Dolutegravir Lamivudine Brand Name– Dovato
What is Dolutegravir Lamivudine
Dolutegravir lamivudine is a two-drug combination product that includes a human immunodeficiency virus type 1 (HIV-1) integrase strand transfer inhibitor (INSTI) and a nucleoside reverse transcriptase inhibitor (NRTI) in a single tablet that is administered once daily.
This combination product constitutes a complete treatment regimen and is indicated for the treatment of HIV-1 infection in adults with no antiretroviral treatment history and with no known or suspected substitutions associated with resistance to either drug.
The FDA approved package labeling contains a Black Box Warning regarding the potential for exacerbations of hepatitis B infections following lamivudine discontinuation in patients co-infected with hepatitis B and HIV.
Indications
- human immunodeficiency virus (HIV)
- human immunodeficiency virus (HIV) infection
NOTE: HIV guidelines recommend all women of child-bearing potential undergo pregnancy testing prior to initiation of a dolutegravir-containing regimen.
Side Effects
- abdominal pain
- abnormal dreams
- alopecia
- anaphylactoid reactions
- anemia
- angioedema
- anxiety
- arthralgia
- asthenia
- conjunctivitis
- depression
- diarrhea
- dizziness
- elevated hepatic enzymes
- eosinophilia
- fatigue
- fever
- flatulence
- headache
- hepatic failure
- hepatitis
- hepatitis B exacerbation
- hepatomegaly
- hepatotoxicity
- hyperbilirubinemia
- hyperglycemia
- hypophosphatemia
- insomnia
- lactic acidosis
- malaise
- myalgia
- nausea
- neutropenia
- pancreatitis
- paresthesias
- peripheral neuropathy
- pruritus
- rash
- rhabdomyolysis
- steatosis
- suicidal ideation
- teratogenesis
- thrombocytopenia
- urticaria
- vomiting
- weakness
- weight gain
- wheezing
Monitoring Parameters
- blood glucose
- CBC with differential
- CD4+ T cell count
- hepatitis B serology
- LFTs
- plasma hepatitis C RNA
- plasma HIV RNA
- pregnancy testing
- serum bilirubin (total and direct)
- serum cholesterol
- serum creatinine/BUN
- serum lipid profile
- urinalysis
Contraindications
- alcoholism
- autoimmune disease
- Black patients
- breast-feeding
- contraception requirements
- females
- geriatric
- Graves’ disease
- Guillain-Barre syndrome
- hepatic disease
- hepatitis B and HIV coinfection
- hepatitis B exacerbation
- hepatitis C and HIV coinfection
- hepatotoxicity or lactic acidosis
- Hispanic patients
- human immunodeficiency virus (HIV) infection resistance
- immune reconstitution syndrome
- obesity
- pregnancy
- pregnancy testing
- renal impairment
- reproductive risk
- serious rash
Interactions
- Acalabrutinib
- Adefovir
- Alogliptin; Metformin
- Aluminum Hydroxide
- Aluminum Hydroxide; Magnesium Carbonate
- Aluminum Hydroxide; Magnesium Hydroxide
- Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
- Aluminum Hydroxide; Magnesium Trisilicate
- Amiloride
- Amiloride; Hydrochlorothiazide, HCTZ
- Apalutamide
- Aprepitant, Fosaprepitant
- Armodafinil
- Atazanavir
- Atazanavir; Cobicistat
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Bexarotene
- Bictegravir; Emtricitabine; Tenofovir Alafenamide
- Bortezomib
- Bosentan
- Brigatinib
- Cabozantinib
- Calcium
- Calcium Acetate
- Calcium Carbonate
- Calcium Carbonate; Magnesium Hydroxide
- Calcium Carbonate; Risedronate
- Calcium Carbonate; Simethicone
- Calcium Chloride
- Calcium Gluconate
- Calcium; Vitamin D
- Canagliflozin; Metformin
- Capmatinib
- Carbamazepine
- Carvedilol
- Cenobamate
- Ceritinib
- Chromium
- Clobazam
- Cobicistat
- Conivaptan
- Daclatasvir
- Dalfampridine
- Dapagliflozin; Metformin
- Darolutamide
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dofetilide
- Donepezil; Memantine
- Duvelisib
- Echinacea
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Emtricitabine
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir alafenamide
- Emtricitabine; Tenofovir disoproxil fumarate
- Enzalutamide
- Ertugliflozin; Metformin
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Etravirine
- Fedratinib
- Felbamate
- food
- Fosamprenavir
- Fosphenytoin
- Fostamatinib
- Fostemsavir
- Glipizide; Metformin
- Glyburide; Metformin
- Hetastarch; Dextrose; Electrolytes
- Idelalisib
- Interferon Alfa-2b; Ribavirin
- Interferons
- Iron
- Iron Salts
- Isavuconazonium
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Itraconazole
- Letermovir
- Linagliptin; Metformin
- Lorlatinib
- Lumacaftor; Ivacaftor
- Magnesium Citrate
- Magnesium Hydroxide
- Magnesium Salts
- Memantine
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Mitotane
- Modafinil
- Nevirapine
- Ombitasvir; Paritaprevir; Ritonavir
- Oritavancin
- Orlistat
- Osimertinib
- Oxcarbazepine
- Phenobarbital
- Phentermine; Topiramate
- Phenytoin
- Polysaccharide-Iron Complex
- Primidone
- Procainamide
- Regorafenib
- Ribavirin
- Ribociclib
- Ribociclib; Letrozole
- Rifampin
- Sapropterin
- Sodium Ferric Gluconate Complex; ferric pyrophosphate citrate
- Sorafenib
- Sorbitol
- St. John’s Wort, Hypericum perforatum
- Sucralfate
- Tafamidis
- Tedizolid
- Telotristat Ethyl
- Temsirolimus
- Tipranavir
- Tolvaptan
- Topiramate
- Trospium
- Tucatinib
- Voriconazole
