Dolutegravir Rilpivirine

Dolutegravir Rilpivirine Brand Name– JULUCA

What is Dolutegravir Rilpivirine

Dolutegravir rilpivirine is a two-drug combination of dolutegravir, a human immunodeficiency virus type 1 (HIV-1) integrase strand transfer inhibitor (INSTI), and rilpivirine, a HIV-1 non-nucleoside reverse transcriptase inhibitor (NNRTI), is indicated as a complete regimen for the treatment of HIV-1 infection in adults to replace the current antiretroviral regimen in those who are virologically suppressed (HIV-1 RNA less than 50 copies per mL) on a stable antiretroviral regimen for at least 6 months with no history of treatment failure and no known substitutions associated with resistance to the individual components.

Potential side effects associated with treatment include severe skin reactions, hepatotoxicity, and depressive disorders

Indications

1. human immunodeficiency virus (HIV)
2. human immunodeficiency virus (HIV) infection

NOTE: HIV guidelines recommend consideration be given to avoiding use of rilpivirine-containing regimens in patients with pre-existing psychiatric illnesses or prolongation of the QTc interval.

NOTE: HIV guidelines recommend all women of child-bearing potential undergo pregnancy testing prior to initiation of a dolutegravir-containing regimen.

Side Effects

1. abdominal pain
2. abnormal dreams
3. adrenocortical insufficiency
4. anxiety
5. arthralgia
6. cholecystitis
7. cholelithiasis
8. depression
9. diarrhea
10. dizziness
11. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
12. dysphoria
13. elevated hepatic enzymes
14. fatigue
15. flatulence
16. glomerulonephritis
17. headache
18. hepatic failure
19. hepatitis
20. hyperbilirubinemia
21. hyperglycemia
22. insomnia
23. myalgia
24. nausea
25. nephrolithiasis
26. nephrotic syndrome
27. pruritus
28. rash
29. suicidal ideation
30. teratogenesis
31. vomiting
32. weight gain

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
• serum lipid profile
• urinalysis

Contraindications

• alcoholism
• autoimmune disease
• Black patients
• bradycardia
• breast-feeding
• cardiac arrhythmias
• cardiac disease
• children
• contraception requirements
• coronary artery disease
• depression
• diabetes mellitus
• females
• geriatric
• Graves’ disease
• Guillain-Barre syndrome
• heart failure
• hepatic disease
• hepatitis B and HIV coinfection
• hepatitis C and HIV coinfection
• Hispanic patients
• human immunodeficiency virus (HIV) infection resistance
• hypertension
• hypocalcemia
• hypokalemia
• hypomagnesemia
• immune reconstitution syndrome
• infants
• long QT syndrome
• malnutrition
• myocardial infarction
• neonates
• pregnancy
• pregnancy testing
• QT prolongation
• renal failure
• reproductive risk
• serious rash
• suicidal ideation
• thyroid disease

Interactions

• Abarelix
• Acalabrutinib
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Aclidinium; Formoterol
• Adefovir
• Albuterol
• Albuterol; Ipratropium
• Aldesleukin, IL-2
• Alfuzosin
• Alogliptin; Metformin
• Aluminum Hydroxide
• Aluminum Hydroxide; Magnesium Carbonate
• Aluminum Hydroxide; Magnesium Hydroxide
• Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
• Aluminum Hydroxide; Magnesium Trisilicate
• Amiodarone
• Amitriptyline
• Amitriptyline; Chlordiazepoxide
• Amobarbital
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Anagrelide
• Antacids
• Apalutamide
• Apomorphine
• Aprepitant, Fosaprepitant
• Arformoterol
• Aripiprazole
• Armodafinil
• Arsenic Trioxide
• Artemether; Lumefantrine
• Asenapine
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Omeprazole
• Atazanavir
• Atazanavir; Cobicistat
• Atomoxetine
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Azithromycin
• Bedaquiline
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Bepridil
• Bexarotene
• Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Boceprevir
• Bosentan
• Brigatinib
• Budesonide; Formoterol
• Buprenorphine
• Buprenorphine; Naloxone
• Butabarbital
• 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
• Chloramphenicol
• Chloroquine
• Chlorpromazine
• Chromium
• Cimetidine
• Ciprofloxacin
• Cisapride
• Citalopram
• Clarithromycin
• Class IA Antiarrhythmics
• Clobazam
• Clofazimine
• Clomipramine
• Clozapine
• Cobicistat
• Codeine; Phenylephrine; Promethazine
• Codeine; Promethazine
• Conivaptan
• Crizotinib
• Dabrafenib
• Daclatasvir
• Dalfampridine
• Danazol
• Dapagliflozin; Metformin
• Darolutamide
• Darunavir
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Dasatinib
• Degarelix
• Delavirdine
• Desflurane
• Desipramine
• Deutetrabenazine
• Dexamethasone
• Dexlansoprazole
• Dextromethorphan; Promethazine
• Dextromethorphan; Quinidine
• Didanosine, ddI
• Diltiazem
• Disopyramide
• Dofetilide
• Dolasetron
• Donepezil
• Donepezil; Memantine
• Doxepin
• Dronedarone
• Droperidol
• Duvelisib
• Efavirenz
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Elagolix
• Elagolix; Estradiol; Norethindrone acetate
• Eliglustat
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Encorafenib
• Enflurane
• Entrectinib
• Enzalutamide
• Eribulin
• Ertugliflozin; Metformin
• Erythromycin
• Erythromycin; Sulfisoxazole
• Escitalopram
• Eslicarbazepine
• Esomeprazole
• Esomeprazole; Naproxen
• Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
• Ethinyl Estradiol; Norethindrone; Ferrous fumarate
• Etravirine
• Ezogabine
• Famotidine
• Famotidine; Ibuprofen
• Fedratinib
• Felbamate
• Fingolimod
• Flecainide
• Fluconazole
• Fluoxetine
• Fluoxetine; Olanzapine
• Fluphenazine
• Flutamide
• Fluticasone; Salmeterol
• Fluticasone; Umeclidinium; Vilanterol
• Fluticasone; Vilanterol
• Fluvoxamine
• food
• Formoterol
• Formoterol; Mometasone
• Fosamprenavir
• Foscarnet
• Fosphenytoin
• Fostamatinib
• Fostemsavir
• Gemifloxacin
• Gemtuzumab Ozogamicin
• Gilteritinib
• Glasdegib
• Glipizide; Metformin
• Glyburide; Metformin
• Glycopyrrolate; Formoterol
• Goserelin
• Granisetron
• grapefruit juice
• Halofantrine
• Halogenated Anesthetics
• Haloperidol
• Halothane
• Hetastarch; Dextrose; Electrolytes
• Histrelin
• Hydroxychloroquine
• Hydroxyzine
• Ibutilide
• Idelalisib
• Iloperidone
• Imatinib
• Imipramine
• Indacaterol
• Indacaterol; Glycopyrrolate
• Indinavir
• Inotuzumab Ozogamicin
• Interferon Alfa-2a
• Interferon Alfa-2b
• Interferon Alfa-2b; Ribavirin
• Interferon Alfa-n3
• Interferon Alfacon-1
• Interferon Beta-1a
• Interferon Beta-1b
• Interferon Gamma-1b
• Interferons
• Iron
• Iron Salts
• Isavuconazonium
• Isoflurane
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Itraconazole
• Ivosidenib
• Ketoconazole
• Lansoprazole
• Lansoprazole; Naproxen
• Lapatinib
• Lefamulin
• Lenvatinib
• Lesinurad
• Lesinurad; Allopurinol
• Letermovir
• Leuprolide
• Leuprolide; Norethindrone
• Levalbuterol
• Levofloxacin
• Levomethadyl
• Linagliptin; Metformin
• Lithium
• Lofexidine
• Long-acting beta-agonists
• Loperamide
• Loperamide; Simethicone
• Lopinavir; Ritonavir
• Lorlatinib
• Lumacaftor; Ivacaftor
• Lumacaftor; Ivacaftor
• Macimorelin
• Magnesium Citrate
• Magnesium Hydroxide
• Magnesium Salts
• Maprotiline
• Mefloquine
• Meperidine; Promethazine
• Mephobarbital
• Mesoridazine
• Metaproterenol
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methadone
• Methohexital
• Metronidazole
• Midostaurin
• Mifepristone
• Mirtazapine
• Mitotane
• Modafinil
• Moxifloxacin
• Nafcillin
• Nefazodone
• Nelfinavir
• Nevirapine
• Nicardipine
• Nilotinib
• Nizatidine
• Norfloxacin
• Nortriptyline
• Octreotide
• Ofloxacin
• Olanzapine
• Olodaterol
• Ombitasvir; Paritaprevir; Ritonavir
• Omeprazole
• Omeprazole; Amoxicillin; Rifabutin
• Omeprazole; Sodium Bicarbonate
• Ondansetron
• Oritavancin
• Osilodrostat
• Osimertinib
• Oxaliplatin
• Oxcarbazepine
• Ozanimod
• Paliperidone
• Panobinostat
• Pantoprazole
• Pasireotide
• Pazopanib
• Peginterferon Alfa-2a
• Peginterferon Alfa-2b
• Peginterferon beta-1a
• Pentamidine
• Pentobarbital
• Perphenazine
• Perphenazine; Amitriptyline
• Phenobarbital
• Phentermine; Topiramate
• Phenylephrine; Promethazine
• Phenytoin
• Pimavanserin
• Pimozide
• Pirbuterol
• Pitolisant
• Polysaccharide-Iron Complex
• Posaconazole
• Primaquine
• Primidone
• Procainamide
• Prochlorperazine
• Promethazine
• Propafenone
• Proton pump inhibitors
• Protriptyline
• Quetiapine
• Quinidine
• Quinine
• Rabeprazole
• Ranitidine
• Ranolazine
• Regorafenib
• Ribavirin
• Ribociclib
• Ribociclib; Letrozole
• Rifabutin
• Rifampin
• Rifapentine
• Risperidone
• Romidepsin
• Salmeterol
• Sapropterin
• Saquinavir
• Secobarbital
• Selpercatinib
• Sertraline
• Sevoflurane
• Short-acting beta-agonists
• Siponimod
• Sodium Bicarbonate
• Sodium Ferric Gluconate Complex; ferric pyrophosphate citrate
• Solifenacin
• Sorafenib
• Sotalol
• St. John’s Wort, Hypericum perforatum
• Sucralfate
• Sunitinib
• Tacrolimus
• Tafamidis
• Tamoxifen
• Tedizolid
• Telavancin
• Telithromycin
• Telotristat Ethyl
• Temsirolimus
• Terbutaline
• Tetrabenazine
• Thiopental
• Thioridazine
• Ticagrelor
• Tiotropium; Olodaterol
• Tipranavir
• Tolterodine
• Tolvaptan
• Topiramate
• Toremifene
• Trandolapril; Verapamil
• Trazodone
• Triclabendazole
• Tricyclic antidepressants
• Trifluoperazine
• Trimipramine
• Triptorelin
• Tucatinib
• Umeclidinium; Vilanterol
• Vandetanib
• Vardenafil
• Vemurafenib
• Venlafaxine
• Verapamil
• Voriconazole
• Vorinostat
• Zafirlukast
• Ziprasidone