During HIV therapy there may be an increase in weight and in levels of blood lipids and glucose. This is partly linked to restored health and life style, and in the case of blood lipids sometimes to the HIV medicines themselves. Your doctor will test for these changes.
Like all medicines, this medicine can cause side effects, although not everyone gets them.
When you are being treated for HIV, it can be hard to tell whether a symptom is a side effect of Abacavir/Lamivudine or other medicines you are taking, or an effect of the HIV disease itself. So it is very important to talk to your doctor about any changes in your health.
It is important to read the information later in this section under ‘Other possible side effects of combination therapy for HIV’.
Abacavir/Lamivudine contains abacavir (which is also an active substance in medicines such as Kivexa, Trizivir, Triumeq and Ziagen). Abacavir can cause a serious allergic reaction known as a hypersensitivity reaction. These hypersensitivity reactions have been seen more frequently in people taking medicines that contain abacavir.
Who gets these reactions?
Anyone taking Abacavir/Lamivudine could develop a hypersensitivity reaction to abacavir, which could be life threatening if they continue to take Abacavir/Lamivudine.
You are more likely to develop this reaction if you have a gene called HLA-B*5701 (but you can get a reaction even if you do not have this gene). You should have been tested for this gene before Abacavir/Lamivudine was prescribed for you. If you know you have this gene, tell your doctor before you take Abacavir/Lamivudine.
About 3 to 4 in every 100 patients treated with abacavir in a clinical trial who did not have the HLA-B*5701 gene developed a hypersensitivity reaction.
What are the symptoms?
The most common symptoms are:
- fever (high temperature) and skin rash.
Other common symptoms are:
- nausea (feeling sick), vomiting (being sick), diarrhoea, abdominal (stomach) pain, severe tiredness.
Other symptoms include:
Pains in the joints or muscles, swelling of the neck, shortness of breath, sore throat, cough, occasional headaches, inflammation of the eye (conjunctivitis), mouth ulcers, low blood pressure, tingling or numbness of the hands or feet.
When do these reactions happen?
Hypersensitivity reactions can start at any time during treatment with Abacavir/Lamivudine, but are more likely during the first 6 weeks of treatment.
Contact your doctor immediately:
1. if you get a skin rash, OR
2. if you get symptoms from at least 2 of the following groups:
- fever
- shortness of breath, sore throat or cough
- nausea or vomiting, diarrhoea or abdominal pain
- severe tiredness or achiness, or generally feeling ill.
Your doctor may advise you to stop taking Abacavir/Lamivudine.
If you have stopped taking Abacavir/Lamivudine
If you have stopped taking Abacavir/Lamivudine because of a hypersensitivity reaction, you must NEVER AGAIN take Abacavir/Lamivudine, or any other medicine containing abacavir (e.g. Kivexa, Trizivir, Triumeq or Ziagen). If you do, within hours, your blood pressure could fall dangerously low, which could result in death.
If you have stopped taking Abacavir/Lamivudine for any reason —especially because you think you are having side effects, or because you have other illness:
Talk to your doctor before you start again. Your doctor will check whether your symptoms were related to a hypersensitivity reaction. If the doctor thinks they may have been, you will then be told never again to take Abacavir/Lamivudine, or any other medicine containing abacavir (e.g. Kivexa, Trizivir, Triumeq or Ziagen). It is important that you follow this advice.
Occasionally hypersensitivity reactions have developed in people who start taking abacavir containing products again, but who had only one symptom on the Alert Card before they stopped taking it.
Very rarely patients who have taken medicines containing abacavir in the past without any symptoms of hypersensitivity have developed a hypersensitivity reaction when they start taking these medicines again.
If your doctor advises that you can start taking Abacavir/Lamivudine again, you may be asked to take your first doses in a place where you will have ready access to medical care if you need it.
If you are hypersensitive to Abacavir/Lamivudine, return all your unused Abacavir/Lamivudine tablets for safe disposal. Ask your doctor or pharmacist for advice.
The Abacavir/Lamivudine pack includes an Alert Card, to remind you and medical staff about hypersensitivity reactions. Detach this card and keep it with you at all times.
Common side effects
These may affect up to 1 in 10 people:
- hypersensitivity reaction
- headache
- being sick (vomiting)
- feeling sick (nausea)
- diarrhoea
- stomach pains
- loss of appetite
- tiredness, lack of energy
- fever (high temperature)
- general feeling of being unwell
- difficulty in sleeping (insomnia)
- muscle pain and discomfort
- joint pain
- cough
- irritated or runny nose
- skin rash
- hair loss
Uncommon side effects
These may affect up to 1 in 100 people and may show up in blood tests:
- a low red blood cell count (anaemia) or low white blood cell count (neutropenia)
- an increase in the level of liver enzymes
- a decrease in the number of cells involved in blood clotting (thrombocytopenia).
Rare side effects
These may affect up to 1 in 1000 people:
- liver disorders, such as jaundice, enlarged liver or fatty liver, inflammation (hepatitis)
- inflammation of the pancreas (pancreatitis)
- breakdown of muscle tissue.
Rare side effects that may show up in blood tests are:
- increase in an enzyme called amylase.
Very rare side effects
These may affect up to 1 in 10,000 people:
- numbness, tingly feelings in the skin (pins and needles)
- sensation of weakness in the limbs
- skin rash, which may form blisters and looks like small targets (central dark spots surrounded by a paler area, with a dark ring around the edge) (erythema multiforme)
- a widespread rash with blisters and peeling skin, particularly around the mouth, nose, eyes and genitals (Stevens–Johnson syndrome), and a more severe form causing skin peeling in more than 30% of the body surface (toxic epidermal necrolysis).
- lactic acidosis (excess lactic acid in the blood).
Combination therapy such as Abacavir/Lamivudine may cause other conditions to develop during HIV treatment.
Symptoms of infection and inflammation
Old infections may flare up
People with advanced HIV infection (AIDS) have weak immune systems, and are more likely to develop serious infections (opportunistic infections). Such infections may have been “silent” and not detected by the weak immune system before treatment was started. After starting treatment, the immune system becomes stronger, and may attack the infections, which can cause symptoms of infection or inflammation. Symptoms usually include fever, plus some of the following:
- headache
- stomach ache
- difficulty breathing
In rare cases, as the immune system becomes stronger, it can also attack healthy body tissue (autoimmune disorders). The symptoms of autoimmune disorders may develop many months after you start taking medicine to treat your HIV infection. Symptoms may include:
- palpitations (rapid or irregular heartbeat) or tremor
- hyperactivity (excessive restlessness and movement)
- weakness beginning in the hands and feet and moving up towards the trunk of the body.
If you get any symptoms of infection and inflammation or if you notice any of the symptoms above:
Tell your doctor immediately. Do not take other medicines for the infection without your doctor’s advice.
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