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Juluca
Juluca is a fixed-dose combination medication containing dolutegravir and rilpivirine. It is used for the treatment of HIV-1 infection in adults who are virologically suppressed (i.e., have a consistent low viral load). This medication is prescribed as part of a complete HIV treatment regimen and is particularly beneficial for patients looking for a simplified, once-daily dosing option. Juluca works by inhibiting the replication of the HIV virus, helping to maintain viral suppression.
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Frequently Asked Questions
How quickly does Juluca work?
Patients typically begin to see reductions in their viral load within a few weeks of starting Juluca, although it is important to continue treatment as prescribed for long-term viral suppression.
Can I take Juluca with food?
Yes, Juluca can be taken with or without food. However, it is best to take it consistently the same way each day.
What should I do if I miss a dose of Juluca?
If you miss a dose, take it as soon as you remember on the same day. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses.
Is Juluca safe to use during pregnancy?
The safety of Juluca during pregnancy is not fully established. Consult your healthcare provider for personalized guidance if you are pregnant or planning to become pregnant.
Can I stop taking Juluca once my viral load is undetectable?
No, it is important to continue taking Juluca as prescribed even if your viral load becomes undetectable, as discontinuing treatment can lead to viral rebound and resistance. Always consult your healthcare provider before making any changes to your treatment regimen.
Comprehensive Drug Guide
How Does Juluca Work?
- Dolutegravir works by inhibiting the integrase enzyme that HIV uses to insert its genetic material into the host cell's DNA. This prevents the virus from replicating and producing new virus particles.
- Rilpivirine inhibits the reverse transcriptase enzyme, which is essential for converting viral RNA into DNA. By blocking this enzyme, rilpivirine helps to prevent the virus from replicating.
Together, these mechanisms effectively reduce the viral load in patients living with HIV-1.
Common Dosages
- 1 tablet taken once daily, with or without food.
Typical Dosing
- For HIV-1 treatment: The standard dosing is 1 tablet of Juluca daily. It is essential to take it at the same time each day to maintain consistent drug levels in the body.
Typical Dosing
FDA Approved Indications
- Treatment of HIV-1 infection in adults who are virologically suppressed on a stable antiretroviral regimen for at least 6 months with no history of treatment failure and no known resistance to either dolutegravir or rilpivirine.
Who Shouldn't Take Juluca?
- Hypersensitivity or allergy to dolutegravir, rilpivirine, or any components of the formulation.
- Concurrent use of certain medications that can significantly affect the levels of dolutegravir or rilpivirine, such as strong inducers of CYP3A.
Advice From The Pharmacist
- Take Juluca exactly as prescribed: Follow your healthcare provider's instructions regarding dosing and timing. Do not skip doses or stop taking the medication without consulting your provider.
- Monitor for side effects: Common side effects include headache, fatigue, and gastrointestinal discomfort. Report any severe or unusual symptoms to your healthcare provider.
- Regular follow-up: Routine monitoring of your viral load and CD4 count is important to assess the effectiveness of the treatment.
- Store Juluca at room temperature, away from moisture and heat, and keep it out of reach of children.
Side Effects of Juluca
Common Side Effects
- Headache
- Nausea
- Diarrhea
- Fatigue
- Insomnia
Uncommon/Severe Side Effects
- Severe allergic reactions (e.g., rash, swelling, difficulty breathing)
- Liver problems: Symptoms may include jaundice (yellowing of the skin or eyes), dark urine, or abdominal pain.
- Depression or mood changes: Monitor for any significant changes in mood or behavior.
Risks and Warnings of Juluca
- Liver Function: Liver function tests should be monitored regularly during treatment, particularly in patients with a history of liver disease.
- Drug Interactions: Inform your healthcare provider about all medications, supplements, and over-the-counter products you are taking, as Juluca can interact with various drugs.
- Mental Health: Be aware of potential mood changes or depression. Report any concerning symptoms to your healthcare provider.
Interactions with Juluca
Common Drug Interactions
- Strong CYP3A inducers: Such as rifampin, which may reduce the effectiveness of rilpivirine.
- Antacids or supplements containing aluminum, magnesium, or calcium: These can interfere with the absorption of rilpivirine. It is advised to take Juluca at least 2 hours before or 4 hours after these products.
Alternatives to Juluca
- Other antiretroviral therapies: Patients may consider alternative regimens that include different combinations of ARTs based on their viral load, treatment history, and potential drug interactions.
- Single-tablet regimens: Similar combinations of other antiretroviral medications that are taken once daily, such as Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide) or Triumeq (dolutegravir/abacavir/lamivudine).
