Triumeq is a 3-in-1 combination tablet containing the FDA-approved antiretroviral drugs: dolutegravir, abacavir, and lamivudine. It is indicated for the treatment of HIV infection in adults and adolescents above 12 years of age and weighing at least 40kg. When taken properly and using the right dosage, Triumeq is generally well tolerated. However, you may still experience mild and temporary side effects such as nausea, headache, vomiting, or diarrhea. In clinical practice, there are a few cases of severe depression reported, but a strong correlation has not been established due to the lack of clinical and pharmacological studies to confirm it. If you experience depression, anxiety, and suicidal thoughts while taking this medication, call your health care provider immediately.
Before taking Triumeq
Being a fixed-dose tablet, the drug should not be taken if your case requires dose adjustment.
Before taking Triumeq, your doctor will request a blood test to check for the presence of what is called the HLAB*5701 gene. People with this gene mutation may have an allergic reaction to abacavir, which is one of the active ingredients of this medication. Testing positive means, you cannot use this combination pill.
Recommended dosage and method of administration
Triumeq is intended for oral use and can be taken with or without food. The recommended dose in adults and children over 12 years of age is one tablet once daily. The active ingredients in this regimen is also available in separate preparations. In case of dose adjustment or discontinuance of the drug due to side effects, your doctor may incorporate one of these drugs together with other anti-HIV pills.
- For adults and children
This drug has not been tested in children below 12 years of age. You should not take Triumeq if you are below 40 kilograms because the fixed dose tablet cannot be reduced.
- For the elderly
If you are 65 years and above, you may be prescribed with the same dose, but you must contact your health care provider if you experience any unusual or prolonged side effects.
- For patients with renal impairment
This drug should not be used in patients with a creatinine clearance of <50ml/min.
- For patients taking certain UGT1A or CYP3A inducers
The recommended dose for this group is 50mg twice daily. Your doctor may prescribe an additional 50mg dose of dolutegravir, with at least 12-hour interval from the usual Triumeq dose.
- For patients with moderate or severe liver impairment
Triumeq is not recommended for this patient group. Your doctor will suggest a suitable alternative for this treatment regimen as it can make your condition worse.
Missed doses and extra doses
In case you miss a dose of Triumeq and the next dose is not due within 4 hours, take the dose as soon as you remember it. If it’s almost time for your next dose, do not take the missed dose, and just take the next dose as scheduled. Always take Triumeq according to your doctor’s instructions. Call your doctor immediately if you take too much Triumeq. You may also contact your local poison control center or go to the nearest hospital.
Role of Triumeq on viral suppression
The goal of antiretroviral regimens like Triumeq is to reduce the patient’s viral load (copies of the virus in a milliliter of blood) until it becomes “undetectable.” When your viral load becomes undetectable, it means you have fewer than 50 copies of HIV in a milliliter of blood. This results to a healthier and longer life for patients, as well as reduced risk of transmitting the virus to HIV-negative individuals.
The PARTNER study reported a 0% transmission among heterosexual and MSM couples in which the infected partner has an undetectable viral load and who reported to engage in condomless sex for 1.3 years. In clinical trials, 88% of previously untreated patients have responded to Triumeq treatment after 48 weeks compared with 81% of patients who received Atripla.
If you are taking an old regimen that contains tenofovir, your doctor may advise you to switch to Triumeq because it contains a newer tenofovir derivative that will not affect kidney function. If the virus is kept at low levels in the blood, it may delay the progression of the disease and the development of conditions associated with AIDS by improving your immune function. The drugs in Triumeq are absorbed the same way as separate medications.