Meds and you

27 September 2013

The combination of Abacavir, lamivudine and zidovudine

The combination of Abacavir, lamivudine and zidovudine is an antiretroviral drug. Antiretrovirals are drugs that suppress the activity or replication of retroviruses such as HIV.


The combination of abacavir, lamivudine and zidovudine is the active ingredient of Trizivar (Nappi Code: 703537-001).

General Information
The combination of Abacavir, lamivudine and zidovudine is an antiretroviral drug. Antiretrovirals are drugs that suppress the activity or replication of retroviruses such as HIV. This specific antiviral is classified as a combination of reverse transcriptase inhibitors, meaning that it blocks an enzyme, which is essential for the retrovirus to multiply.

In South Africa this combination is registered for the treatment of infection with the human immunodeficiency virus (HIV).

If not treated, HIV will advance to weaken the body's immune system, gradually chipping away to create grounds for other infections, against which the body will find more and more difficult to protect itself. HIV develops into acquired immune deficiency syndrome (Aids) when your immune system has been severely weakened.

For this combination to be effective, it has to be taken regularly. By skipping even a few doses, the risk for treatment failure increases substantially. Try to ensure that you take all your doses, and at the correct time.

It should be understood that this combination is not a cure for HIV or Aids, but is one of a variety of drugs that only restricts the advance of the virus, keeping the immune system up and running. It is used in combination with other antiretroviral drugs and should not be prescribed on its own.

This drug does not reduce transmission of HIV; you can still infect another person with the virus, and the use of appropriate precautions to prevent the spread to other persons is highly recommended.

How does this combination work?
When HIV infects a human T-cell, a type of white blood cell that plays a key role in the functioning of the immune system, viral genetic information in the form of RNA needs to be converted to DNA for the virus to have any effect. It makes use of an enzyme called reverse transcriptase to achieve this conversion. This drug targets and inhibits this enzyme, thus preventing the spread of HIV.

Fast facts

Drug schedule: schedule 4
Available as: this combination is available as tablets.
What does it do? The combination of abacavir, lamivudine and zidovudine is an anti-viral drug
Overdose risk: medium
Dependence risk: low
Is this combination available as a generic? no
Is this combination available on prescription only? yes

User information


Dietary advice: the combination of zidovudine and lamivudine may be taken with or without food; Be sure to take this drug with plenty of water to prevent ulceration of the oesophagus.
Stopping this medicine: do not stop taking this drug without consulting your doctor. If you are instructed to stop taking this combination, do not restart it in future as a severe allergy is possible, even if you’ve never experienced signs of an allergic reaction before.
Prolonged use: side effects may develop with long-term use; frequent blood tests may be required with prolonged therapy to prevent serious blood disorders and to determine liver function.

Special precautions
Consult your doctor before using this drug if:

  • you have known liver or kidney problems
  • you are anaemic
  • you have a history of alcohol abuse

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: avoid. Not only can HIV-infection be passed to your baby through breast milk, but the drug lamivudine is also present and transmitted in breast milk.
Porphyria: avoid. This medication may cause serious adverse effects. Consult your doctor before use.
The elderly: caution is advised in the elderly as side effects may be more severe.
Infants and children: this medication is not intended for use in children under the age of 12.
Driving and hazardous work: caution is advised as use of this medication may lead to dizziness. Avoid such activities until you know how this medication affects you.
Alcohol: avoid. Concurrent use with alcohol and alcohol-containing products may result in increased concentrations of abacavir in the body with an increased risk of toxicity.

Possible side effects


Side Effect
Consult your doctor
Only if severe
In all cases
abdominal pain
pins and needles
cough/shortness of breath
muscle pain
sore throat
skin peeling
skin rash
muscle wasting


Drug interactions


clarithromycin reduced effect of this combination
fluconazole risk of antiretroviral toxicity
ganciclovir risk of severe blood disorders
methadone risk of antiretroviral toxicity
paracetamol risk of bone marrow suppression
phenytoin fluctuation in phenytoin levels in body
probenecid risk of antiretroviral toxicity
rifampicin reduced effect of this combination
benzodiazepines increased risk of side effects with this combination
prednisone increased incidence of rash
St Johns wort reduced efficacy of this combination
azathioprine increased risk of pancreatic inflammation

Many other drugs may interact with this combination. It is important to consult your doctor or pharmacist before combining any drug with this drug.

Disease interactions
Contact your doctor if you have a liver or kidney disease

Overdose action
A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention.

Recommended dosage
See each individual agent.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.


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