Juluca (Dolutegravir and Rilpivirine) - Oral

Warning:

What Is Juluca?

Juluca (dolutegravir and rilpivirine) is a medicine used to treat human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS).

Juluca is one product that contains two drugs: dolutegravir and rilpivirine. It falls into the broad category of antiretroviral drugs. Dolutegravir is an HIV-1 integrase strand transfer inhibitor (INSTI). Rilpivirine is an HIV-1 non-nucleoside reverse transcriptase inhibitor (NNRTI). Both of these drugs target stages of the virus’ life cycle, preventing it from making copies of itself. Without the ability to replicate itself, HIV can be suppressed to undetectable levels, which keeps the immune system functioning and also reduces the risk of transmitting the virus to others.

Juluca comes as a tablet taken by mouth. It is a prescription product, so you can’t purchase it over the counter. You’ll receive a prescription from your healthcare provider and get the medication from your pharmacy.

Drug Facts

Generic Name: Dolutegravir and rilpivirine

Brand Name: Juluca 

Drug Availability: Prescription

Therapeutic Classification: Antiretroviral: INSTI and NNRTI combination

Available Generically: No

Controlled Substance: N/A

Administration Route: Oral

Active Ingredient: Dolutegravir and rilpivirine

Dosage Form: Tablet

What Is Juluca Used For?

The Food and Drug Administration (FDA) approved Juluca to treat HIV in people who have already achieved viral suppression, meaning a lab test will detect less than 50 copies of the virus per milliliter of blood. This will include individuals who have been on a previous antiretroviral drug regimen for at least six months that successfully treated their HIV.

Juluca (Dolutegravir and Rilpivirine) Drug Information - Illustration by Zoe Hansen

Verywell / Zoe Hansen

How to Take Juluca

Take Juluca at the same time every day with a meal. Taking Juluca with a meal that contains some fat is important because it will ensure that you absorb enough of the drug and receive the full dose. You can take it with whichever meal is most convenient for you, as long as you get enough calories. Around 600 calories should be the minimum, with about 200 calories coming from fat.

Storing Juluca

Store Juluca at room temperature (between 68 and 77 degrees Fahrenheit) in the original container with the lid on, out of reach of children and pets. Avoid storing your pill bottle in an area with a lot of heat and moisture, like the bathroom.

If you’re traveling by plane, you’ll want to keep Juluca in your carry-on luggage so that you aren’t separated from it if your checked baggage goes missing. If you’re traveling by car, take care not to leave your pill bottle in especially hot or cold temperatures for long periods, like overnight in the car.

How Long Does Juluca Take to Work?

Juluca begins working right away to prevent HIV replication. However, if you stop taking the medication, even the smallest amount of virus left in your blood will be able to start replicating again and return to high levels. For this reason, you will likely need to be on HIV medication for the rest of your life.

What Are the Side Effects of Juluca?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Some common side effects that you may experience while taking Juluca include headache and diarrhea.

Severe Side Effects

Potential side effects of Juluca that were rarer in clinical trials but potentially more severe include:

  • Severe skin and hypersensitivity reactions, including drug reaction cases with eosinophilia and systemic symptoms (DRESS): This is a serious reaction that can happen even weeks after beginning a drug and may include symptoms like fever, redness and blistering, and abnormal liver lab tests.
  • Liver toxicity: Let your healthcare provider know if you also have hepatitis B or C or any other liver conditions, as these conditions are at an increased risk of worsening when taking Juluca.
  • Psychiatric disorders, such as depression, especially in individuals with a history of psychiatric illness

Call your healthcare provider right away if you feel like you are experiencing serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Long-Term Side Effects

No specific side effects apart from the ones listed above are associated with long-term use of Juluca.

Report Side Effects

Juluca may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Juluca Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For treatment of HIV infection:
      • Adults—1 tablet once a day with food. For patients who are also taking this medicine together with rifabutin, take an additional 25 milligrams (mg) tablet of rilpivirine (Edurant®) once a day.
      • Children—Use and dose must be determined by your doctor.

Modifications

You may need to take precautions while using or administering this medication in certain cases.

Pregnancy

It is unknown whether taking Juluca while pregnant increases the risk of birth defects or miscarriage. There is an online pregnancy exposure registry that reports outcomes in people exposed to antiretrovirals while pregnant. The overall risk does not seem to be higher in pregnant women exposed to the medicines that Juluca contains. However, there is not enough data here to make any definite conclusions.

Breastfeeding

It is not known whether Juluca is present in human breast milk. However, due to the risk of transmitting HIV through breast milk, the Centers for Disease Control and Prevention (CDC) recommends against breastfeeding if you have HIV.

Children

Juluca has not been established as safe or effective for children.

Older Adults

There have not been specific studies to determine whether older adults (above age 65) respond differently to Juluca than younger adults. In general, Juluca should be used cautiously in older adults, keeping in mind any decreased liver or kidney function and other medications that may interact with Juluca.

Missed Dose

If you forget to take a dose of Juluca, you can take it as soon as you remember. Just remember to take it with a meal.

If you are closer to your next dose than the dose you missed, go ahead and skip the missed dose and wait for your next scheduled one. For example, if you usually take Juluca at 8 am, and you remember at 9 pm that you forgot your morning dose, wait and take your next dose the following day at 8 am. Do not double up doses to make up for missed ones.

It is especially important to remember to refill your prescription when your supply gets too low. If you stop taking Juluca, the virus in your blood can increase and return to high levels, making it difficult to treat.

Overdose: What Happens If I Take Too Much Juluca?

As long as you take Juluca once daily as prescribed, you don’t need to be too concerned about overdosing. Treatment for an overdose would most likely consist of monitoring your vital signs, heart rhythm, and general condition.

What Happens If I Overdose on Juluca?

If you think you or someone else may have overdosed on Juluca, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Juluca, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

It is important to tell your doctor if you are pregnant or planning to become pregnant before using this medicine. Using this medicine while you are pregnant can harm your unborn baby. If you are a woman who can get pregnant, your doctor may do tests to make sure you are not pregnant before starting treatment. Do not use this medicine during the first part of your pregnancy unless your doctor tells you to. Use an effective form of birth control to keep from getting pregnant.

This medicine should not be used together with dexamethasone (Decadron®), dofetilide (Tikosyn®), certain seizure medicines (eg, carbamazepine, oxcarbazepine, phenobarbital, phenytoin, Dilantin®, Tegretol®, Trileptal®), medicine for tuberculosis (eg, rifampin, rifapentine, Priftin®, Rifadin®, Rimactane®), certain stomach medicines (eg, esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole, Aciphex®, Nexium®, Prevacid®, Prilosec®) or St. John's wort.

This medicine may cause serious allergic reactions including anaphylaxis and drug reaction with eosinophilia and systemic symptoms (DRESS), which can be life-threatening and requires immediate medical attention. Call your doctor right away if you or your child have black, tarry stools, chest pain, chills, cough, fever, painful or difficult urination, rash, itching, hoarseness, lightheadedness or dizziness, sore throat, sores, ulcers, or white spots on the lips or in the mouth, swollen glands, trouble breathing, trouble swallowing, unusual bleeding or bruising, unusual tiredness or weakness, or any swelling of your hands, face, or mouth with this medicine.

This medicine may cause serious liver problems. This may occur in patients with hepatitis B or C infection. Check with your doctor right away if you or your child have clay-colored stools, dark urine, a decreased appetite, fever, headache, itching, nausea and vomiting, skin rash, stomach pain or tenderness, swelling of the feet or lower legs, unusual tiredness or weakness, or yellow eyes or skin.

Tell your doctor right away if you start to feel depressed and have thoughts about hurting yourself. Report any unusual thoughts or behavior that troubles you, especially if they are new or get worse quickly.

This medicine will not keep you from giving HIV to your partner during sex. Make sure you understand this and practice safe sex, even if your partner also has HIV, by using a latex condom or other barrier method. This medicine will also not keep you from giving HIV to other people if they are exposed to your blood. Do not re-use or share needles with anyone.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn't Take Juluca?

You should not take Juluca if you:

  • Have had a previous hypersensitivity (allergic) reaction to Juluca. This includes an allergy to either of the drugs in Juluca (dolutegravir or rilpivirine).
  • Also have hepatitis B or C that is not well controlled and has caused your liver function tests to be elevated. Make sure your healthcare provider is aware if you also have hepatitis or another liver disease, as Juluca may worsen these conditions.
  • Also take a drug that interacts significantly with Juluca, such as the ones listed below.

What Other Medications Interact With Juluca?

Make sure the healthcare provider prescribing Juluca for you is aware of all other medicines and supplements you take. The following can have important interactions with Juluca:

  • Tikosyn (dofetilide) is a drug that treats heart arrhythmias (abnormal heart rates). Taking Juluca at the same time can elevate the amount of Tikosyn in your system, which can worsen heart arrhythmias to the point of being severe or life-threatening.

The following drugs may cause less Juluca to be absorbed into your system. This can lead to the drug not working well enough to suppress your HIV, meaning your virus may become detectable again, and symptoms may return.

What Medications Are Similar?

Dozens of drugs across different classes and mechanisms of action exist to treat HIV. It is necessary to use more than one drug class to effectively treat HIV and prevent it from replicating, which is why drugs from different classes are combined into one combination product. This provides the convenience of getting multiple drugs with only one pill.

These medications may be used at various stages of treatment, like right after you are diagnosed with HIV or after you have achieved undetectable virus levels. Many other combination products exist besides Juluca. A few of them are:

  • Dovato (dolutegravir/lamivudine)
  • Cabenuva (cabotegravir/rilpivirine)
  • Triumeq (abacavir/dolutegravir/lamivudine)
  • Genvoya (elvitegravir/cobicistat/emtricitabine/tenofovir)
  • Stribild (elvitegravir/cobicistat/emtricitabine/tenofovir)

Genvoya and Stribild have the same components but differ slightly. Genvoya contains tenofovir alafenamide, whereas Stribild contains tenofovir disoproxil fumarate. This is especially important because Genvoya causes less kidney or bone damage than Stribild but is a more expensive option.

This is NOT a list of drugs recommended to take with Juluca. You should not take these drugs together. Ask your pharmacist or a healthcare provider if you have questions.

Frequently Asked Questions

  • What is Juluca used for?

    Juluca is used to treat human immunodeficiency virus (HIV), the virus that leads to acquired immunodeficiency syndrome (AIDS). This virus can cause weight loss and severe infections.

  • How does Juluca work?

    Juluca contains two antiretroviral drugs: dolutegravir and rilpivirine. Together, these drugs target stages of the virus’ life cycle, preventing it from making copies of itself and suppressing it to undetectable levels.

  • What are the side effects of Juluca?

    The most common side effects of Juluca include headache and diarrhea.

  • What drugs interact with Juluca?

    Several drugs should be avoided entirely while taking Juluca due to significant interactions, including several anti-seizure medications, an herbal supplement called St. John’s Wort, and proton pump inhibitors used for heartburn.

How Can I Stay Healthy While Taking Juluca?

Finding out you are HIV positive can be overwhelming. The good news is that HIV treatments have advanced rapidly in the last couple of decades, and life expectancy is close to the same as an uninfected person. People diagnosed with HIV can live normal lives if they begin treatment promptly and remain adherent.

The goal of treatment with antiretroviral medication is always to keep the HIV virus undetectable in your blood. Undetectable means that a test run with a sample of your blood can only pick up an extremely small number of the virus, or none at all. Being in this status drastically reduces your chances of transmitting HIV to others and developing infections.

Learn everything you can about HIV and the treatment you are receiving, as this can make treatment more approachable and help you understand it. When living with a condition like HIV, it’s also essential to prioritize your mental health. Exercising, joining support groups, or seeking counseling if it feels necessary can improve or maintain your mental wellbeing.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Juluca (dolutegravir/rilpivirine) package insert.

  2. Choudhary S, McLeod M, Torchia D, Romanelli P. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome. J Clin Aesthet Dermatol. 2013;6(6):31-37.

  3. ViiV Healthcare. Juluca product monograph.

  4. Food and Drug Administration. HIV and AIDS: medicines to help you.

  5. Marcus JL, Leyden WA, Alexeeff SE, et al. Comparison of overall and comorbidity-free life expectancy between insured adults with and without HIV infection, 2000-2016. JAMA Netw Open. 2020;3(6):e207954.

By Sara Hoffman, PharmD
Sara is a clinical pharmacist that believes everyone should understand their medications, and aims to achieve this through her writing.