WARNING

Dolutegravir and lamivudine are both antiretroviral drugs used to treat HIV/AIDS. While they are generally effective and well-tolerated, like any medication, they carry potential risks. Here are some of the risks associated with taking them:

• Drug Interactions: Both drugs can interact with other medications, potentially reducing their effectiveness or causing harmful side effects. It’s essential to inform your healthcare provider about all medications you’re taking to avoid such interactions.
• Allergic Reactions: Some individuals may experience allergic reactions to either dolutegravir or lamivudine, which can range from mild to severe and require immediate medical attention.
• Side Effects: Common side effects of dolutegravir include headache, insomnia, and nausea, while lamivudine may cause nausea, diarrhea, and fatigue. These side effects usually diminish over time but can be bothersome for some individuals.
• Resistance: Taking dolutegravir and lamivudine alone without other antiretroviral drugs can potentially lead to the development of drug resistance, making future treatment less effective.
• Liver and Kidney Toxicity: Both drugs can affect liver and kidney function, particularly in individuals with pre-existing liver or kidney conditions. Regular monitoring of liver and kidney function is essential during treatment.
• Lactic Acidosis: Lamivudine, along with other nucleoside reverse transcriptase inhibitors (NRTIs), has been associated with a rare but serious condition called lactic acidosis, which involves the buildup of lactic acid in the bloodstream.
• Bone Health: Some research suggests that long-term use of certain antiretroviral drugs, including dolutegravir, may be associated with bone density loss and an increased risk of fractures.

It’s crucial to discuss these risks with your healthcare provider before starting treatment with dolutegravir and lamivudine. They can help you weigh the potential benefits against the risks and monitor you for any adverse effects during treatment.

Why is this medication prescribed?

Dolutegravir and Lamivudine are commonly prescribed medications used in the treatment of HIV infection.

Dolutegravir belongs to a class of drugs called integrase inhibitors. It works by blocking the action of an enzyme called integrase, which HIV needs to multiply. By inhibiting this enzyme, dolutegravir helps to reduce the amount of HIV in the body, slowing down the progression of the disease.

Lamivudine is a nucleoside reverse transcriptase inhibitor (NRTI). It works by interfering with the enzyme reverse transcriptase, which is necessary for the HIV virus to replicate. By inhibiting this enzyme, lamivudine helps to prevent the virus from multiplying and spreading in the body.

Dolutegravir and Lamivudine are often prescribed together as a fixed-dose combination therapy for HIV infection. This combination therapy is known to be highly effective in suppressing HIV viral load and improving immune function.

How should this medicine be used?

Dolutegravir and Lamivudine are typically prescribed together as part of combination therapy for the treatment of HIV/AIDS. Here’s how they should be used:

• Dosage: The recommended dosage of Dolutegravir is usually 50 mg once daily, and for Lamivudine, it’s typically 300 mg once daily. However, dosage may vary based on individual factors such as other medications being taken and the patient’s overall health condition.
• Administration: Both medications are available in tablet form and are taken orally. They can be taken with or without food, but it’s essential to take them consistently at the same time each day to maintain steady levels of the drugs in the body.
• Combination Therapy: Dolutegravir and Lamivudine are often prescribed together as a fixed-dose combination tablet, which contains both medications in the correct doses. This simplifies the dosing regimen and ensures that both drugs are taken together as part of a comprehensive HIV treatment plan.
• Follow Healthcare Provider’s Instructions: It’s crucial to follow the dosage instructions provided by your healthcare provider exactly. Do not skip doses or stop taking the medication without consulting your doctor first, as this can lead to treatment failure and the development of drug resistance.
• Monitoring: Your healthcare provider will monitor your progress regularly while taking Dolutegravir and Lamivudine. This may include blood tests to check HIV viral load and CD4 cell count, as well as monitoring for any side effects or complications.
• Adherence: Adhering to your prescribed treatment regimen is essential for the success of HIV therapy. Missing doses or not taking the medications as directed can lead to treatment failure and the development of drug resistance.
• Consultation: Always communicate with your healthcare provider if you have any questions, concerns, or experience any side effects while taking Dolutegravir and Lamivudine. They can provide guidance, support, and adjustments to your treatment plan as needed to ensure the best possible outcomes.

Remember, Dolutegravir is not a cure for HIV, but it’s a crucial component of HIV management when used as part of a comprehensive treatment plan. If you have any questions or concerns about how to use Dolutegravir or its potential side effects, be sure to discuss them with your healthcare provider.

Other uses for this medicine

Some potential off-label uses for these medications may include:

• Prevention of HIV Transmission: Dolutegravir and lamivudine may be used as part of pre-exposure prophylaxis (PrEP) to prevent HIV transmission in individuals at high risk of acquiring the virus.
• Hepatitis B Virus (HBV) Infection: Lamivudine is also approved for the treatment of chronic hepatitis B virus infection, either alone or in combination with other antiviral medications.
• Antiretroviral Therapy in Pregnancy: Dolutegravir and lamivudine are considered safe and effective for use during pregnancy and are recommended as part of antiretroviral therapy to prevent mother-to-child transmission of HIV.

What special precautions should I follow?

Special precautions should be taken when using dolutegravir and lamivudine, including:

• Liver and Kidney Function: These medications can affect liver and kidney function. Your healthcare provider may perform regular tests to monitor your liver and kidney function while taking dolutegravir and lamivudine, especially if you have pre-existing liver or kidney conditions.
• Drug Interactions: Dolutegravir and lamivudine can interact with other medications, including over-the-counter drugs and herbal supplements. It’s essential to inform your healthcare provider about all medications you are taking to avoid potential interactions.
• Allergic Reactions: Some individuals may experience allergic reactions to dolutegravir or lamivudine. If you develop symptoms such as rash, itching, swelling, or difficulty breathing, seek medical attention immediately.
• Pregnancy and Breastfeeding: If you are pregnant or breastfeeding, discuss the risks and benefits of taking dolutegravir and lamivudine with your healthcare provider. These medications are generally considered safe during pregnancy and breastfeeding, but your healthcare provider will monitor you and your baby closely.
• Resistance: Taking dolutegravir and lamivudine as prescribed and adhering to your treatment regimen is essential to prevent the development of drug resistance. Do not skip doses or stop taking the medications without consulting your healthcare provider.
• Side Effects: Like all medications, dolutegravir and lamivudine can cause side effects. Common side effects may include headache, nausea, diarrhea, and fatigue. If you experience any bothersome or persistent side effects, contact your healthcare provider.

What special dietary instructions should I follow?

• Food: Dolutegravir and Lamivudine can be taken with or without food. You can take them with a meal or on an empty stomach, whichever is more convenient for you.
• Grapefruit: Avoid consuming grapefruit or grapefruit juice while taking Dolutegravir and Lamivudine, as it may interact with the medications and affect their effectiveness.

What should I do if I forget a dose?

• Take it as soon as you remember: If you miss a dose of Dolutegravir and Lamivudine, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the regular time.
• Do not double dose: Do not take a double dose to make up for a missed one. Taking too much medication at once can increase the risk of side effects and complications.
• Follow-up with your healthcare provider: If you frequently forget doses or have difficulty adhering to your treatment regimen, discuss this with your healthcare provider. They can provide strategies to help you remember your medication or adjust your treatment plan if necessary.

What side effects can this medication cause?

Dolutegravir and Lamivudine, like any medication, can cause side effects. It’s important to note that not everyone will experience these side effects, and their severity can vary from person to person. Some common side effects associated with Dolutegravir and Lamivudine may include:

• Nausea or vomiting
• Diarrhea
• Headache
• Insomnia (difficulty sleeping) or abnormal dreams
• Dizziness or lightheadedness
• Fatigue or weakness
• Rash or skin reactions
• Abnormal liver function tests
• Changes in body fat distribution (lipodystrophy)
• Elevated blood sugar levels (hyperglycemia)
• Changes in blood cell counts (anemia, neutropenia)

These side effects are usually mild to moderate and tend to improve as the body adjusts to the medication. However, if any of these side effects persist or worsen, it’s essential to inform your healthcare provider promptly.

In some cases, Dolutegravir has been associated with more serious side effects, such as hypersensitivity reactions (including rash, fever, and liver problems), psychiatric symptoms (such as depression or suicidal thoughts), and rare but severe skin reactions (such as Stevens-Johnson syndrome or toxic epidermal necrolysis). These reactions are uncommon but require immediate medical attention if they occur.

Lamivudine may also rarely cause severe liver problems, lactic acidosis (a buildup of lactic acid in the blood), and severe allergic reactions.

It’s crucial to report any unusual or severe symptoms to your healthcare provider immediately, as they may indicate a serious reaction or complication that requires prompt medical attention. Additionally, always follow your healthcare provider’s instructions regarding the use of Dolutegravir and Lamivudine and inform them of any other medications or supplements you are taking to avoid potential interactions.

What should I know about storage and disposal of this medication?

When it comes to storing and disposing of Dolutegravir and Lamivudine, here’s what you should know:

Storage:

• • Store both medications at room temperature, away from moisture and heat.
  • Keep them in their original packaging or container to protect them from light.
  • Do not store Dolutegravir and Lamivudine in the bathroom or kitchen, where they may be exposed to moisture and humidity.

Disposal:

• • Dispose of any unused or expired medication properly according to local guidelines or regulations.
  • Do not flush Dolutegravir and Lamivudine down the toilet or pour them down the drain unless instructed to do so by your pharmacist or local waste management authorities.
  • Consult your pharmacist or healthcare provider for guidance on the proper disposal of unused medications.

In case of emergency/overdose

• If you suspect an overdose of Dolutegravir and Lamivudine, seek immediate medical attention or contact your local poison control center.
• Symptoms of overdose may include severe dizziness, fainting, rapid or irregular heartbeat, and difficulty breathing.

What other information should I know?

• Follow-up Appointments: Attend all scheduled follow-up appointments with your healthcare provider to monitor your progress and response to treatment.
• Lab Tests: Your healthcare provider may order regular blood tests to monitor your liver and kidney function, as well as your viral load and CD4 cell count.
• Adherence: Adhere to your prescribed treatment regimen and take Dolutegravir and Lamivudine exactly as directed by your healthcare provider. Missing doses or stopping treatment prematurely can lead to treatment failure and the development of drug resistance.
• Medical Alert: Inform all healthcare providers involved in your care, including dentists and specialists, that you are taking Dolutegravir and Lamivudine.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of Dolutegravir and Lamivudine with your healthcare provider. These medications are generally considered safe during pregnancy and breastfeeding, but close monitoring is essential.
• Drug Interactions: Inform your healthcare provider about all medications, supplements, and herbal products you are taking, as Dolutegravir and Lamivudine can interact with other drugs.

Always consult your healthcare provider or pharmacist if you have any questions or concerns about Dolutegravir and Lamivudine or their use. They can provide personalized advice and guidance based on your individual needs and circumstances.