Skip to Content

ABACAVIR/LAMIVUDINE SANDOZ 600 MG/300 MG FILM-COATED TABLETS

Active substance(s): ABACAVIR HYDROCHLORIDE / LAMIVUDINE / ABACAVIR HYDROCHLORIDE / LAMIVUDINE / ABACAVIR HYDROCHLORIDE / LAMIVUDINE

View full screen / Print PDF » Download PDF ⇩

PDF Transcript

Package leaflet: Information for the user

SZ00000LT000

Abacavir/Lamivudine 600 mg/300 mg
Film-coated Tablets

abacavir/lamivudine
Read all of this leaflet carefully before you start taking this medicine because it
contains important information for you.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others.
It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any
possible side effects not listed in this leaflet. See section 4.

IMPORTANT — Hypersensitivity reactions

Abacavir/Lamivudine contains abacavir (which is also an active substance in
medicines such as Trizivir, Triumeq and Ziagen). Some people who take abacavir
may develop a hypersensitivity reaction (a serious allergic reaction), which can be
life-threatening if they continue to take abacavir containing products.
You must carefully read all the information under ‘Hypersensitivity reactions’ in the
panel in Section 4.
The Abacavir/Lamivudine pack includes an Alert Card, to remind you and medical
staff about abacavir hypersensitivity. Keep this card with you at all times.
What is in this leaflet
1. What Abacavir/Lamivudine is and what it is used for
2. What you need to know before you take
Abacavir/Lamivudine
3. How to take Abacavir/Lamivudine
4. Possible side effects
5. How to store Abacavir/Lamivudine
6. Contents of the pack and other information

1. What Abacavir/Lamivudine is and what it is used for
Abacavir/Lamivudine is used to treat HIV (human immunodeficiency virus)
infection in adults, adolescents and in children weighing at least 25 kg.
Abacavir/Lamivudine contains two active ingredients that are used to treat HIV
infection: abacavir and lamivudine. These belong to a group of anti-retroviral
medicines called nucleoside analogue reverse transcriptase inhibitors (NRTIs).

Abacavir/Lamivudine does not completely cure HIV infection; it reduces the amount
of virus in your body, and keeps it at a low level. It also increases the CD4 cell count in
your blood. CD4 cells are a type of white blood cells that are important in helping your
body fight infection.
Not everyone responds to treatment with Abacavir/Lamivudine in the same way. Your
doctor will monitor the effectiveness of your treatment.

2. What you need to know before you take Abacavir/Lamivudine
Do not take Abacavir/Lamivudine:
• if you are allergic (hypersensitive) to abacavir (or any other medicine
containing abacavir - (e.g. Trizivir, Triumeq or Ziagen), lamivudine, or any of
the other ingredients of this medicine (listed in Section 6)
Carefully read all the information about hypersensitivity reactions in Section 4.
• if you have severe liver disease
Check with your doctor if you think any of these apply to you. Do not take
Abacavir/Lamivudine.
Take special care with Abacavir/Lamivudine
Some people taking abacavir/lamivudine or other combination treatments for HIV are
more at risk of serious side effects. You need to be aware of the extra risks:
• if you have ever had liver disease, including hepatitis B or C (if you have
hepatitis B infection, do not stop Abacavir/Lamivudine without your doctor’s advice,
as your hepatitis may come back)
• if you are seriously overweight (especially if you are a woman)
• if you are diabetic and using insulin
• if you have a kidney problem
Talk to your doctor if any of these apply to you before using Abacavir/
Lamivudine. You may need extra check-ups, including blood tests, while you are
taking your medicine. See Section 4 for more information.
Abacavir hypersensitivity reactions
Even patients who do not have the HLA-B*5701 gene may still develop a
hypersensitivity reaction (a serious allergic reaction).
Carefully read all the information about hypersensitivity reactions in Section 4 of
this leaflet.

Risk of heart attack
It cannot be excluded that abacavir may increase the risk of having a heart attack.
Tell your doctor if you have heart problems, if you smoke, or have other illnesses that
may increase your risk of heart disease such as high blood pressure, or diabetes.
Do not stop taking Abacavir/Lamivudine unless your doctor advises you to do so.
Look out for important symptoms
Some people taking medicines for HIV infection develop other conditions, which can
be serious. You need to know about important signs and symptoms to look out for
while you are taking Abacavir/Lamivudine.
Read the information ‘Other possible side effects of combination therapy for HIV’
in Section 4 of this leaflet.
Protect other people
HIV infection is spread by sexual contact with someone who has the infection, or by
transfer of infected blood (for example, by sharing injection needles). You can still
pass on HIV when taking this medicine, although the risk is lowered by effective
antiretroviral therapy. Discuss with your doctor the precautions needed to avoid infecting
other people.
Other medicines and Abacavir/Lamivudine
Tell your doctor or pharmacist if you are taking any other medicines, or if you
have taken any recently, including herbal medicines or other medicines you bought
without a prescription.

Remember to tell your doctor or pharmacist if you begin taking a new medicine while
you are taking Abacavir/Lamivudine.

These medicines should not be used with Abacavir/Lamivudine:
• emtricitabine, to treat HIV infection
• other medicinal products containing lamivudine, used to treat HIV infection or
hepatitis B infection
• high doses of trimethoprim/sulfamethoxazole, an antibiotic
• cladribine, used to treat hairy cell leukaemia
Tell your doctor if you are being treated with any of these.

Some medicines interact with Abacavir/Lamivudine
These include:

• phenytoin, for treating epilepsy.
Tell your doctor if you are taking phenytoin. Your doctor may need to monitor
you while you are taking Abacavir/Lamivudine.

• methadone, used as a heroin substitute. Abacavir increases the rate at which
methadone is removed from the body. If you are taking methadone, you will be
checked for any withdrawal symptoms. Your methadone dose may need to be
changed. Tell your doctor if you are taking methadone.

• ribavirin, for treating hepatitis C. Abacavir may make the combination of
ribavirin and pegylated interferon less effective at reducing levels of hepatitis C
virus in the body. Tell your doctor if you are taking ribavirin.

Pregnancy
Abacavir/Lamivudine is not recommended for use during pregnancy. Abacavir/
lamivudine and similar medicines may cause side effects in unborn babies.
If you become pregnant while you are taking Abacavir/Lamivudine, your baby may be
given extra check-ups (including blood tests) to make sure it is developing normally.
If you are pregnant, if you become pregnant, or if you are planning to become
pregnant:
Talk to your doctor immediately about the risks and benefits of taking Abacavir/
Lamivudine, or other medicines for treating HIV infection, during your pregnancy.

Breast-feeding
Women who are HIV-positive must not breast-feed, because HIV infection can be
passed on to the baby in breast milk. A small amount of the ingredients in Abacavir/
Lamivudine can also pass into your breast milk.
If you are breast-feeding, or thinking about breast-feeding:
Talk to your doctor immediately.

Driving and using machines
Abacavir/Lamivudine may cause side effects which could affect your ability to drive or
use machines. Talk to your doctor about your ability to drive or operate machines
while taking Abacavir/Lamivudine.

Important information about some of the other ingredients of Abacavir/
Lamivudine
Abacavir/Lamivudine contains a colouring called sunset yellow (E110), this may cause
allergic reactions in some people.

3. How to take Abacavir/Lamivudine
Always take this medicine exactly as your doctor has told you. Check with your
doctor or pharmacist if you are not sure.

The recommended dose of Abacavir/Lamivudine for adults, adolescents and
children weighing 25 kg or more is one tablet once a day.

Swallow the tablets whole, with some water. Abacavir/Lamivudine can be taken with or
without food.
Stay in regular contact with your doctor
Abacavir/Lamivudine helps to control your condition. You need to keep taking it every
day to stop your illness getting worse. You may still develop other infections and
illnesses linked to HIV infection.
Keep in touch with your doctor and do not stop taking Abacavir/Lamivudine
without your doctor’s advice.

If you take more Abacavir/Lamivudine than you should
If you accidentally take too much Abacavir/Lamivudine, tell your doctor or your
pharmacist, or contact your nearest hospital emergency department for further advice.
If you forget to take Abacavir/Lamivudine
If you forget to take a dose, take it as soon as you remember. Then continue your
treatment as before.
Do not take a double dose to make up for a forgotten dose.

It is important to take Abacavir/Lamivudine regularly, because if you take it at irregular
intervals, you may be more likely to have a hypersensitivity reaction.

If you have stopped taking Abacavir/Lamivudine
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 taking it again.
Your doctor will check whether your symptoms were related to a hypersensitivity reaction.
If the doctor thinks they may have been related, you will be told to never take
Abacavir/Lamivudine again, or any other medicine containing abacavir (e.g.
Trizivir or Ziagen). It is important that you follow this advice.

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.

4. Possible side effects
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.
Even patients who do not have the HLA-B*5701 gene may still develop a
hypersensitivity reaction (a serious allergic reaction), described in this leaflet in the
panel headed ‘Hypersensitivity reactions’.
It is very important that you read and understand the information about this
serious reaction.

As well as the side effects listed below for Abacavir/Lamivudine, other conditions
can develop during combination therapy for HIV. It is important to read the information
later in this section under ‘Other possible side effects of combination therapy for HIV’.
Hypersensitivity reactions

Abacavir/Lamivudine contains abacavir (which is also an active substance in
medicines such as 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.
Continued on next page >>

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.

If you continue to take Abacavir/Lamivudine, the symptoms will get worse,
and may be life-threatening.
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 take Abacavir/Lamivudine again, or any other
medicine containing abacavir (e.g. 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 to never take Abacavir/Lamivudine again, or
any other medicine containing abacavir (e.g. 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. This card contains important
safety information, 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)
• lactic acidosis (see the next section, ‘Other possible side effects of combination
therapy for HIV’)
• 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).
If you notice any of these symptoms contact a doctor urgently.
Very rare side effects that may show up in blood tests are:
• a failure of the bone marrow to produce new red blood cells (pure red cell aplasia).

If you get side effects
Tell your doctor or pharmacist if any of the side effects get severe or troublesome,
or if you notice any side effects not listed in this leaflet.
Other possible side effects of combination therapy for HIV
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.

Your body shape may change
People taking combination therapy for HIV may find that their body shape changes,
because of changes in fat distribution:
• Fat may be lost from the legs, arms or face.
• Extra fat may build up around the tummy (abdomen), or on the breasts or internal
organs.
• Fatty lumps (sometimes called buffalo hump) may appear on the back of the neck.
It is not yet known what causes these changes, or whether they have any long-term
effects on your health. If you notice changes in your body shape: Tell your doctor.
Lactic acidosis is a rare but serious side effect
Some people taking abacavir/lamivudine, or other medicines like it (NRTIs), develop a
condition called lactic acidosis, together with an enlarged liver.

Lactic acidosis is caused by a build-up of lactic acid in the body. It is rare; if it happens,
it usually develops after a few months of treatment. It can be life-threatening, causing
failure of internal organs.
Lactic acidosis is more likely to develop in people who have liver disease, or in obese
(very overweight) people, especially women.
Signs of lactic acidosis include:
• feeling sick (nausea), being sick (vomiting)
• stomach pain
• generally feeling unwell

• loss of appetite, weight loss
• deep, rapid, difficult breathing
• numbness or weakness in the limbs

During your treatment, your doctor will monitor you for signs of lactic acidosis. If you
have any of the symptoms listed above or any other symptoms that worry you:
See your doctor as soon as possible.
You may have problems with your bones
Some people taking combination therapy for HIV develop a condition called
osteonecrosis. With this condition, parts of the bone tissue die because of reduced
blood supply to the bone. People may be more likely to get this condition:
• if they have been taking combination therapy for a long time
• if they are also taking anti-inflammatory medicines called corticosteroids
• if they drink alcohol
• if their immune systems are very weak
• if they are overweight
Signs of osteonecrosis include:
• stiffness in the joints
• aches and pains (especially in the hip, knee or shoulder)
• difficulty moving
If you notice any of these symptoms: Tell your doctor.

Other effects may show up in blood tests
Combination therapy for HIV can also cause:
• increased levels of lactic acid in the blood, which on rare occasions can lead to
lactic acidosis
• increased levels of sugar and fats (triglycerides and cholesterol) in the blood
• resistance to insulin (so if you are diabetic, you may have to change your
insulin dose to control your blood sugar).
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any
possible side effects not listed in this leaflet. You can also report side effects directly
via the Yellow Card Scheme (www.mhra.gov.uk/yellowcard). By reporting side effects
you can help provide more information on the safety of this medicine.

5. How to store Abacavir/Lamivudine
Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton after EXP.
The expiry date refers to the last day of that month.
Store below 25°C.

Do not throw away any medicines via wastewater or household waste. Ask your
pharmacist how to throw away medicines you no longer use. These measures will help
protect the environment.

6. Contents of the pack and other information
What Abacavir/Lamivudine contains
The active substances in each Abacavir/Lamivudine Film-coated Tablet are abacavir
hydrochloride equivalent to 600 mg abacavir and 300 mg of lamivudine.

The other ingredients are microcrystalline cellulose, crospovidone (Type A), povidone
(K-30), iron oxide yellow (E172) and magnesium stearate in the core of the tablet. The
tablet coating contains hypromellose HPMC 2910 -3mPas, hypromellose HPMC 2910
-6mPas, titanium dioxide (E171), macrogol 400, polysorbate 80 and sunset yellow
aluminium lake (E110).
What Abacavir/Lamivudine looks like and contents of the pack
Abacavir/Lamivudine are orange coloured, capsule shaped, biconvex, 20.6 mm x 9.1
mm film-coated tablets, engraved with“300” on one side and “600” on other side.
Abacavir/Lamivudine is supplied in blister packs containing 30, 60 or 90
film-coated tablets or multi blister packs containing 60 or 90 film-coated tablets.
30 film-coated tablets are also supplied in bottles containing an activated carbon
sachet or an activated carbon sachet and oxygen absorber to control the moisture in
the bottle.
Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

Marketing Authorisation Holder
Sandoz Limited, Frimley Business Park, Frimley, Camberley, Surrey, GU16 7SR, UK

Manufacturer
Lupin (Europe) Ltd, Victoria Court, Bexton Road, Knutsford, Cheshire, WA16 0PF, UK
or Salutas Pharma GmbH, Otto-von-Guericke-Allee 1, Sachsen-Anhalt, 39179
Barleben, Germany
This leaflet was last revised in 08/2016.
00000000
SZ00000LT000

Expand Transcript

Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

Hide