Kivexa (Epzicom) is a fixed-dose combination tablet combining 300mg lamivudine (3TC) and 600mg abacavir, manufactured by GlaxoSmithKline. Abacavir and lamivudine are both nucleoside reverse transcriptase inhibitors (NRTIs).
The standard dose of Kivexa is one tablet once a day, with or without food, in combination with at least one other anti-HIV drug. It is licensed for use in adults and children over 12 years of age. Its European Union and US marketing licence were both granted in 2004, under the trade names Kivexa and Epzicom and respectively.
Kivexa was licensed following demonstration that it had similar anti-HIV effects to once-daily lamivudine (Epivir) and abacavir (Ziagen) taken separately when they were combined with the non-nucleoside reverse transcriptase inhibitor (NNRTI) efavirenz (Sustiva). In a study of 770 people on first-line therapy, success rates were similar in both two arms. (Moyle) Kivexa has also been shown to be as effective as its constituent drugs taken separately in treatment-experienced people. The efficacy of lamivudine and abacavir had already been demonstrated in previous studies.
A 2008 study in patients looking at adherence found that switching from separate abacavir and lamivudine formulations to fixed-dose Kivexa significantly improved adherence to therapy, using MEMS cap monitoring and patient satisfaction surveys. (Maitland)
This drug is not recommended for use in pregnancy. For more information on lamivudine and abacavir, including side-effects, resistance and drug interactions, see lamivudine (Epivir) and abacavir (Ziagen).
Abacavir and lamivudine are also contained in the fixed-dose combination product Triumeq, combined with dolutegravir (see Triumeq for further information).
Moyle G et al. Abacavir once or twice daily combined with once-daily lamivudine and efavirenz for the treatment of antiretroviral-naive HIV-infected adults: results of the Ziagen Once Daily in Antiretroviral Combination Study. Journal of Acquired Immune Deficiency Syndromes, 38: 417-425, 2005.
Maitland D et al. Switching from twice-daily abacavir and lamivudine to the once-daily fixed-dose combination tablet of abacavir and lamivudine improves patient adherence and satisfaction with therapy. HIV Medicine, 9: 667-672, 2008.