Abacavir (Ziagen) is a guanosine nucleoside analogue indicated for the therapy of HIV-1 infection in adults and children. It is used as part of a multidrug regimen and is available in a fixed-dose combination with zi-dovudine and lamivudine (Trizivir). It is also used for postexposure HIV infection prophylaxis.

Abacavir is associated with side effects such as anorexia, nausea, vomiting, malaise, headache, and insomnia. A potentially fatal hypersensitivity reaction develops in approximately 5% of patients, usually early in the course of treatment. Fever and rash are the most common symptoms of this reaction; malaise, respiratory symptoms, and gastrointestinal complaints may also occur. Resistance to abacavir may be associated with resistance to zidovudine, didanosine, and lamivudine.

Abacavir undergoes extensive hepatic metabolism; therefore, patients with liver disease should be monitored closely if this drug is given. Ethanol inhibits the metabolism of abacavir because it competes for metab olism by alcohol dehydrogenase. Abacavir is not known to inhibit or induce cytochrome P450 isozymes.

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