Dolutegravir
Dolutegravir is an HIV integrase inhibitor sold as Tivicay 50mg tablets and in the combination tablets Triumeq and Viropil, taken daily to lower the viral load.
How dolutegravir works against HIV
HIV (human immunodeficiency virus) wears down the immune system, and left untreated it can lead to AIDS. To make new copies, the virus has to splice its genetic material into the DNA of the immune cells it infects, and it needs an enzyme called integrase to do that. Dolutegravir is an integrase inhibitor: it jams that enzyme, so the splice never happens and copying stalls. Over weeks the viral load (the amount of HIV in the blood) drops and immune cells build back up. The virus is held down, not removed, so treatment is long term rather than a course of weeks.
Tivicay, Triumeq and Viropil: how the listings differ
Dolutegravir turns up in three listings. Tivicay is dolutegravir by itself, in 50mg tablets, and is taken together with other HIV medicines. Triumeq and Viropil put a whole three-drug regimen into one daily tablet: Triumeq adds abacavir and lamivudine, Viropil adds lamivudine and tenofovir disoproxil fumarate. Pick by the partners. Someone whose regimen is built on abacavir looks at Triumeq; someone whose regimen uses tenofovir disoproxil fumarate looks at Viropil.
Taking dolutegravir: timing and spacing
Dolutegravir is a tablet taken once a day, or twice a day when another medicine in the regimen calls for it. Swallow it with water. A meal makes no difference to how much is absorbed, so the aim is a steady daily time that keeps the level in the blood even. Missed doses are the real hazard: the virus begins multiplying again, and repeated gaps can make it harder to control later, which is why the tablet carries on through days of feeling perfectly well.
A few everyday products compete with it. Antacids and laxatives, multivitamins containing aluminium, magnesium or calcium, calcium and iron supplements, sucralfate and buffered medicines such as buffered aspirin all cut the amount of dolutegravir that reaches the blood when taken at the same time. The fix is spacing: 2 hours after, or 6 hours before, a dolutegravir dose. If the dose is taken with food, they can be taken together. St John's wort also works against dolutegravir and is best left out. Keep the tablets in the pack they came in.
Side effects to expect, and the ones that matter
The usual complaints are nausea, diarrhoea, headache, tiredness and disturbed sleep, and many of them fade as treatment goes on. A hypersensitivity reaction is rare; it begins with a rash and fever, sometimes with a swollen face or tongue or laboured breathing, and is an emergency. Yellow skin or eyes, dark urine or pain in the upper right of the abdomen point to the liver. Weight and blood fat levels can also creep up over the long run.
Sources
- Dolutegravir: MedlinePlus Drug Information — National Library of Medicine
- About HIV - CDC — Centers for Disease Control and Prevention
Where can I order Dolutegravir for delivery in Hong Kong?
Dolutegravir can be ordered online with delivery to Hong Kong, listed as generic Tivicay in 50mg, also sold as plain Dolutegravir tablets, plus the combination tablets generic Triumeq and Viropil in the strengths shown on their product pages. A parcel that does not arrive within the delivery window, or arrives damaged, is sent again free, and if that is not possible the order is refunded.
How much do Dolutegravir products cost in Hong Kong?
It depends on the product, strength and pack size. Each of the three dolutegravir products listed here shows its current prices in HKD or the currency you select.
Do I need a prescription to order Dolutegravir?
PockDose does not ask you to upload a prescription when you order dolutegravir. See the ordering FAQ for details.
What are the brand names for dolutegravir?
Tivicay is a brand name of dolutegravir. Here, dolutegravir can be bought online as generic Tivicay. These are generics, not the original brand.
Is dolutegravir taken once or twice a day?
It depends on the rest of the regimen. Dolutegravir is taken once or twice daily, at around the same times each day, and certain medicines taken alongside it call for the twice-daily schedule. Tivicay here comes as 50mg tablets.
What is the difference between Tivicay and Triumeq?
Tivicay contains dolutegravir alone, so it is taken with other HIV medicines chosen for the regimen. Triumeq packs dolutegravir, abacavir and lamivudine into one tablet, which means three medicines go in as a single dose.
Can I take dolutegravir with food?
Yes. A meal makes no difference to how much dolutegravir the body absorbs, so the tablet can be taken with breakfast, with dinner or between meals. Keeping to roughly the same time each day matters more than what is on the plate.
How long should I leave between dolutegravir and an antacid?
Two hours after or six hours before. That gap covers antacids, laxatives, multivitamins containing aluminium, magnesium or calcium, iron and calcium supplements, sucralfate and buffered medicines. When dolutegravir is taken with food, these products can be taken at the same time instead.
Can I stop dolutegravir once my viral load is undetectable?
No. An undetectable viral load means the treatment is holding the virus down, not that it has gone; the amount of HIV in the blood climbs again when dolutegravir is stopped or doses are skipped, and the virus can become harder to suppress. Staying on it also prevents passing HIV on through sex.