Chemical structure of abacavir.
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Ziagen

Abacavir (ABC) is the most powerful nucleoside analog reverse transcriptase inhibitor (NARTI) used to treat HIV and AIDS. It has been well tolerated, its main side effect being hypersensitivity reactions, which can be dangerous. It is available under the trade name Ziagen™ by GlaxoSmithKline and the combination drug Trizivir™. more...

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Abacavir is one of the most deadly NARTIs, due its ability to trigger to hypersensitivity reactions that lead to sudden death in certain individuals. However, a genetic test is now available that, while not perfect, has reasonable accuracy in predicting whether an individual will be hypersensitive. Over 90% of patients can safely take abacavir.

Strains that are resistant to zidovudine (AZT) or lamivudine (3TC) are generally sensitive to abacavir, whereas strains that are resistant to AZT and 3TC are not as sensitive to abacavir.

History

Abacavir was approved by the Food and Drug Administration (FDA) on December 18, 1998 and is thus the fifteenth approved antiretroviral drug in the United States. Its patent will expire in the United States on 2009-12-26.

Mechanism of action

ABC is an analog of guanosine. It is capable of crossing the blood-brain barrier.

Abacavir is given orally and has a high bio-availability of 83%. It is metabolised primarily through alcohol dehydrogenase or gluconyl transferase.

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HIV Drug Gets Speedy Approval - Ziagen - Brief Article
From FDA Consumer, 3/1/99

A new drug that can help reduce the amount of human immunodeficiency virus when combined with other anti-HIV medications has received approval from FDA.

Ziagen (abacavir), approved last December, is taken twice daily to treat HIV, a virus that mutates rapidly and may become resistant to current treatments. The drug, one of a class called nucleoside analogue reverse transcriptase inhibitors (NRTIs), is approved for adults and children older than three months.

The drug, however, has been associated with a potentially fatal allergic reaction in at least 5 percent of patients. Possible symptoms include skin rash, fever, nausea, abdominal pain, and severe tiredness. Patients experiencing such a reaction should stop taking the drug and call their doctors right away. Ziagen should not be taken again after a reaction occurs because more severe symptoms could arise within hours that may include life-threatening low blood pressure or death.

Physicians can register patients developing symptoms of hypersensitivity by calling 1-800-270-0425.

All NRTIs can cause lactic acidosis, a fatal metabolic disorder that causes an abnormal buildup of lactic acid. Symptoms may include an enlarged liver. Other reported side effects of Ziagen include nausea, vomiting, fatigue, headache, diarrhea, and loss of appetite.

Ziagen received accelerated approval, and, at present, there are no results from controlled trials showing the long-term effectiveness of Ziagen to suppress HIV infection or AIDS.

Ziagen is marketed by GlaxoWellcome Inc., Research Triangle Park, N.C.

COPYRIGHT 1999 U.S. Government Printing Office
COPYRIGHT 2004 Gale Group

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