Abacavir Disease Interactions

Hepatotoxicity including lactic acidosis, severe hepatomegaly with steatosis, fulminant hepatitis, and hepatic failure has been associated with the use of some nucleoside reverse transcriptase inhibitors (NRTIs) alone or in combination with other antiretroviral agents. Therapy with NRTIs should be administered cautiously in patients with preexisting liver disease, a history of alcohol abuse, or hepatitis. Therapy should be suspended if clinical or laboratory findings suggestive of lactic acidosis or pronounced hepatotoxicity occur. The use of abacavir is contraindicated in patients with moderate to severe liver dysfunction as its safety and efficacy have not been established in these patients.

Some clinical trials have reported increased risk of myocardial infarction in patients treated with abacavir. Although some of the findings are inconclusive, as a precaution, the underlying risk of coronary heart disease should be assessed before therapy, and action should be taken to minimize all modifiable risk factors such as hypertension, hyperlipidemia, diabetes mellitus, smoking, etc.