New Fixed-Dose Combination Pill: Dolutegravir + Abacavir + Lamivudine
September 26, 2014
The FDA has approved the coformulation of the integrase inhibitor dolutegravir (50 mg) with the NRTIs abacavir (600 mg) and lamivudine (300 mg); its brand name is Triumeq. Triumeq is the first single-pill combination that does not include tenofovir.
Dosing is 1 tablet once daily; there are no food restrictions.
It is intended for persons who do not have resistance to any of its components, and of course the cautions that apply to the components also apply to the combination. Notably:
- Serum levels of dolutegravir are decreased by a number of other medications. Coadministration of certain ARVs with dolutegravir requires an additional daily dose of dolutegravir, and some combinations are not recommended.
- The presence (or suspicion) of integrase resistance mutations may require an additional daily dose of dolutegravir.
- This ARV combination should not be given to persons who test positive for HLA-B*5701 or who have a history of abacavir hypersensitivity reaction; persons must be screened for HLA-B*5701 before starting Triumeq.
For additional information, see the Triumeq and dolutegravir prescribing information at [email protected].
Susa Coffey is medical editor of the NCRC. She is a Professor of Medicine at UCSF in the Division of HIV, Infectious Diseases and Global Medicine and a longtime clinician and educator in the HIV at San Francisco General Hospital clinic (“Ward 86”). She also is medical editor of HIV InSite.