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MEDICATION GUIDE

ZIAGEN®
(ZY-uh-jen)
(abacavir sulfate) Tablets and Oral Solution

Read this Medication Guide before you start taking ZIAGEN and each time you get arefill. There may be new information. This information does not take the place oftalking to your healthcare provider about your medical condition or your treatment.Be sure to carry your ZIAGEN Warning Card with you at all times.

What is the most important information I should know about ZIAGEN?

1. Serious allergic reaction (hypersensitivity reaction). ZIAGEN containsabacavir (also contained in EPZICOM® and TRIZIVIR®). Patients taking ZIAGENmay have a serious allergic reaction (hypersensitivity reaction) that can causedeath. Your risk of this allergic reaction is much higher if you have a genevariation called HLA-B*5701. Your healthcare provider can determine with ablood test if you have this gene variation.

If you get a symptom from 2 or more of the following groups whiletaking ZIAGEN, call your healthcare provider right away to find out ifyou should stop taking ZIAGEN.

A list of these symptoms is on the Warning Card your pharmacist gives you. Carry this Warning Card with you at all times.

If you stop ZIAGEN because of an allergic reaction, never take ZIAGEN (abacavir sulfate) or any other abacavir-containing medicine (EPZICOM and TRIZIVIR) again. If you take ZIAGEN or any other abacavir-containing medicine again after you have had an allergic reaction, within hours you may get life-threatening symptoms that may include very low blood pressure or death. If you stop ZIAGEN for any other reason, even for a few days, and you are not allergic to ZIAGEN, talk with your healthcare provider before taking it again. Taking ZIAGEN again can cause a serious allergic or life-threatening reaction, even if you never had an allergic reaction to it before.

If your healthcare provider tells you that you can take ZIAGEN again, start taking it when you are around medical help or people who can call a healthcare provider if you need one.

2. Lactic Acidosis (buildup of acid in the blood). Some human immunodeficiency virus (HIV) medicines, including ZIAGEN, can cause a rare but serious condition called lactic acidosis. Lactic acidosis is a serious medical emergency that can cause death and must be treated in the hospital.

Call your healthcare provider right away if you get any of the following signs or symptoms of lactic acidosis:

• you feel very weak or tired
• you have unusual (not normal) muscle pain
• you have trouble breathing
• you have stomach pain with nausea and vomiting
• you feel cold, especially in your arms and legs
• you feel dizzy or light-headed
• you have a fast or irregular heartbeat

3. Serious liver problems. Some people who have taken medicines like ZIAGEN have developed serious liver problems called hepatotoxicity, with liver enlargement (hepatomegaly) and fat in the liver (steatosis). Hepatomegaly with steatosis is a serious medical emergency that can cause death.

Call your healthcare provider right away if you get any of the following signs or symptoms of liver problems:

• your skin or the white part of your eyes turns yellow (jaundice)
• your urine turns dark
• your bowel movements (stools) turn light in color
• you don't feel like eating food for several days or longer
• you feel sick to your stomach (nausea)
• you have lower stomach area (abdominal) pain

You may be more likely to get lactic acidosis or serious liver problems if you are female, very overweight, or have been taking nucleoside analogue medicines for a long time.

What is ZIAGEN?

ZIAGEN is a prescription medicine used to treat HIV infection. ZIAGEN is a medicine called a nucleoside analogue reverse transcriptase inhibitor (NRTI). ZIAGEN is always used with other anti-HIV medicines. When used in combination with these other medicines, ZIAGEN helps lower the amount of HIV in your blood.

• ZIAGEN does not cure HIV infection or AIDS.
• It is not known if ZIAGEN will help you live longer or have fewer of the medical problems that people get with HIV or AIDS.
• It is very important that you see your doctor regularly while you are taking ZIAGEN.

Who should not take ZIAGEN?

Do not take ZIAGEN if you:

• are allergic to abacavir or any of the ingredients in ZIAGEN. See the end of this Medication Guide for a complete list of ingredients in ZIAGEN.
• have certain liver problems.

What should I tell my healthcare provider before taking ZIAGEN?

Before you take ZIAGEN, tell your healthcare provider if you:

• have been tested and know whether or not you have a particular gene variation called HLA-B*5701
• have hepatitis B virus infection or have other liver problems
• have heart problems, smoke, or have diseases that increase your risk of heart disease such as high blood pressure, high cholesterol, or diabetes.
• are pregnant or plan to become pregnant. It is not known if ZIAGEN will harm your unborn baby. Talk to your healthcare provider if you are pregnant or plan to become pregnant.
• Pregnancy Registry. If you take ZIAGEN while you are pregnant, talk to your healthcare provider about how you can take part in the Pregnancy Registry for ZIAGEN. The purpose of the pregnancy registry is to collect information about the health of you and your baby.
• are breastfeeding or plan to breastfeed. Do not breastfeed. We do not know if ZIAGEN can be passed to your baby in your breast milk and whether it could harm your baby. Also, mothers with HIV-1 should not breastfeed because HIV-1 can be passed to the baby in the breast milk.
• Tell your healthcare provider about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Especially tell your healthcare provider if you take:

• alcohol
• methadone
• TRIZIVIR (abacavir sulfate, lamivudine, and zidovudine)
• EPZICOM (abacavir sulfate and lamivudine)

Ask your healthcare provider if you are not sure if you take one of the medicines listed above.

ZIAGEN may affect the way other medicines work, and other medicines may affect how ZIAGEN works.

Know the medicines you take. Keep a list of your medicines with you to show to your healthcare provider and pharmacist when you get a new medicine.

How should I take ZIAGEN?

• Take ZIAGEN exactly as your healthcare provider tells you to take it.
• ZIAGEN is taken by mouth as a tablet or a strawberry- and banana-flavored liquid.
• ZIAGEN may be taken with or without food.
• Do not skip doses.
• Children aged 3 months and older can also take ZIAGEN. The child's healthcare provider will decide the right dose and whether the child should take the tablet or liquid, based on the child's weight. The dose should not be more than the recommended adult dose.
• Do not let your ZIAGEN run out.
  If you stop your anti-HIV medicines, even for a short time, the amount of virus in your blood may increase and the virus may become harder to treat. If you take too much ZIAGEN, call your healthcare provider or poison control center or go to the nearest hospital emergency room right away.

What are the possible side effects of ZIAGEN?

• ZIAGEN can cause serious side effects including allergic reactions, lactic acidosis, and liver problems. See “What is the most important information I should know about ZIAGEN?”
• Changes in immune system (Immune Reconstitution Syndrome). Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Tell your healthcare provider if you start having new or worse symptoms of infection after you start taking ZIAGEN.
• Changes in body fat (fat redistribution). Changes in body fat (lipoatrophy or lipodystrophy) can happen in some people taking antiretroviral medicines including ZIAGEN.
  These changes may include:
  • more fat in or around your trunk, upper back and neck (buffalo hump), breast, or chest
  • loss of fat in your legs, arms, or face
• Heart attack (myocardial infarction). Some HIV medicines including ZIAGEN may increase your risk of heart attack.

The most common side effects of ZIAGEN in adults include:

• bad dreams or sleep problems
• nausea
• headache
• tiredness
• vomiting

The most common side effects of ZIAGEN in children include:

• fever and chills
• nausea
• vomiting
• rash
• ear, nose, or throat infections

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all the possible side effects of ZIAGEN. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

How should I store ZIAGEN?

• Store ZIAGEN at room temperature, between 68°F to 77°F (20°C to 25°C).
• Do not freeze ZIAGEN.
• Keep ZIAGEN and all medicines out of the reach of children.

General information for safe and effective use of ZIAGEN

Avoid doing things that can spread HIV-1 infection to others.

• Do not share needles or other injection equipment.
• Do not share personal items that can have blood or body fluids on them, like toothbrushes and razor blades.
• Do not have any kind of sex without protection. Always practice safe sex by using a latex or polyurethane condom to lower the chance of sexual contact with semen, vaginal secretions, or blood.

Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use ZIAGEN for a condition for which it was not prescribed. Do not give ZIAGEN to other people, even if they have the same symptoms that you have. It may harm them.

This Medication Guide summarizes the most important information about ZIAGEN. If you would like more information, talk with your healthcare provider. You can ask your healthcare provider or pharmacist for the information that is written for healthcare professionals.

For more information go to www.ZIAGEN.com or call 1-877-844-8872.

What are the ingredients in ZIAGEN?

Tablets

Active ingredient: abacavir sulfate

Inactive ingredients: colloidal silicon dioxide, magnesium stearate, microcrystalline cellulose, and sodium starch glycolate, and afilm-coating made of hypromellose, polysorbate 80, synthetic yellow iron oxide, titanium dioxide, and triacetin.

Oral Solution:

Active ingredient: abacavir sulfate

Inactive ingredients: artificial strawberry and banana flavors, citric acid (anhydrous), methylparaben and propylparaben (added as preservatives), propylene glycol, saccharin sodium, sodium citrate (dihydrate), sorbitol solution, and water.

This Medication Guide has been approved by the US Food and Drug Administration.

Last reviewed on RxList: 3/26/2012
This monograph has been modified to include the generic and brand name in many instances.