Abacavir lamivudine zidovudine drug interactions
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sheng Shi, M.D. [2]
Drug Interactions
No drug interaction trials have been conducted using TRIZIVIR Tablets [see Clinical Pharmacology (12.3)].
Antiretroviral Agents
Zidovudine:Stavudine: Concomitant use of Zidovudine with Stavudine should be avoided since an antagonistic relationship has been demonstrated in vitro.
Nucleoside Analogues Affecting DNA Replication: Some nucleoside analogues affecting DNA replication, such as ribavirin, antagonize the in vitro antiviral activity of Zidovudine against HIV-1; concomitant use of such drugs should be avoided.
Doxorubicin
Zidovudine: Concomitant use of Zidovudine with doxorubicin should be avoided since an antagonistic relationship has been demonstrated in vitro.
Ethanol
Abacavir: Abacavir has no effect on the pharmacokinetic properties of ethanol. Ethanol decreases the elimination of Abacavir causing an increase in overall exposure [see Clinical Pharmacology (12.3)].
Hematologic/Bone Marrow Suppressive/Cytotoxic Agents
Zidovudine: Coadministration of ganciclovir, interferon alfa, ribavirin, and other bone marrow suppressive or cytotoxic agents may increase the hematologic toxicity of Zidovudine.
Interferon- and ribavirin-Based Regimens
Lamivudine: Although no evidence of a pharmacokinetic or pharmacodynamic interaction (e.g., loss of HIV-1/HCV virologic suppression) was seen when ribavirin was coadministered with Lamivudine in HIV-1/HCV co-infected subjects, hepatic decompensation (some fatal) has occurred in HIV-1/HCV co-infected subjects receiving combination antiretroviral therapy for HIV-1 and interferon alfa with or without ribavirin [see Warnings and Precautions (5.6), Clinical Pharmacology (12.3)].
Methadone
Abacavir: The addition of methadone has no clinically significant effect on the pharmacokinetic properties of Abacavir. In a trial of 11 HIV-1-infected subjects receiving methadone-maintenance therapy with 600 mg of ZIAGEN twice daily (twice the currently recommended dose), oral methadone clearance increased [see Clinical Pharmacology (12.3)]. This alteration will not result in a methadone dose modification in the majority of patients; however, an increased methadone dose may be required in a small number of patients.
Trimethoprim/Sulfamethoxazole (TMP/SMX)
Lamivudine: No change in dose of either drug is recommended [see Clinical Pharmacology (12.3)]. There is no information regarding the effect on Lamivudine pharmacokinetics of higher doses of TMP/SMX such as those used to treat PCP.[1]
References
- ↑ "TRIZIVIR ([[Abacavir]] SULFATE, [[Lamivudine]], AND [[Zidovudine]]) TABLET, FILM COATED [VIIV HEALTHCARE COMPANY]". Retrieved 9 January 2014. URL–wikilink conflict (help)
Adapted from the FDA Package Insert.