Treating HIV With Triumeq

Triumeq is a ​once-daily, single-pill drug formulation used in the treatment of HIV. Comprised of abacavir, lamivudine, and dolutegravir, Triumeq was approved by the U.S. Food and Drug Administration in August 2014 and was designated a preferred drug in first-line therapy by the Department of Health and Human Services.

Pre-Treatment Screening

Before starting Triumeq, you must be screened to see if you have the HLA-B*5701 genetic mutation.

If you do, you would not be able to take Triumeq as you run the risk of a potentially serious abacavir hypersensitivity reaction.

Triumeq can also not be used in people with kidney impairment. To avoid drug-associated toxicity, kidney function tests must be performed before treatment can be prescribed.

Dosage and Administration

Triumeq is formulated in an oral tablet comprised of abacavir 600mg, lamivudine 300mg, and dolutegravir 50mg. The recommended dosage is one pill daily, taken with or without food. Triumeq is an off-white oblong tablet embossed on one side with "572 Tri."

Common Side Effects

Triumeq is considered safe when used as directed but may cause side effects in some. Most of these side effects are tolerable and usually resolve on their own within a week. The most common (occurring at least two percent of cases) are:

• Insomnia
• Headache
• Dizziness
• Nausea
• Fatigue

Contraindications and Interactions

Tikosyn (dofetilide), used in the treatment of arrhythmia (irregular heartbeat), is contraindicated for use with Triumeq.

Speak with your doctor about substituting either Triumeq or Tikosyn if you require treatment for both condition

To avoid drug-drug interaction, advise your doctor if you are taking any of the following medications:

• Anti-seizure medication: Trileptal (oxcarbazepine), Dilantin (phenytoin), Phenytek (phenytoin), Luminal (phenobarbital), or carbamazepine agents such as Carbatrol, Equetro, Tegretol, Teril, or Epitol

• Rifampin-based antibiotics: Rifadin, Rifater, Rifamate, Rimactane
• Metformin diabetic drugs: Fortamet, Glucophage, Glumetza, Riomet
• St. John's Wort

Dosages may need to be adjusted or substitutions found.

Considerations

Contact your doctor immediately if you experience an allergic reaction after starting Triumeq. Seek emergency care if you have a rash accompanied by fever, muscle or joint pains, blisters, breathing problems, or swelling of the eyes, face, or mouth.

Triumeq should only be taken two hours before or six hours after taking an aluminum- or magnesium-based antacid or laxative, iron supplement, calcium supplement, buffered medication, or sucralfate used in the treatment of peptic ulcers.

Inform your doctor of any liver conditions you may have before starting Triumeq. Triumeq may cause a worsening of symptoms, particularly in people with hepatitis B or hepatitis C. Once treatment is started, liver enzymes should be monitored as part of a person's routine blood tests.

Sources:

U.S. Food and Drug Administration. "Highlights of Prescribing Information: TRIUMEQ (abacavir, dolutegravir, and lamivudine) tablets for oral use." Silver Spring, Maryland; August 2014.

Weller, S.; Chen, S.; Borland, J.; et al. "Bioequivalence of a dolutegravir, abacavir, and lamivudine fixed-dose combination tablet and the effect of food." Journal of Acquired Immune Deficiency Syndrome. August 1,2014;66(4):393-398. DOI: 10.1097/QAI.0000000000000193.