← Search & browse all drugs
ANTIINFECTIVES FOR SYSTEMIC USE › ANTIVIRALS FOR SYSTEMIC USE › DIRECT ACTING ANTIVIRALS › Antivirals for treatment of HIV infections, combinations
lamivudine, tenofovir disoproxil and dolutegravir
J05AR27
Forms & Strengths
- Fixed-dose combination tablet: Lamivudine 300 mg / Tenofovir disoproxil fumarate 300 mg / Dolutegravir 50 mg
Adult Dosing
- One tablet orally once daily, taken with or without food.
Pediatric Dosing
- Not recommended for pediatric patients weighing less than 35 kg due to fixed-dose combination strength restrictions.
Indications
- Treatment of Human Immunodeficiency Virus Type 1 (HIV-1) infection in adults and adolescents weighing at least 35 kg.
Mechanism of Action
- Lamivudine: Nucleoside reverse transcriptase inhibitor (NRTI) terminating viral DNA chain synthesis.
- Tenofovir disoproxil fumarate: Nucleotide reverse transcriptase inhibitor (NtRTI) interfering with viral RNA-dependent DNA polymerase.
- Dolutegravir: Integrase strand transfer inhibitor (INSTI) blocking the catalytic activity of HIV integrase, preventing viral DNA integration into host cell genome.
Contraindications
- Previous hypersensitivity reaction to lamivudine, tenofovir, or dolutegravir.
- Co-administration with dofetilide due to potential for increased dofetilide plasma concentrations and severe arrhythmias.
Adverse Reactions
- Insomnia
- Headache
- Dizziness
- Nausea and diarrhea
- Fatigue
- Elevated transaminases and creatine phosphokinase
- Renal impairment / Fanconi syndrome (attributed to tenofovir)
Drug Interactions
- Metformin: Dolutegravir increases metformin exposure; monitor blood glucose and adjust dose if needed.
- Polyvalent cation antacids/laxatives (Mg, Al, Ca, Fe): Decrease absorption of dolutegravir; administer dolutegravir 2 hours before or 6 hours after.
- Inducers of CYP3A and UGT1A1 (e.g., rifampin, St. John's wort): Decrease dolutegravir concentrations; adjust dolutegravir dose.
- Nephrotoxic drugs: Co-administration with tenofovir increases risk of renal toxicity.
Curated Content: Needs Vetting Before Put to Clinical Use