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<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="citation_inbook_title" content="Drugs and Lactation Database (LactMed®) [Internet]" /><meta name="citation_title" content="Abacavir" /><meta name="citation_publisher" content="National Institute of Child Health and Human Development" /><meta name="citation_date" content="2024/07/15" /><meta name="citation_pmid" content="30000607" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK501547/" /><meta name="citation_keywords" content="Abacavir sulfate" /><meta name="citation_keywords" content="abacavir" /><meta name="citation_keywords" content="Ziagen" /><meta name="citation_keywords" content="Epzicom" /><meta name="citation_keywords" content="Trizivir" /><meta name="citation_keywords" content="Triumeq" /><meta name="citation_keywords" content="1592U89 sulfate" /><meta name="citation_keywords" content="UNII-J220T4J9Q2" /><meta name="citation_keywords" content="HSDB 7154" /><meta name="citation_keywords" content="J220T4J9Q2" /><meta name="citation_keywords" content="1592U89" /><meta name="citation_keywords" content="[(1S,4R)-4-[2-amino-6-(cyclopropylamino)purin-9-yl]cyclopent-2-en-1-yl]methanol" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Abacavir" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Institute of Child Health and Human Development" /><meta name="DC.Date" content="2024/07/15" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK501547/" /><meta name="description" content="Abacavir appears in breastmilk in small quantities. Very little information is available on the safety of its use during breastfeeding. Achieving and maintaining viral suppression with antiretroviral therapy decreases breastfeeding transmission risk to less than 1%, but not zero. Individuals with HIV who are on antiretroviral therapy with a sustained undetectable viral load and who choose to breastfeed should be supported in this decision. If a viral load is not suppressed, banked pasteurized donor milk or formula is recommended.[1,2]" /><meta name="og:title" content="Abacavir" /><meta name="og:type" content="book" /><meta name="og:description" content="Abacavir appears in breastmilk in small quantities. Very little information is available on the safety of its use during breastfeeding. Achieving and maintaining viral suppression with antiretroviral therapy decreases breastfeeding transmission risk to less than 1%, but not zero. Individuals with HIV who are on antiretroviral therapy with a sustained undetectable viral load and who choose to breastfeed should be supported in this decision. If a viral load is not suppressed, banked pasteurized donor milk or formula is recommended.[1,2]" /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK501547/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-lactmed-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/lactmed/LM656/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK501547/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} </style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script>
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. </p></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK501547_"><span class="title" itemprop="name">Abacavir</span></h1><p class="small">Last Revision: <span itemprop="dateModified">July 15, 2024</span>.</p><p><em>Estimated reading time: 3 minutes</em></p></div><div class="body-content whole_rhythm" itemprop="text"><p>CASRN: 188062-50-2</p><a href="https://pubchem.ncbi.nlm.nih.gov/substance/388760395" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=388760395" alt="image 388760395 in the ncbi pubchem database" /></a><div id="LM656.Drug_Levels_and_Effects"><h2 id="_LM656_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM656.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Abacavir appears in breastmilk in small quantities. Very little information is available on the safety of its use during breastfeeding. Achieving and maintaining viral suppression with antiretroviral therapy decreases breastfeeding transmission risk to less than 1%, but not zero. Individuals with HIV who are on antiretroviral therapy with a sustained undetectable viral load and who choose to breastfeed should be supported in this decision. If a viral load is not suppressed, banked pasteurized donor milk or formula is recommended.[<a class="bk_pop" href="#LM656.REF.1">1</a>,<a class="bk_pop" href="#LM656.REF.2">2</a>]</p></div><div id="LM656.Drug_Levels"><h3>Drug Levels</h3><p><i>Maternal Levels.</i> Fifteen women had been taking abacavir 300 mg twice daily for 53 to 182 days as part of a 3-drug combination that included zidovudine and lamivudine. Breastmilk samples were collected at just before a dose at a median of 1 month postpartum. Whole breastmilk levels contained a median of 0.057 mg/L of abacavir, which was a median of 85% of maternal blood levels.[<a class="bk_pop" href="#LM656.REF.3">3</a>]</p><p>Eleven mothers taking abacavir 600 mg once daily provided milk samples at a median of 12.8 hours after a dose. The median drug concentration in milk was 91 mcg/L, which resulted in an estimated infant dosage of 50 mcg/kg daily and a relative infant dose of 0.12% of the maternal weight-adjusted dosage.[<a class="bk_pop" href="#LM656.REF.4">4</a>]</p><p><i>Infant Levels.</i> Nine infants were breastfed either partially or exclusively by their mothers who had been taking abacavir 300 mg twice daily for 53 to 182 days as part of a 3-drug combination that included zidovudine and lamivudine. Infant blood was collected at a median of 1 month postpartum 11 to 17 hours after the mothers previous dose, and at a median of 1 hour (range 6 minutes to 35 hours) after the last breastfeeding. Eight of 9 infants studied had undetectable (<16 mcg/L) plasma abacavir levels.[<a class="bk_pop" href="#LM656.REF.3">3</a>]</p><p>Four infants were breastfed by mothers taking abacavir 600 mg once daily, although the extent of breastfeeding was not sated. Infant serum concentrations taken between 11 and 18 hours after maternal drug intake at 1 month of age ranged from 1 to 49 mcg/L.[<a class="bk_pop" href="#LM656.REF.4">4</a>]</p></div><div id="LM656.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>An HIV-positive mother took a combination tablet containing dolutegravir 50 mg, abacavir sulfate 600 mg and lamivudine 300 mg (Triumeq) once daily. Her infant was exclusively breastfed for about 30 weeks and partially breastfed for about 20 weeks more. No obvious side effects were noted.[<a class="bk_pop" href="#LM656.REF.5">5</a>]</p></div><div id="LM656.Effects_on_Lactation_and_Breastmil"><h3>Effects on Lactation and Breastmilk</h3><p>Gynecomastia has been reported among men receiving highly active antiretroviral therapy. Gynecomastia is unilateral initially, but progresses to bilateral in about half of cases. No alterations in serum prolactin were noted and spontaneous resolution usually occurred within one year, even with continuation of the regimen.[<a class="bk_pop" href="#LM656.REF.6">6</a>-<a class="bk_pop" href="#LM656.REF.8">8</a>] Some case reports and in vitro studies have suggested that protease inhibitors might cause hyperprolactinemia and galactorrhea in some male patients,[<a class="bk_pop" href="#LM656.REF.9">9</a>,<a class="bk_pop" href="#LM656.REF.10">10</a>] although this has been disputed.[<a class="bk_pop" href="#LM656.REF.11">11</a>] The relevance of these findings to nursing mothers is not known. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.</p></div><div id="LM656.References"><h3>References</h3><dl class="temp-labeled-list"><dt>1.</dt><dd><div class="bk_ref" id="LM656.REF.1">World Health Organization. Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: Recommendations for a public health approach. 2021. <a href="https://www.who.int/publications/i/item/9789240031593" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>.who.int/publications<wbr style="display:inline-block"></wbr>/i/item/9789240031593</a> [<a href="https://pubmed.ncbi.nlm.nih.gov/34370423" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34370423</span></a>]</div></dd><dt>2.</dt><dd><div class="bk_ref" id="LM656.REF.2">Department of Health and Human Services. Recommendations for the use of antiretroviral drugs during pregnancy and interventions to reduce perinatal HIV transmission in the United States. 2024. <a href="https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/perinatal-hiv/guidelines-perinatal.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https:<wbr style="display:inline-block"></wbr>//clinicalinfo<wbr style="display:inline-block"></wbr>.hiv.gov/sites/default<wbr style="display:inline-block"></wbr>/files/guidelines/documents<wbr style="display:inline-block"></wbr>/perinatal-hiv<wbr style="display:inline-block"></wbr>/guidelines-perinatal.pdf</a></div></dd><dt>3.</dt><dd><div class="bk_ref" id="LM656.REF.3">Shapiro
|
||
RL, Rossi
|
||
S, Ogwu
|
||
A, et al.
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||
Therapeutic levels of lopinavir in late pregnancy and abacavir passage into breast milk, in the Mma Bana Study, Botswana.
|
||
Antivir Ther
|
||
2013;18:585-90.
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||
[<a href="/pmc/articles/PMC5502724/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5502724</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23183881" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23183881</span></a>]</div></dd><dt>4.</dt><dd><div class="bk_ref" id="LM656.REF.4">Aebi-Popp
|
||
K, Kahlert
|
||
CR, Crisinel
|
||
PA, et al.
|
||
Transfer of antiretroviral drugs into breastmilk: A prospective study from the Swiss Mother and Child HIV Cohort Study.
|
||
J Antimicrob Chemother
|
||
2022;77:3436-42.
|
||
[<a href="/pmc/articles/PMC9704434/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9704434</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36177836" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36177836</span></a>]</div></dd><dt>5.</dt><dd><div class="bk_ref" id="LM656.REF.5">Kobbe
|
||
R, Schalkwijk
|
||
S, Dunay
|
||
G, et al.
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||
Dolutegravir in breast milk and maternal and infant plasma during breastfeeding.
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||
AIDS
|
||
2016;30:2731-3.
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||
[<a href="https://pubmed.ncbi.nlm.nih.gov/27782968" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27782968</span></a>]</div></dd><dt>6.</dt><dd><div class="bk_ref" id="LM656.REF.6">García-Benayas
|
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T, Blanco
|
||
F, Martin-Carbonero
|
||
L, et al.
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||
Gynecomastia in HIV-infected patients receiving antiretroviral therapy.
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||
AIDS Res Hum Retroviruses
|
||
2003;19:739-41.
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||
[<a href="https://pubmed.ncbi.nlm.nih.gov/14585204" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14585204</span></a>]</div></dd><dt>7.</dt><dd><div class="bk_ref" id="LM656.REF.7">Pantanowitz
|
||
L, Evans
|
||
D, Gross
|
||
PD, et al.
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||
HIV-related gynecomastia.
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||
Breast J
|
||
2003;9:131-2.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/12603389" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12603389</span></a>]</div></dd><dt>8.</dt><dd><div class="bk_ref" id="LM656.REF.8">Evans
|
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DL, Pantanowitz
|
||
L, Dezube
|
||
BJ, et al.
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||
Breast enlargement in 13 men who were seropositive for human immunodeficiency virus.
|
||
Clin Infect Dis
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||
2002;35:1113-9.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/12384846" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12384846</span></a>]</div></dd><dt>9.</dt><dd><div class="bk_ref" id="LM656.REF.9">Hutchinson
|
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J, Murphy
|
||
M, Harries
|
||
R, et al.
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||
Galactorrhoea and hyperprolactinaemia associated with protease-inhibitors.
|
||
Lancet
|
||
2000;356:1003-4.
|
||
[<a href="https://pubmed.ncbi.nlm.nih.gov/11041407" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11041407</span></a>]</div></dd><dt>10.</dt><dd><div class="bk_ref" id="LM656.REF.10">Orlando
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G, Brunetti
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L, Vacca
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||
M. Ritonavir and saquinavir directly stimulate anterior pituitary prolactin secretion, in vitro.
|
||
Int J Immunopathol Pharmacol
|
||
2002;15:65-8.
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||
[<a href="https://pubmed.ncbi.nlm.nih.gov/12593790" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12593790</span></a>]</div></dd><dt>11.</dt><dd><div class="bk_ref" id="LM656.REF.11">Montero
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A, Bottasso
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OA, Luraghi
|
||
MR, et al.
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||
Galactorrhoea, hyperprolactinaemia, and protease inhibitors.
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||
Lancet
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||
2001;357:473-5.
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||
[<a href="https://pubmed.ncbi.nlm.nih.gov/11273087" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11273087</span></a>]</div></dd></dl></div></div><div id="LM656.Substance_Identification"><h2 id="_LM656_Substance_Identification_">Substance Identification</h2><div id="LM656.Substance_Name"><h3>Substance Name</h3><p>Abacavir</p></div><div id="LM656.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>188062-50-2</p></div><div id="LM656.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Milk, Human</p><p>Anti-Infective Agents</p><p>Antiviral Agents</p><p>Anti-HIV Agents</p><p>Anti-Retroviral Agents</p><p>Reverse Transcriptase Inhibitors</p></div></div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></div><div id="bk_toc_contnr"></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a><p class="small"><b>Attribution Statement:</b> LactMed is a registered trademark of the U.S. Department of Health and Human Services.</p></div><div class="small"><span class="label">Bookshelf ID: NBK501547</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/30000607" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">30000607</a></span></div><div style="margin-top:2em" class="bk_noprnt"><a class="bk_cntns" href="/books/n/lactmed/">Contents</a><div class="pagination bk_noprnt"><a class="active page_link prev" href="/books/n/lactmed/ADAMTS13/" title="Previous page in this title">< Prev</a><a class="active page_link next" href="/books/n/lactmed/LM893/" title="Next page in this title">Next ></a></div></div></div></div>
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