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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIVIRALS FOR SYSTEMIC USE › DIRECT ACTING ANTIVIRALS › Antivirals for treatment of HIV infections, combinations
lamivudine and dolutegravir
J05AR25
Forms & Strengths
- Fixed-dose combination tablet: Dolutegravir 50 mg / Lamivudine 300 mg
Adult Dosing
- One tablet orally once daily with or without food
Pediatric Dosing
- Safety and efficacy not established in pediatric patients weighing less than 40 kg
Indications
- Treatment of HIV-1 infection in adults and adolescents weighing at least 40 kg with no known substitution associated with resistance to the integrase inhibitor class or lamivudine
Mechanism of Action
- Dolutegravir inhibits HIV integrase by binding to the integrase active site, blocking the strand transfer step of retroviral DNA integration
- Lamivudine is a synthetic nucleoside analogue phosphorylated intracellularly to active triphosphate, which inhibits HIV-1 reverse transcriptase via viral DNA chain termination
Contraindications
- Previous hypersensitivity reaction to dolutegravir or lamivudine
- Coadministration with dofetilide
Adverse Reactions
- Headache
- Insomnia
- Diarrhea
- Nausea
- Fatigue
- Weight gain
- Elevation of liver transaminases
- Creatine phosphokinase elevations
Drug Interactions
- Dofetilide: coadministration contraindicated due to potential for increased dofetilide concentrations and severe arrhythmias
- Polyvalent cation-containing antacids and laxatives: decrease absorption of dolutegravir; administer dolutegravir/lamivudine 2 hours before or 6 hours after
- Metformin: dolutegravir increases metformin exposure; monitor renal function and adjust metformin dosage as needed
- Inducers of UGT1A1 or CYP3A (e.g., rifampin, carbamazepine, St. John's wort): decrease dolutegravir concentrations; adjust dolutegravir dosing if applicable
Curated Content: Needs Vetting Before Put to Clinical Use