Once-Daily Abacavir in Place of Twice-Daily Administration

Abstract

Once-daily administration of abacavir has not been shown to be inferior to twice-daily dosing, but it may put patients at increased risk for severe hypersensitivity reactions and diarrhea. More data are needed to confirm this risk.

Abacavir/lamivudine fixed-dose combination antiretroviral therapy for the treatment of HIV

“…50,51 Overall, the frequency and type of adverse events are similar whether or not the drugs are dosed once daily as a FDC or twice daily. In general, abacavir/lamivudine-FDC is considered to be well tolerated with the most common (≥5%) moderate to severe adverse events of insomnia, depression, headache, fatigue, dizziness, diarrhea, and rash.…”

“…27,50,51 Initially, concern was raised after one blinded randomized trial showed a nonsignificant difference of severe hypersensitivity reaction for once-versus twice-daily abacavir dosing (5% vs. 2%, respectively, P =0.28). 47 Subsequently, a larger randomized clinical trial found the opposite result with less severe hypersensitivity among those on once- compared to twice-daily dosing (0.9% vs. 2.2%, respectively).…”

Antiviral Pharmacodynamics in Hollow Fibre Bioreactors

“…These results suggested that abacavir can be given on a once a day schedule instead of a twice daily regimen as had been recommended for other nucleoside analogues for the treatment of HIV. Several clinical studies have demonstrated that abacavir, as part of a combination of antiretroviral drugs, can be given once a day [20].…”

“One pill, once daily”: what clinicians need to know about Atripla™

“…Correspondingly, the rate of deaths due to AIDS was dramatically reduced and the number of persons living with HIV/AIDS has continued to increase (Palella et al 1998; Egger et al 2002; CDC 2005). As the number of persons chronically prescribed antiretrovirals has grown and the realization that these would be required to be continued for life, pharmaceutical manufacturers have developed new classes of agents, improved the pharmacokinetics of marketed products through dosing reformulations and in an effort to maximize success with respect to adherence, compiled into a single dosing unit all necessary elements for an antiretroviral regimen (Finzi et al 1999; Heeswijk et al 2000; Eron et al 2004; Montfore et al 2005; Goedken and Herman 2005; Moyle et al 2005; Atripla™ 2006; Bartlett et al 2006). Atripla™ (Gilead Sciences, Foster City, CA, and Bristol-MyersSquibb, Newark, NJ, USA) is the first example of a fixed-dose combination (FDC) containing all elements of a preferred antiretroviral regimen as recommended in the most recent HIV treatment guidelines (Atripla™ 2006; Bartlett and Lane 2007).…”