Abacavir, also known by the abbreviation ABC, is a nucleoside reverse transcriptase inhibitor (NRTI) used to treat HIV-1 infection. It is never used alone; doctors always prescribe it together with other antiretroviral medicines as part of a combination regimen, sometimes as a single co-formulated tablet with drugs such as lamivudine or dolutegravir. Abacavir slows down the ability of HIV to make copies of itself, helping keep the amount of virus in the blood low. Before starting Abacavir, doctors test patients for a gene variant called HLA-B*5701, because carrying it raises the risk of a serious hypersensitivity reaction to the drug.
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Abacavir, also known by the abbreviation ABC, is a nucleoside reverse transcriptase inhibitor (NRTI) used to treat HIV-1 infection. It is never used alone; doctors always prescribe it together with other antiretroviral medicines as part of a combination regimen, sometimes as a single co-formulated tablet with drugs such as lamivudine or dolutegravir. Abacavir slows down the ability of HIV to make copies of itself, helping keep the amount of virus in the blood low. Before starting Abacavir, doctors test patients for a gene variant called HLA-B*5701, because carrying it raises the risk of a serious hypersensitivity reaction to the drug.
Abacavir belongs to the nucleoside reverse transcriptase inhibitor (NRTI) class of antiretroviral medicines and is a guanosine analogue, meaning it is a lab-made copy of guanosine, one of the natural building blocks the body normally uses to build DNA. Inside the body it is converted into its active form, carbovir triphosphate (the activated form of the drug that actually does the work inside cells), which blocks the HIV enzyme reverse transcriptase by competing with the virus's natural building blocks and getting incorporated into the growing viral DNA chain, stopping the chain from being completed. Because HIV cannot replicate without this enzyme, viral copying slows down considerably.
Abacavir is approved for HIV-1 infection in adults and in children older than 3 months, always combined with other antiretroviral agents rather than used by itself. It is manufactured as film-coated tablets and as an oral solution, giving flexibility for adults and for younger children who cannot swallow tablets.
The single most important safety consideration with Abacavir is a serious, sometimes fatal, hypersensitivity reaction that is strongly linked to a genetic marker called HLA-B5701. Because of this, screening for the HLA-B5701 allele before the first dose is standard practice, and the medicine is contraindicated in anyone who tests positive for it or who has had a hypersensitivity reaction to it before. Abacavir also carries warnings for lactic acidosis and severe enlargement of the liver with fatty change, effects that have been reported with this class of nucleoside analogue drugs. Because of this safety profile, Abacavir is prescribed and monitored only under medical supervision, with regular blood tests to track liver function and overall response to treatment.
Abacavir is indicated for:
Abacavir is never prescribed as a stand-alone treatment for HIV-1; it works only as one component of a multi-drug antiretroviral combination.
Common Side Effects (Usually Mild and May Lessen With Continued Use)
Serious Side Effects (Seek Urgent Medical Attention)
Abacavir is a nucleoside reverse transcriptase inhibitor (NRTI) and a guanosine analogue. Once inside cells, it is converted through several enzymatic steps into its active form, carbovir triphosphate. This active form competes with the body's natural nucleotide building blocks for incorporation into the DNA that HIV's reverse transcriptase enzyme is building from the virus's RNA. When carbovir triphosphate is used instead of the natural building block, it stops the DNA chain from growing any further. Because the virus cannot complete this step, it cannot finish copying itself, which slows the spread of infection to new cells. The active metabolite has a half-life of more than 20 hours inside cells, which is part of why once-daily dosing is possible even though the parent drug itself clears from plasma more quickly.
Store Abacavir at room temperature, between 20°C and 25°C (68°F to 77°F). Keep it away from excess light and moisture, in its original container, and out of the sight and reach of children and pets.
Food has not been shown to have a clinically relevant effect on Abacavir absorption, so it can be taken with or without meals. Alcohol is the notable exception: drinking alcohol while taking Abacavir raises Abacavir blood levels (a documented 41% increase in total exposure), so alcohol use should be discussed with the prescribing doctor rather than treated as an ordinary dietary choice.
Product labelling describes an adult dose of 600 mg once daily or 300 mg twice daily, always taken as part of a combined antiretroviral regimen. In patients with mild liver impairment, this is reduced to 200 mg twice daily. Children older than 3 months are given a lower, weight-based dose decided individually by their doctor. The exact dose, timing, and any adjustment always depend on what the prescribing doctor has decided for a specific patient, and the label-directed dose should never be changed without medical advice.
There is no known specific treatment for an Abacavir overdose. If an overdose is suspected, the person should be monitored and given standard supportive medical care as needed. Anyone who may have taken more Abacavir than prescribed should contact a doctor, go to the nearest emergency department, or call a poison control helpline right away.
If a dose is missed, take it as soon as it is remembered on the same day. If it is almost time for the next scheduled dose, skip the missed one and continue with the regular schedule. Do not take two doses together to make up for a missed one. Missing doses regularly can allow HIV to become harder to treat, so a missed dose pattern should be discussed with the treating doctor.
Contact a doctor immediately, or seek emergency care, if any of the following occur:
Therapeutic Class
Antiretroviral agent (used in combination therapy for HIV-1 infection)
Action Class
Nucleoside Reverse Transcriptase Inhibitor (NRTI)
Chemical Class
Nucleoside (guanosine) analogue
Habit Forming
No
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