Abalam

Abalam is required to prevent HIV-1infection treatment. Abalam tablets are hostile to retroviral pharmaceutical, which containsfunctioning substances like abacavir and lamivudine. Abacavir belongs to nucleoside analogue of HIV reverse transcriptase inhibitor, also an analogue of guanosine. Lamivudine is a inhibitor of reverse transcriptase enzyme, associates of Zalcitabine. Both abacavir and lamivudine are none relieving the contamination; thereby it ready to lessen the movement of HIV disease to AIDS.

Lamivudine & Abacavir

Abalam

300mg & 600mg

Hetero





Indication of Abalam

The drug Abalam is used in patients for the treatment of HIV-1 infections.

Mechanism of Abalam

Lamivudine

Lamivudine is one of the active molecule present in Abalam tablets. Lamivudine is involved as nucleoside analogue. Lamivudine is converted into dynamic 5' triphosphate metabolite intracellularly by adding phosphate group (lamivudine triphosphate 3TC-TP. This effective metabolite containsa barrier of switch transcriptase through chain end after addition of nucleotide simple.

Abacavir

Abacavir is belongs to carboxylic synthetic nucleoside reverse transcriptase inhibitor, which is active opposite to HIV infection. Abacavir is added a phosphate group into carbovir triphosphate (deoxyguanosine 5'triphosphate) dGTP a functioning metabolite This hostile metabolite stops the activity of reverse transcriptase by oppose with dGTP and fixed into viral DNA. The development of viral DNA gets changed by inclusion of nucleotide which cause absence of OH particle. For the development of 5' to 3' phosphodiester linkage, an OH atom is necessary. The 3’ phosphodiester linkage formation oversees chain stretching which get inhibited.




PHARMACOKINETIC

The drug Abalam maximum absorbed after administration. Bioavailability of both Lamivudine 87% & abacavir 83% respectively.

The human plasma protein binding nature of lamivudine is very low. Bounds to human plasma protein of Abacavir is almost 50%.

Abacavir metabolized by using alcohol dehydrogenase &glucuronic transferees’ enzymes. The metabolism of Lamivudine is highly metabolized to trans-sulfoxide and sulfotransferases is essential for biotransformation of lamivudine.

The abacavir systemic clearance value is 0.80L/hr/kg plus or minus 0.24L/hr/kg & lamivudine is 0.33 plus or minus of 0.06L/hr/kg. The renal clearance of abacavir is 0.007 plus or minus to 0.0008L/h/kg; lamivudine is 0.22 plus or minus to 0.06L/h/kg. Half-life period of Abalam tablets are; Abacavir: 1.45 plus or minus to 0.32 hours. Lamivudine: 5 to 7 hours





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Abalam
Brand Abalam
Ingredients Lamivudine & Abacavir
Strength 300mg & 600mg
Manufactured Hetero
Rating


Abalam Dosage and administration

Prior to initiate the treatment with Abalam tablets, patient should be cover up for HLA-B*5701 allele. The prescribed dose of Abalam tablets is one tablet should be administered as a single dose. The drug will be concomitant use with other anti-retroviral drugs.

The dosage adjustment should not be recommended; Abalam is a type of fixed dose combination, dosage adjustment should not be suggested in case of; Patients having creatinine clearance < 50ml/minPatient with mild liver impairment condition Administered Abalam tablets with or without food. It should be administer with whole of water. Abalam should not be chew, crush or broke.

Over dosage

The over dosage of Abalam is treated by; Analyze the manifestation along with over dosage of Abalam tablets Providing supportive treatment for the patients

Abalam caused side effects

Severe hypersensitivity or sometimes causes fatal related to abacavir Fatigue, Malaise, Dizziness, Vertigo, Nausea, Diarrhea, Rash, Pyrexia, Insomnia, Depression, Headache or migraine, Abdominal pain, Abnormal dreams, Anxiety

Other effects

Pancreatitis, Myocardial infarction, Stevens Johnson’s syndrome, Toxic epidermal necrolysis, Fat redistribution, Stomatitis, Weakness, Aplastic anemia, Lymphadenopathy, Splenomegaly, Lactic acidosis, hepatic steatosis, Rhabdomyolysis, Seizures, Wheezing, Alopecia, Erythema multiforme

Immune reconstitution syndrome

Discontinue the treatment, If this fatal case occurs.

Occurrence of lamivudine resistance may happen

The efficacy of lamivudine for HIV/HBV co infected patients has not been investigated. hepatitis B infection risk variations related with protection from lamivudine has additionally been accounted for in HIV-1-contaminated subjects who have gotten lamivudine-containing antiretroviral regimens within the sight of simultaneous disease with hepatitis B infection.

Lactic acidosis, hepatic steatosis

These fatal cases are mainly occurred in patients getting anti-retroviral treatment as single therapy or in combinations. Dropping the treatment for reducing this kind of adverse.

Aggravation of hepatitis B

This patient who are affected by HIV/HBV co infection will occur this condition. Check the patient’s liver functions very closely for inhibition this fatal case. In serious condition, continue the anti-hepatitis drugs.

Myocardial infarction

Patient has any risk of CVS disorders should be investigate prior to starting the treatment. In severe condition, stop the therapy.

Fat redistribution

This may cause to obesity mostly occurred in women. To overcome the problem patient should be treated with alternative measures and in serious condition discontinue the treatment.


DRUG INTERACTION



  • Lamivudine 150mg interaction with Nelfinavir 750mg for thrice daily leads to causes increasing AUC of lamivudine by 10%.
  • Concomitant use of Lamivudine 300mg with trimethoprim 160mg & Sulfamethoxazole 800mg will increase AUC of lamivudine by 43%.
  • Ribavirin causes reduction of phosphorylation of lamivudine.
  • The patients caused by HIV who are getting methadone concomitant treatment, combined with 600mg of abacavir as twice daily, this concludes as increasing the oral clearance of methadone.
  • Interaction of 600mg of abacavir withEthanol 0.7g/kg will cause increasing AUC of abacavir by 41%.




Contraindication


Abalam tablets are contraindicated to;
HLA-B*5701 condition
any hypersensitivity reactions to abacavir
moderate or severe liver damage



Pregnancy category C Abalam should not be administered to both pregnant& lactating women. Liability of postnatal transmission occurs The potency of Abalam has not been evaluated in pediatric patients. While using Abalam in geriatric patients Caution should be taken.

Stored at 25°C (77°F). Protect away from moisture, heat & light

If patients missed a dose, thendiscuss with medical practitioner and follow the instruction given by physician. Or leave the missed dose and follow the normal schedule. The normal dosing schedule should be retained. The missed dose leads to over dosage condition.

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