Combination Therapy: This tablet contains a fixed-dose combination of two antiretroviral agents: Abacavir (A) 60 mg and Lamivudine (B) 30 mg.
Formulation: It is an oral tablet, specifically formulated for pediatric patients (indicated by “P”) to simplify dosing and improve adherence to HIV treatment.
NRTI Class: Both abacavir and lamivudine are classified as Nucleoside Reverse Transcriptase Inhibitors (NRTIs), a foundational class of drugs for managing HIV.
Not Monotherapy: This combination is not a complete regimen on its own. It is always used as part of a multi-drug regimen with at least one other antiretroviral agent from a different class.
Advantages
Improved Adherence: The fixed-dose combination simplifies the treatment regimen for children by reducing the number of pills they need to take, which is a major factor in improving adherence and treatment success.
Synergistic Antiviral Effect: The two drugs work synergistically to suppress HIV replication, providing a powerful and effective therapeutic combination.
Reduced Pill Burden: The single tablet formulation reduces the overall pill burden, making the regimen more manageable for pediatric patients and their caregivers.
Effective & Well-Tolerated: The combination is highly effective against HIV-1 and has a well-established safety and tolerability profile.
Uses
HIV-1 Infection: Indicated for the treatment of HIV-1 infection in pediatric patients, in combination with other antiretroviral agents.
First-Line Therapy: It is a common component of first-line antiretroviral therapy (ART) regimens for children, especially as part of a three- or four-drug combination.
Weight-Based Dosing: The specific 60 mg/30 mg strength is designed to allow for accurate weight-based dosing in children, a critical component of pediatric HIV care.
Genetic Screening: A crucial prerequisite is that the patient must have been tested and confirmed negative for the HLA-B*5701 allele to avoid a severe and potentially fatal hypersensitivity reaction to abacavir.
Nature
Nucleoside Reverse Transcriptase Inhibitors (NRTIs): Both abacavir and lamivudine are NRTIs, which are prodrugs that are converted to their active triphosphate forms inside the cell.
Mechanism of Action: Their active forms compete with natural nucleosides to be incorporated into the growing viral DNA chain. This leads to premature chain termination, which blocks the action of the viral enzyme reverse transcriptase.
Inhibition of Viral Replication: By inhibiting reverse transcriptase, both drugs prevent the transcription of the HIV RNA genome into DNA, thus blocking a crucial step in the viral replication cycle.
Metabolism & Resistance: Both drugs are primarily eliminated by the kidneys. Resistance to the combination is reduced because two different mutations are needed for the virus to become resistant to both drugs simultaneously.
Storage
Temperature: Store the tablets at controlled room temperature, typically between 20∘C to 25∘C (68∘F to 77∘F).
Protection: Keep the tablets in their original, tightly closed container, protected from light and moisture.
Child Safety: Store the medication in a secure location, out of the reach of children and pets, as this is a potent medication.
Adherence: Patients and caregivers must be educated on the importance of taking every dose as prescribed to prevent the development of viral resistance and to ensure long-term treatment success.
