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Trizivir

General Information This drug is actually a combination of three antiviral drugs - zidovudine, abacavir, and lamivudine.  It may be used as one component of a multiple drug combination or sometimes it can be used by itself.
Specifics Trizivir is a well-recognized and important drug for the treatment of HIV infection  Trizivir works by inhibiting the formation of HIV's genetic material.  Trizivir's three components are all called nucleoside reverse transcriptase inhibitors (NRTIs) or nukes.
Dosing Generally Trizivir is taken at 1 pill twice a day without food or with a low-fat food.  Fat in food may decrease the levels of the zidovudine part of Trizivir and compromise its potency. 
Adherence
(this refers to your willingness, ability, and actual performance in taking your medications)
As with any antiviral drug or antibiotic, try not to ever miss a dose.  If you miss a dose and notice that you have done so within a few hours of its scheduled time, you may take the dose as usual and take the next dose at its regular time.

Because Trizivir contains abacavir, it is recommended that you do NOT stop this medication without consulting with your healthcare provider or someone experienced with the use of abacavir.

If you miss more than one dose, look at the reasons why you missed them and come up with a plan to avoid it in the future.  For example, if you fell asleep too early, take the medicine earlier in the evening, with your later meal, set an alarm, or have someone appointed to wake you up for your medicine.  

It is strongly recommended that you consider using weekly pill boxes and arrange all of your doses a week in advance.  Buy a small pill box so that you can carry a dose or two of your medicines with you in case you are away from home.

Possible Side Effects
The package insert for most drugs including Trizivir is often overwhelming and scary with perhaps an overemphasis on side effects.  We have summarized the important and more common problems here.

Most people take Trizivir without many side effects

Possible side effects include nausea (which usually gets better over time,) headache, muscle aches, liver problems, anemia (low red blood cells) low white blood cells, or allergy.  Usually you will have blood tests done in the first month to look for the beneficial effects of zidovudine and any side effects. 

Many minor side effects will either stay constant or get better with time.  It is mainly the side effects that are severe or get worse that may cause significant health risks for you.

Symptoms of anemia are weakness, fatigue, appearing pale, fast heartrate, and shortness of breath.  Symptoms of low white blood cells are fever or infections.

Approximately 5% of patients who take abacavir (which is one of the components of Trizivir) develop allergy or "hypersensitivity" to it.  This is a well-recognized problem and it is easy to diagnose and treat.  The allergic symptoms usually consist of the SEVERAL of the following that always get worse as you take the drug: fever, body rash, cough, diarrhea, and nausea that gets worse over time.  These symptoms may occur with other problems such as flu, food poisoning and allergies to other drugs.  Therefore you should remember to inform your healthcare provider of any of these symptoms that tend to get worse and worse or more numerous as you continue to take Trizivir.  It is very important that you do not stop the Trizivir unless instructed to by your healthcare provider or someone who is familiar with Trizivir or abacavir.

Occasionally you may be prescribed an injectable hormone and iron pills to increase red blood cell production if you get anemic due to the zidovudine in Trizivir. 

All drugs of this type can cause or contribute to abnormal fat redistribution characterized by thinning of the face, arms, or legs.  In most cases this would be also accompanied by elevated cholesterol levels, elevated triglyceride levels, and perhaps a tendency to develop diabetes. 

Rarely, a build-up of (lactic) acid may occur due to taking medications of this type.  Persons taking multiple nukes (NRTIs), those taking d4T (stavudine, Zerit), those on the combination of d4T (stavudine, Zerit) and ddI (didanosine, Videx), and those persons with hepatitis C are the most likely to encounter this rare, but potentially fatal problem.  Pregnancy may also raise the risk of this problem.  The symptoms are vague but troublesome including nausea, vomiting, muscle aches, weakness, turning yellow with jaundice, and just feeling plain bad.

Report to you healthcare provider or go to an Emergency Room if you have severe side effects, increasing side effects, shortness of breath, uncontrollable diarrhea, fever, weakness, jaundice (eyes and skin turn yellow,) muscle pain, nausea and vomiting so that you cannot hold down your food and liquids.
You can download this handout in PDF format by clicking HERE.

6.17.2004