Brand-Name Abacavir Tablets Are Discontinued
In a series of announcements in late 2023, ViiV Healthcare, the manufacturer of brand-name abacavir products, confirmed the discontinuation of several specific tablet formulations. The phase-out was completed by January 1, 2024, and impacted multiple products containing the active ingredient abacavir sulfate.
Discontinued Brand-Name Products
The discontinuation specifically targeted the following products and formulations in the United States:
- Ziagen (abacavir sulfate) 300mg tablets: Distribution of these single-agent abacavir tablets ceased on January 1, 2024.
- Epzicom (abacavir sulfate, lamivudine) 600/300mg tablets: The 600/300mg tablets were discontinued on January 1, 2024.
- Trizivir (abacavir sulfate, lamivudine, zidovudine) 300mg/150mg/300mg tablets: Distribution for this triple-combination tablet ended in November 2023.
These discontinuations were reported to the U.S. Food and Drug Administration (FDA). ViiV's decision was influenced by the availability of effective generic versions on the market, as well as the evolution of standard-of-care HIV treatment towards newer, more comprehensive regimens.
Generic Abacavir and Other Formulations Remain Available
Despite the discontinuation of certain brand-name tablets, abacavir is not off the market entirely. Patients and healthcare providers still have access to this medication through several alternative sources, which is a key reason the brand-name versions were able to be phased out without a major disruption to care.
Available Abacavir Formulations
- Generic Tablets: Multiple manufacturers continue to produce and distribute generic versions of abacavir sulfate tablets (300mg) and generic abacavir/lamivudine combinations. Generic medication is often a more cost-effective alternative to brand-name drugs.
- Oral Solution: The oral solution formulation of Ziagen (abacavir sulfate) remains available for patients who have difficulty swallowing pills or for pediatric use.
- Combination Tablets: Abacavir is a component of other currently available combination antiretroviral drugs. For example, Triumeq, a combination tablet containing abacavir, lamivudine, and dolutegravir, continues to be produced and marketed by ViiV Healthcare.
Changing Treatment Guidelines and Potential Cardiovascular Risk
Abacavir's changing availability also reflects broader developments in HIV medicine. In recent years, newer, highly effective antiretroviral therapies have become available with different safety profiles. As a result, treatment guidelines have shifted.
Updated Recommendations and Considerations
- Cardiovascular Risk: Recent studies have strengthened the association between abacavir use and increased risk of cardiovascular disease (CVD) in some people living with HIV. An analysis published in July 2025 further solidified this link, leading to re-evaluation of abacavir's use in certain adult patients.
- Guideline Updates: In April 2025, an updated review of guidelines recommended that abacavir be removed from some standard adult antiretroviral therapy (ART) regimens. The recommendation is not a universal ban but emphasizes avoiding abacavir or using it with caution in people with HIV who have an elevated cardiovascular risk profile.
- Genetic Testing: A critical safety precaution for abacavir is the mandatory genetic screening for the HLA-B5701 gene. Individuals with this gene have a significantly higher risk of developing a severe, potentially life-threatening hypersensitivity reaction to abacavir. Screening for HLA-B5701 is standard practice before prescribing abacavir.
Abacavir Availability Comparison
| Feature | Discontinued Brand-Name Abacavir Tablets (Ziagen, Epzicom, Trizivir Tablets) | Currently Available Generic/Combination Abacavir Products |
|---|---|---|
| Manufacturer | ViiV Healthcare | Multiple generic manufacturers; ViiV Healthcare (for oral solution and Triumeq) |
| Availability Status | Discontinued as of late 2023/early 2024 | Widely available |
| Formulations | Tablets only | Tablets, oral solution, and combinations like Triumeq |
| FDA Reporting | Reported as discontinued to the FDA | Still actively marketed and sold |
| Cost | Typically higher cost | Often significantly lower cost |
The Evolution of HIV Treatment
The changes surrounding abacavir illustrate the dynamic nature of HIV treatment. Early in the HIV epidemic, abacavir was a crucial tool, offering a potent option for managing the virus. However, the field has advanced dramatically since abacavir's initial approval in the late 1990s. The emergence of safer and equally effective antiretroviral alternatives with fewer associated risks has reshaped treatment strategies.
Conclusion
While the brand-name tablet versions of abacavir, including Ziagen, Epzicom, and Trizivir tablets, have been discontinued by the manufacturer, the active ingredient abacavir is far from obsolete. It remains readily available through generic manufacturers and as a component of other combination therapies like Triumeq. Any perceived unavailability is due to a shift from brand-name to generic manufacturing and evolving treatment paradigms.
For patients currently taking abacavir, there is no need for alarm. However, recent guideline updates regarding cardiovascular risk underscore the importance of ongoing consultation with a healthcare provider. Patients should always discuss their medication options, health history, and risk factors to ensure they are on the most appropriate and safest antiretroviral regimen. The HIV treatment landscape continues to offer effective options, and healthcare providers can seamlessly transition patients to suitable alternatives if necessary. For more detailed information on current HIV treatment options, you can consult the official guidelines from the U.S. Department of Health and Human Services (HHS) at Clinical Info.
