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Triumeq
Triumeq is a combination medication used to treat HIV-1 infection in adults and certain pediatric patients. It contains three active ingredients: abacavir, dolutegravir, and lamivudine. These drugs belong to different classes of antiretrovirals and work together to suppress the replication of the HIV virus, helping to reduce the viral load in the body and prevent the progression of HIV to AIDS. Triumeq is typically part of a long-term antiretroviral therapy (ART) regimen.
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Frequently Asked Questions
Can I stop taking Triumeq if my viral load becomes undetectable?
No, it is important to continue taking Triumeq as prescribed, even if your viral load is undetectable. Stopping treatment can lead to viral rebound and resistance.
What should I do if I miss a dose of Triumeq?
If you miss a dose, take it as soon as you remember unless it is almost time for your next dose. Do not take two doses at once to make up for a missed dose.
Can I take Triumeq with food?
Yes, Triumeq can be taken with or without food. However, avoid taking it at the same time as antacids or supplements containing magnesium or aluminum.
Is Triumeq safe during pregnancy?
Triumeq can be used during pregnancy, but only if the potential benefits outweigh the risks. Pregnant women should consult with their healthcare provider about the safety of continuing the medication.
Can I drink alcohol while taking Triumeq?
It is recommended to avoid excessive alcohol consumption while taking Triumeq, as it can increase the risk of liver problems. Discuss alcohol use with your healthcare provider.
Comprehensive Drug Guide
How Does Triumeq Work?
- Dolutegravir: An integrase inhibitor that blocks the enzyme HIV integrase, which the virus needs to insert its genetic material into human DNA.
- Abacavir and Lamivudine: Both are nucleoside reverse transcriptase inhibitors (NRTIs) that block reverse transcriptase, an enzyme HIV uses to replicate. These drugs help prevent the virus from making copies of itself.
Common Dosages
- Abacavir (600 mg), Dolutegravir (50 mg), and Lamivudine (300 mg).
Typical Dosing
- The usual recommended dose of Triumeq is one tablet taken once daily, with or without food.
- Patients should be tested for the HLA-B*5701 allele before starting treatment due to the risk of severe hypersensitivity reactions with abacavir.
Typical Dosing
FDA Approved Indications
- Treatment of HIV-1 infection in adults and pediatric patients weighing at least 40 kg who have no known resistance to the components of the drug.
Who Shouldn't Take Triumeq?
- HLA-B*5701 positive status (due to the risk of life-threatening hypersensitivity reactions to abacavir).
- A history of hypersensitivity to abacavir, dolutegravir, or lamivudine.
- Moderate to severe liver disease.
- Concurrent use of the drug dofetilide, as it can cause dangerous interactions.
Advice From The Pharmacist
- Take Triumeq exactly as prescribed, at the same time each day. Missing doses can increase the risk of treatment failure and viral resistance.
- You may take the tablet with or without food.
- Ensure regular blood tests to monitor your HIV status and liver function while taking Triumeq.
- Keep all medications, including Triumeq, out of the reach of children.
- If you experience any symptoms of a hypersensitivity reaction (such as rash, fever, or shortness of breath), seek medical attention immediately.
Side Effects of Triumeq
Common Side Effects
- Headache
- Fatigue
- Nausea
- Diarrhea
- Trouble sleeping (insomnia)
Uncommon/Severe Side Effects
- Hypersensitivity reactions (fever, rash, respiratory symptoms)
- Liver problems, including liver failure (especially in individuals with hepatitis B or C)
- Lactic acidosis and severe liver enlargement (more common in women and obese patients)
Risks and Warnings of Triumeq
- Hypersensitivity Reaction: Patients should be tested for the HLA-B*5701 allele before starting treatment with Triumeq. If a hypersensitivity reaction occurs, discontinue the medication immediately and do not restart it, as this could lead to a life-threatening situation.
- Liver Toxicity: Triumeq can cause liver problems, particularly in individuals with pre-existing liver conditions or hepatitis B/C co-infection. Regular monitoring of liver function is recommended.
- Lactic Acidosis: NRTIs (abacavir and lamivudine) can rarely cause a buildup of lactic acid in the blood, which can be life-threatening. Symptoms include nausea, vomiting, or abdominal pain.
- Immune Reconstitution Syndrome: When starting antiretroviral therapy, patients may experience immune reconstitution syndrome, where their recovering immune system responds aggressively to previously undiagnosed infections.
Interactions with Triumeq
Common Drug Interactions
- Dofetilide: Concurrent use is contraindicated due to the risk of serious heart arrhythmias.
- Antacids and laxatives containing aluminum or magnesium: These can reduce the effectiveness of dolutegravir, one of the components of Triumeq. Separate dosing by at least 2 hours.
- Metformin: May require dose adjustment when taken with dolutegravir due to an increased risk of elevated blood glucose levels.
- Rifampin: Reduces the concentration of dolutegravir; dose adjustments may be required.
Alternatives to Triumeq
- Biktarvy: Another single-tablet regimen containing bictegravir, emtricitabine, and tenofovir alafenamide, used to treat HIV-1.
- Genvoya: A fixed-dose combination of elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide, also used for HIV-1.
- Dovato: A two-drug regimen (dolutegravir and lamivudine) for treating HIV in certain patients with no history of treatment resistance.
- Atripla: A combination of efavirenz, emtricitabine, and tenofovir used to treat HIV-1 infection.