Epzicom/Kivexa (Abacavir + Lamivudine)
November 29, 2012
Fact Sheet 475).
The drugs in Epzicom are called nucleoside analog reverse transcriptase inhibitors, or nukes. These drugs block the reverse transcriptase enzyme. This enzyme changes HIV's genetic material (RNA) into the form of DNA. This has to occur before HIV's genetic code gets inserted into an infected cell's own genetic codes.
There are no absolute rules about when to start antiretroviral therapy (ART). You and your health care provider should consider your CD4 cell count, your viral load, any symptoms you are having, and your attitude about taking ART. Fact Sheet 404 has more information about guidelines for the use of ART.
Epzicom should not be used by people under 13 years old or people with a damaged liver.
If you take Epzicom with other antiretroviral drugs (ARVs), you can reduce your viral load to extremely low levels, and increase your CD4 cell counts. This should mean staying healthier longer.
Epzicom provides two drugs in one pill. It can be more convenient to use Epzicom than some other combinations of drugs. This could mean fewer missed doses and better control of HIV.
Although lamivudine can be used to treat hepatitis B, a lower dose is used than for HIV. People with HIV infection should use the higher (HIV) dose. Some people had a flare-up of hepatitis B after stopping lamivudine treatment. People with hepatitis B should not stop taking lamivudine (or Epzicom) without careful monitoring by their health care provider.
Fact Sheet 126 for more information on resistance.
Sometimes, if your virus develops resistance to one drug, it will also have resistance to other ARVs. This is called "cross-resistance."
Resistance can develop quickly. It is very important to take ARVs according to instructions, on schedule, and not to skip or reduce doses.
Epzicom can be taken with food, or between meals.
The dosage of lamivudine should be reduced for people who weigh less than 50 kilograms (110 pounds). People who weigh less than 110 pounds should normally not take Epzicom.
The most common side effects of Epzicom are the same as with abacavir (Ziagen) and Epivir (lamivudine). They include nausea, vomiting, fatigue, and headaches. See Fact Sheet 551 for more information on fatigue.
The most serious side effect of abacavir is a hypersensitivity reaction. The FDA recommends a genetic test before using abacavir. This blood test identifies people at high risk of developing the hypersensitivity reaction. People who have this reaction have to stop taking abacavir and cannot take it again. If they do, they will have a serious and possibly fatal reaction. See Fact Sheet 416 for more information on the abacavir hypersensitivity reaction.
The reaction usually starts within two weeks of starting abacavir. Patients had the following symptoms: fever, rash, headache, feeling bad, no energy, nausea, vomiting, diarrhea, stomach pain, cough, shortness of breath, and sore throat. If you develop any of these symptoms while taking Epzicom, call your health care provider immediately.
Epzicom should not be taken with with stavudine (d4T, Zerit) or emtricitabine (Emtriva, FTC). However, since these are other nucleoside analog drugs, there is very little chance that a health care provider would prescribe them along with Epzicom.
Blood levels of lamivudine may be increased by bactrim or septra. See Fact Sheet 535 for more information on these drugs.
This article was provided by AIDS InfoNet. Visit AIDS InfoNet's website to find out more about their activities and publications.