What are the side effects of Abacavir, Dolutegravir, and Lamivudine?
Last updated September 6, 2026.
**The common side effects of this three-drug HIV combination are trouble sleeping, headache, tiredness, nausea, diarrhea, and some weight gain, and most settle within the first few weeks.** The reaction that matters most is abacavir hypersensitivity, an immune response tied to the HLA-B*5701 gene that usually appears in the first six weeks with fever, rash, stomach upset, or breathing symptoms. That is why you get a blood test for HLA-B*5701 before your first dose, and why abacavir is never restarted once a hypersensitivity reaction is suspected. Lamivudine also treats hepatitis B, so stopping it suddenly can trigger a liver flare if you carry that virus. Taking the tablet at the same time each day, with or without food, and moving the dose earlier if sleep is disrupted covers most of the day-to-day problems.
What to do
- Confirm the genetic test: Ask your clinician to confirm your HLA-B*5701 result was negative before you ever start abacavir.
- Know the six-week window: Fever plus rash, vomiting, or breathing trouble in the first six weeks means stop the drug and get seen the same day.
- Never rechallenge: If abacavir was ever stopped for a suspected reaction, do not take it again, and tell every new clinician why.
- Keep the dose steady: Take it once daily at the same time, with or without food, and use a phone alarm or pill box so doses are not missed.
- Shift the timing for insomnia: If sleep is disrupted, ask about taking the dose in the morning instead of at night rather than skipping it.
- Check before stopping: Talk with a clinician before any break in treatment, especially if you have hepatitis B, so your liver and viral load are covered.
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