19:11:05 Abacavir
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