What is Trizivir (abacavir, lamivudine, zidovudine)?
Trizivir (abacavir, lamivudine, zidovudine) is a combination of antiviral medications used for treating infections with the human immunodeficiency virus (HIV).
Anti-HIV drugs are often used in combination to increase HIV suppression and to reduce the chance of the HIV developing resistance to any single drug. Trizivir does not reduce the transmission of HIV among individuals, and it does not cure HIV or AIDS.
Drug interactions of Trizivir include:
- methadone,
- sorbitol-containing medicines,
- stavudine, doxorubicin,
- nucleoside analogues (e.g., ribavirin),
- ganciclovir,
- interferon alfa,
- and other bone marrow suppressive or cytotoxic agents.
Tell your doctor if you are pregnant or plan to become pregnant before using Trizivir; it is unknown how it would affect a fetus. There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to Trizivir during pregnancy.
Use of Trizivir by nursing women has not been adequately studied. HIV-infected mothers should not breastfeed because of the potential risk of transmitting HIV to an infant that is not infected.
What are the side effects of Trizivir?
What are the common side effects of Trizivir?
Common side effects of Trizivir include:
- nausea,
- diarrhea,
- vomiting,
- weight loss,
- and difficulty sleeping.
What are the serious side effects of Trizivir?
Serious side effects of Trizivir include:
- hypersensitivity reactions (symptoms include fever, rash, nausea, vomiting, diarrhea, abdominal pain, fatigue, aches, shortness of breath, cough, and sore throat),
- pancreatitis,
- liver failure,
- metabolic disturbance (lactic acidosis),
- decrease in blood cells,
- muscle pain,
- and weakness and nerve damage in the extremities (peripheral neuropathy).
What drugs interact with Trizivir?
Abacavir
Methadone
In a trial of 11 HIV-1 infected subjects receiving methadone maintenance therapy with 600 mg of Ziagen twice daily (twice the currently recommended dose), oral methadone clearance increased. This alteration will not result in a methadone dose modification in the majority of patients; however, an increased methadone dose may be required in a small number of patients.
Lamivudine
Sorbitol
Coadministration of single doses of lamivudine and sorbitol resulted in a sorbitol dose-dependent reduction in lamivudine exposures. When possible, avoid use of sorbitol-containing medicines with lamivudine-containing medicines.
Zidovudine
Agents Antagonistic With Zidovudine
Concomitant use of zidovudine with the following drugs should be avoided since an antagonistic relationship has been demonstrated in vitro:
- Stavudine
- Doxorubicin
- Nucleoside analogues, e.g., ribavirin
Hematologic/Bone Marrow Suppressive/Cytotoxic Agents
Coadministration with the following drugs may increase the hematologic toxicity of zidovudine:
- Ganciclovir
- Interferon alfa
- Ribavirin
- Other bone marrow suppressive or cytotoxic agents
Trizivir side effects list for healthcare professionals
The following adverse reactions are discussed in other sections of the labeling:
- Serious and sometimes fatal hypersensitivity reactions.
- Hematologic toxicity, including neutropenia and anemia.
- Symptomatic myopathy.
- Lactic acidosis and severe hepatomegaly with steatosis.
- Exacerbations of hepatitis B.
- Hepatic decompensation in patients co-infected with HIV-1 and hepatitis C.
- Exacerbation of anemia in HIV-1/HCV co-infected patients receiving ribavirin and zidovudine.
- Immune reconstitution syndrome.
- Lipoatrophy.
- Myocardial infarction.
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.
Serious And Fatal Abacavir-Associated Hypersensitivity Reactions
In clinical trials, serious and sometimes fatal hypersensitivity reactions have occurred with abacavir, a component of Trizivir. These reactions have been characterized by 2 or more of the following signs or symptoms:
- fever;
- rash;
- gastrointestinal symptoms (including nausea, vomiting, diarrhea, or abdominal pain);
- constitutional symptoms (including generalized malaise, fatigue, or achiness);
- respiratory symptoms (including dyspnea, cough, or pharyngitis).
Almost all abacavir hypersensitivity reactions include fever and/or rash as part of the syndrome.
Other signs and symptoms have included lethargy, headache, myalgia, edema, arthralgia, and paresthesia. Anaphylaxis, liver failure, renal failure, hypotension, adult respiratory distress syndrome, respiratory failure, myolysis, and death have occurred in association with these hypersensitivity reactions.
Physical findings have included lymphadenopathy, mucous membrane lesions (conjunctivitis and mouth ulcerations), and maculopapular or urticarial rash (although some patients had other types of rashes and others did not have a rash). There were reports of erythema multiforme. Laboratory abnormalities included elevated liver chemistries, elevated creatine phosphokinase, elevated creatinine, and lymphopenia, and abnormal chest x-ray findings (predominantly infiltrates, which were localized).
Additional Adverse Reactions With Use Of Trizivir
Treatment-emergent clinical adverse reactions (rated by the investigator as moderate or severe) with a frequency greater than or equal to 5% during therapy with abacavir 300 mg twice daily, lamivudine 150 mg twice daily, and zidovudine 300 mg twice daily compared with indinavir 800 mg 3 times daily, lamivudine 150 mg twice daily, and zidovudine 300 mg twice daily from CNA3005 are listed in Table 1.
Table 1. Treatment-Emergent (All Causality) Adverse Reactions of at Least Moderate Intensity (Grades 2-4, Greater than or Equal to 5% Frequency) in Therapy-Naive Adults (CNA3005) through 48 Weeks of Treatment
Adverse Reaction | ZIAGEN plus Lamivudine/Zidovudine (n = 262) |
Indinavir plus Lamivudine/Zidovudine (n = 264) |
Nausea | 19% | 17% |
Headache | 13% | 9% |
Malaise and fatigue | 12% | 12% |
Nausea and vomiting | 10% | 10% |
Hypersensitivity reaction | 8% | 2% |
Diarrhea | 7% | 5% |
Fever and/or chills | 6% | 3% |
Depressive disorders | 6% | 4% |
Musculoskeletal pain | 5% | 7% |
Skin rashes | 5% | 4% |
Ear/nose/throat infections | 5% | 4% |
Viral respiratory infections | 5% | 5% |
Anxiety | 5% | 3% |
Renal signs/symptoms | <1% | 5% |
Pain (non-site-specific) | <1% | 5% |
Five subjects receiving abacavir in CNA3005 experienced worsening of pre-existing depression compared to none in the indinavir arm. The background rates of pre-existing depression were similar in the 2 treatment arms.
Laboratory Abnormalities
Laboratory abnormalities in CNA3005 are listed in Table 2.
Table 2. Treatment-Emergent Laboratory Abnormalities (Grades 3/4) in CNA3005
Laboratory Parameter | ZIAGEN plus Lamivudine/Zidovudine (n = 262) |
Indinavir plus Lamivudine/Zidovudine (n = 264) |
Elevated CPK (>4 x ULN) | 18 (7%) | 18 (7%) |
ALT (>5.0 x ULN) | 16 (6%) | 16 (6%) |
Neutropenia (<750/mm3) | 13 (5%) | 13 (5%) |
Hypertriglyceridemia (>750 mg/dL) | 5 (2%) | 3 (1%) |
Hyperamylasemia (>2.0 x ULN) | 5 (2%) | 1 (<1%) |
Hyperglycemia (>13.9 mmol/L) | 2 (<1%) | 2 (<1%) |
Anemia (Hgb ≤6.9 g/dL) | 0 (0%) | 3 (1%) |
ULN = Upper limit of normal. n = Number of subjects assessed. |
Other Adverse Events
In addition to adverse reactions in Tables 1 and 2, other adverse events observed in the expanded access program for abacavir were pancreatitis and increased GGT.
Postmarketing Experience
The following adverse reactions have been identified during postmarketing use. Because these reactions are reported voluntarily from a population of unknown size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Abacavir
Cardiovascular: Myocardial infarction.
Skin: Suspected Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) have been reported in patients receiving abacavir primarily in combination with medications known to be associated with SJS and TEN, respectively. Because of the overlap of clinical signs and symptoms between hypersensitivity to abacavir and SJS and TEN, and the possibility of multiple drug sensitivities in some patients, abacavir should be discontinued and not restarted in such cases. There have also been reports of erythema multiforme with abacavir use.
Abacavir, Lamivudine, And/Or Zidovudine
Body as a Whole: Redistribution/accumulation of body fat.
Cardiovascular: Cardiomyopathy.
Digestive: Stomatitis.
Endocrine and Metabolic: Gynecomastia.
Gastrointestinal: Anorexia and/or decreased appetite, abdominal pain, dyspepsia, oral mucosal pigmentation.
General: Vasculitis, weakness.
Hemic and Lymphatic: Aplastic anemia, anemia (including pure red cell aplasia and severe anemias progressing on therapy), lymphadenopathy, splenomegaly, thrombocytopenia.
Hepatic: Lactic acidosis and hepatic steatosis, elevated bilirubin, elevated transaminases, posttreatment exacerbations of hepatitis B.
Hypersensitivity: Sensitization reactions (including anaphylaxis), urticaria.
Musculoskeletal: Arthralgia, myalgia, muscle weakness, rhabdomyolysis.
Nervous: Dizziness, paresthesia, peripheral neuropathy, seizures.
Psychiatric: Insomnia and other sleep disorders.
Respiratory: Abnormal breath sounds/wheezing.
Skin: Alopecia, erythema multiforme, Stevens-Johnson syndrome.
Summary
Trizivir (abacavir, lamivudine, zidovudine) is a combination of antiviral medications used for treating infections with the human immunodeficiency virus (HIV). Anti-HIV drugs are often used in combination to increase HIV suppression and to reduce the chance of the HIV developing resistance to any single drug. Trizivir does not reduce the transmission of HIV among individuals, and it does not cure HIV or AIDS. Common side effects of Trizivir include nausea, diarrhea, vomiting, weight loss, and difficulty sleeping. Serious side effects of Trizivir include hypersensitivity reactions (symptoms include fever, rash, nausea, vomiting, diarrhea, abdominal pain, fatigue, aches, shortness of breath, cough, and sore throat), pancreatitis, liver failure, metabolic disturbance, and more.
Multimedia: Slideshows, Images & Quizzes
-
What Are HIV & AIDS? Symptoms, Treatment, and Prevention
HIV, or human immunodeficiency virus, causes acquired immunodeficiency syndrome, or AIDS. Learn about HIV symptoms, HIV test, HIV...
-
HIV AIDS: Myths and Facts
What is HIV versus AIDS? What are the symptoms of HIV? Is there an HIV cure? Discover myths and facts about living with HIV/AIDS....
-
A Timeline of the HIV/AIDS Pandemic
Get a historical overview of the HIV/AIDS pandemic from human contraction to the present through this slideshow of pictures.
-
Picture of HIV Lipodystrophy
HIV lipodystrophy describes a constellation of changes in subcutaneous and visceral fat distribution in patients on...
-
HIV & AIDS Quiz: HIV Testing & Symptoms
Now, more than ever, you should know about HIV/AIDS, especially its causes, symptoms treatments, and complications. Take the...
-
Picture of HIV/AIDS
Acronym for the Human Immunodeficiency Virus, the cause of AIDS (acquired immunodeficiency syndrome). See a picture of HIV/AIDS...
-
Picture of HIV-associated Dementia (HAD)
A 40-year-old woman diagnosed with HIV presented with confusion and decline in memory. See a picture of HIV-associated Dementia...
Related Disease Conditions
-
HIV Early Signs and Stages
HIV (human immunodeficiency virus) weakens your immune system. Some people with HIV don’t have any symptoms, but those that do may experience mononucleosis-like or flu-like symptoms. There are 3 stages of HIV.
-
HIV and AIDS
Second Source article from WebMD
-
Human Immunodeficiency Virus (HIV)
HIV (human immunodeficiency virus) infection left untreated causes AIDS (acquired immunodeficiency syndrome). The human immunodeficiency virus (HIV) is a type of virus called a retrovirus, which can infect humans when it comes in contact with tissues that line the vagina, anal area, mouth, or eyes, or through a break in the skin. HIV infection is generally a slowly progressive disease in which the virus is present throughout the body at all stages of the disease. Three stages of HIV infection have been described. The initial stage of infection (primary infection), which occurs within weeks of acquiring the virus, often is characterized by the flu- or mono-like illness that generally resolves within weeks. The stage of chronic asymptomatic infection (meaning a long duration of infection without symptoms) lasts an average of eight to 10 years without treatment. The stage of symptomatic infection, in which the body's immune (or defense) system has been suppressed and complications have developed, is called the acquired immunodeficiency syndrome (AIDS). The symptoms are caused by the complications of AIDS, which include one or more unusual infections or cancers, severe loss of weight, and intellectual deterioration (called dementia). When HIV grows (that is, by reproducing itself), it acquires the ability to change (mutate) its own structure. These mutations enable the virus to become resistant to previously effective drug therapy. The goals of drug therapy are to prevent damage to the immune system by the HIV virus and to halt or delay the progress of the infection to symptomatic disease. Therapy for HIV includes combinations of drugs that decrease the growth of the virus to such an extent that the treatment prevents or markedly delays the development of viral resistance to the drugs. The best combination of drugs for HIV are those that effectively suppress viral replication in the blood and also are well tolerated and simple to take so that people can take the medications consistently without missing doses.
-
AIDS (Acquired Immunodeficiency Syndrome)
AIDS is the advanced stage of HIV infection. Symptoms and signs of AIDS include pneumonia due to Pneumocystis jiroveci, tuberculosis, toxoplasmosis, seizures, weakness, meningitis, yeast infection of the esophagus, and Kaposi's sarcoma. Anti-retroviral therapy (HAART) is used in the treatment of AIDS.
-
HIV vs. AIDS
Human immunodeficiency virus causes HIV infection. Acquired immunodeficiency syndrome (AIDS) is a condition that results after HIV has extensively damaged a person's immune system. Risk factors for HIV and AIDS include use of contaminated needles or syringes, unprotected sex, STDs, receiving a blood transfusion prior to 1985 in the United States, having many sex partners, and transmission from a mother to her child.
-
Can HIV be Cured Naturally?
HIV stands for human immunodeficiency virus. If someone has HIV it means that they have been diagnosed with the HIV infection. AIDS (acquired immune deficiency syndrome); however, is the most advanced or final stage of the HIV infection. It is important to get tested for HIV in the early stages of infection to minimize the damage to the immune system. Successful treatment aims to reduce HIV load to a level that is harmless to the body.
-
HIV Medications List and Drug Charts
The ultimate goal of HIV treatment is getting the viral load down below detectable levels. As long as those viral load and antibody levels are below a proscribed range, people with HIV can stave off AIDS and other serious symptoms. Antiviral treatment options usually include combinations of two NRTIs, often referred to as "nucs," and a third drug, typically being a boosted protease inhibitor, a NNRTI, often called "non-nucs," and integrase strand transfer inhibitors.
-
HIV/AIDS Infection Transmission and Prevention
HIV (human immunodeficiency virus) is spread through contact with genital fluids or blood of an infected person. The spread of HIV can occur when these secretions come in contact with tissues such as those lining the vagina, anal area, mouth, eyes (the mucus membranes), or with a break in the skin, such as from a cut or puncture by a needle.
-
HIV/AIDS Testing: Diagnosis and Monitoring
HIV/AIDS diagnosis and monitoring have come a long way from the days when a diagnosis was a death sentence. Crucial parts of the effective treatment regimens developed in the last 40 years are consistent monitoring of the viral load (the amount of virus in the blood), and the immune cell count, which function as biological markers of the disease’s progression. Doctors also must test for drug resistance.
-
HIV/AIDS Facts: What Is HIV?
HIV (human immunodeficiency virus) is the precursor infection to AIDS (acquired immunodeficiency syndrome). HIV is transmitted through blood and genital secretions; most people get it through sexual contact or sharing needles for illegal IV drug use. HIV can be controlled by a strict drug regimen, but left unchecked, it leads to AIDS. In AIDS, the immune system collapses and the body falls prey to secondary, opportunistic infections and cancers that typically kill the person.
-
What Are the Side Effects of HIV Medications?
It’s important to know the potential side effects of all the drugs you take to control your HIV infection, as well as potential drug interactions. All of the NNRTIs (nonnucleoside analogue reverse transcriptase inhibitors), for example, are associated with important drug-drug interactions so they must be used with caution in patients on other medications. Learn more about the side effects of the drugs in standard treatment regimens.
-
HIV Life Expectancy and Long-term Outlook
With early diagnosis and proper treatment, people with HIV can live a healthy and long life. There is no generalized definitive period for which a person with HIV can live.
-
When should you start HIV medication?
Nearly everyone who is infected with HIV (human immunodeficiency virus) should start antiviral medication therapy as soon as they are diagnosed. Older guidelines recommended delaying treatment to help reduce the potential for drug side effects and viral resistance to treatment. Current thinking theorizes that early treatment may preserve more of the body's immune function.
Treatment & Diagnosis
- HIV-AIDS FAQs
- HIV Treatment, Medications, and Prevention
- HIV: Two Patients Face The Diagnosis
- HIV Treatment - To Interrupt or Not
- Unprotected Sex Between HIV-Infected Partners: What's the Harm?
- HIV Transmission and Progression to AIDS Continues
- Physical and Biochemical Changes in HIV Disease
- Babies On The Breast Of HIV Moms
- Generic AIDS Drug Effective - And Now?
- HIV Urine Test Approved
- HIV / AIDS Conference Update 2005 - Index
- Retrovirus & Opportunistic Infections Part II
- Can You Treat Hepatitis B With Aids Drug Lamivudine?
- Does Circumcision Prevent HIV and AIDS?
- Can HIV Cause Kaposi's Sarcoma?
- Do You Need Antiretroviral Therapy for HIV with No Symptoms?
- Does HIV Cause Colorectal Cancer?
- Does Anti-Retroviral Therapy for HIV Cause Diabetes?
- How Long Should You Wait to Get an HIV Test?
- What Liver Problems Does HIV Cause?
- HIV Infection Facts, History, Causes, and Risk Factors
- HIV Tests, Symptoms, Signs, and Stages of Infection
- Baby "Cured" of HIV Infection
Medications & Supplements
- abacavir/lamivudine/zidovudine - oral, Trizivir
- How Effective Is ART for HIV Infection?
- How Do Protease Inhibitors Work in Antiretroviral Therapy for HIV Infection?
- What Are NNRTIs In Antiretroviral Therapy for HIV Infection?
- What ART Drugs Prevent HIV Entry into the Human Immune Cell?
- What Are the Single-Tablet ART Regimens for HIV Infection?
- How Do Integrase Strand-Transfer Inhibitors Work in Antiretroviral Therapy for HIV Infection?
- What Are NRTIs in Antiretroviral Therapy For HIV Infection?
- Dovato (dolutegravir and lamivudine)
- Temixys (lamivudine and tenofovir disoproxil fumarate)
- abacavir, lamivudine, zidovudine (Trizivir)
- Triumeq (abacavir, dolutegravir, and lamivudine)
- Epzicom (abacavir sulfate and lamivudine)

Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.