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Triumeq Drug Interactions

Triumeq Drug Interactions

This 3-in-1, once daily, antiretroviral medication contains the anti-HIV drugs Tivicay (dolutegravir) and Epzicom (abacavir and lamivudine). As per the Department of Health and Human Services HIV guidelines, these drugs are not sufficient to treat HIV-1 infection when used alone. They have to be combined with other antiretroviral agents or included in a single-tablet regimen (STR), like Triumeq, to be considered as a complete antiretroviral therapy (ART).


Triumeq (DTG/ABC/3TC) comes in a purple, biconvex, film-coated tablet form, debossed with the numbers 571 on one side. It contains 50mg dolutegravir, 600mg abacavir, and 300mg lamivudine. Other inactive substances include: magnesium stearate, D-mannitol, microcrystalline cellulose. Povidone K29/32, and sodium starch glycolate. The tablet coating is made of iron oxide black and red, macrogol/PEG. Polyvinyl alcohol (part hydrolyzed) talc, and titanium dioxide.

Antiretroviral drug interactions

There are hundreds of drugs, both generic and brand names, that are known to interact with Triumeq. Drug interactions are dangerous because it can result to significantly lower or higher amount of ART drugs in the blood, which can cause resistance and treatment failure. Some major drug interactions can be fatal. It is important to tell your healthcare provider all the drugs and substances you have used in the past and are currently taking to prevent major interactions with life-threatening effects. Drug interactions affect the absorption, distribution, metabolism, and elimination of antiretroviral agents. Triumeq may be administered with or without food. Absorption of dolutegravir (DTG) is moderately increased based on fat content.

List of drug interactions for Triumeq



No dose adjustment is necessary when co-administered with atazanavir or atazanavir + booster


Abacavir may enhance the effects of amprenavir but may not be an effective combination in people


There are no significant changes observed when used with darunavir/ritonavir or lopinavir/ritonavir


Dose must be adjusted to 50mg DTG twice a day in treatment-naïve patients or treatment-experienced patients.


Dose adjustments are not required if DTG is concurrently administered with atazanavir/ritonavir, darunavir/ritonavir, or lopinavir/ritonavir


DTG must be adjusted to 50mg twice daily in treatment-naïve patients or treatment-experienced patients.


May reduce DTG exposure; co-administration is not recommended because there are not enough data to make dosing recommendations


Reduces DTG concentration. Adjust dolutegravir to 50mg twice a day. Add a 50mg dose with 12 hours interval from Triumeq



Take Triumeq 2 hours before or 6 hours after an antacid containing magnesium, aluminum, iron, or calcium cations, as well as laxatives, sucralfate, oral iron or calcium supplements, and buffered medications.

Calcium channel blockers (amlodipine, diltiazem, verapamil, nifedipine, etc.)

May not have clinically significant interaction with Triumeq


Significantly reduces the concentration of DTG. Patients not previously treated with integrase inhibitors should take DTG 50mg twice daily

Corticosteroids (prednisone, dexamethasone, triamcinolone, etc)

Prednisone slightly increases DTG concentration but results are not clinically significant

H2 blockers (cimetidine,
famotidine, nizatidine, ranitidine, etc.)

No dosing adjustment required


No significant effect when administered with Triumeq. Small number of patients may need an increase in methadone dose.

Oral contraceptives

No significant adjustment required. 50mg DTG can be administered once or twice daily

PDE5 inhibitors (sildenafil, avanafil, tadalafil, vardenafil)

No interactions anticipated with these erectile dysfunction drugs


Requires a dose of 50mg DTG twice daily for integrase-naïve patients


Requires a dose of 50mg DTG twice daily for integrase-naïve patients

Proton pump inhibitors (esomeprazole, lansoprazole,
omeprazole, pantoprazole)

Safe to be administered together with Triumeq


No clinically significant interactions in integrase-naïve patients taking Triumeq


Adjust DTG to 50mg twice daily in treatment-naïve and treatment-experienced patients. Add a 50mg dose with 12 hours interval from Triumeq. Patients with INSTI resistance or suspected resistance must take alternatives to rifampin

**St. John’s Wort

Recommended dose adjustment is 50mg DTG twice daily for integrase-naïve patients.


No significant interactions anticipated


Consider reducing metformin dose when co-administered with Triumeq


Increases overall exposure to abacavir. No dosing adjustment required

Mycophenolic acid

May enhance antiviral effectiveness of abacavir but there are no sufficient data to validate the claim


*Contraindicated with Triumeq
**Avoid co-administration if dosing adjustment is not possible

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