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Nucleoside reverse transcriptase inhibitor (NRTI)

Abacavir

Brand names: Ziagen

Adult dose

Dose: 600 mg once daily or 300 mg twice daily
Route: Oral
Frequency: OD or BD

Clinical pearls

  • MANDATORY HLA-B*5701 screen before initiation
  • Counsel on hypersensitivity warning card
  • Possible association with MI risk in some cohorts

Contraindications

  • HLA-B*5701 positive (severe hypersensitivity)
  • Moderate-severe hepatic impairment

Side effects

  • Hypersensitivity reaction (potentially fatal)
  • Nausea
  • Headache
  • Lactic acidosis

Interactions

  • Methadone (may reduce levels)
  • Ethanol (raises abacavir AUC)
  • Ribavirin

Monitoring

  • LFTs
  • Hypersensitivity symptoms in first 6 weeks
  • Lactate if symptomatic

Reference: BNF; BHIVA Adult ART Guidelines 2022; SmPC; https://bnf.nice.org.uk/drugs/abacavir/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.