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AIDS and HIV Information

AIDS and HIV Information

What is Triumeq? Ingredients and Dosage


What is Triumeq?

Triumeq is a single-tablet regimen (STR) approved by the US Food and Drug Administration for the treatment of HIV-1 infection in adults and children weighing at least 40kgs (88lbs). It contains a combination of 2 nucleoside analogue reverse transcriptase inhibitors abacavir and lamivudine, and an integrase strand transfer inhibitor (INSTI) dolutegravir.
At the time of this writing, there are currently 7 once-daily, complete single-pill regimen approved by the FDA to treat HIV-infected patients. Triumeq was the fourth STR to be granted approval in 2014. The advent of combination antiretroviral therapies (ART) significantly improved patient survival and minimizes viral resistance. The newest update from the Department of Health and Human Services guideline recommends that all HIV-infected individuals must begin ART, regardless of CD4 cell count. Single-pill regimens may provide beneficial effects on patients:

  • Who have not received antiretroviral medications in the past;
  • Who would like to reduce pill burden from the same or similar individual HIV medications;
  • Who would like to shift from a complicated or poorly-tolerated regimen and have not developed resistance to any of the components of these STRs.

Components

Active ingredients:

  • Dolutegravir – is an integrase inhibitor that interferes with HIV replication.
  • Abacavir – a nucleotide analogue reverse transcriptase inhibitor that blocks the viral enzyme reverse transcriptase from converting RNA into DNA.
  • Lamivudine – a nucleotide analogue that inhibits reverse transcription of HIV by terminating the viral DNA chain.

Inactive ingredients:

D-mannitol, magnesium stearate, microcrystalline cellulose, povidone, and sodium starch glycolate.

Tablet film-coating ingredients:

Iron oxide black, iron oxide red, macrogol/PEG, polyvinyl alcohol–part hydrolyzed, talc, and titanium oxide.

Recommended Dosage

Triumeq (dolutegravir/abacavir/lamivudine) is available in a 30-tablet bottle. Each pill contains 600mg abacavir sulfate (ABC), 50mg dolutegravir (DTG), and 300mg lamivudine. (3TC). Patients without known HIV resistance to any components of Triumeq must take 1 tablet once a day, with or without food. The presence of abacavir requires hypersensitivity pretreatment testing. Being a complete ARV regimen, it should not be combined with other HIV medications that contain any of its active ingredients.

How does Triumeq work?

The combination of dolutegravir (marketed as Tivicay), abacavir (Ziagen), and lamivudine (Epivir) has done well in many clinical trials in terms of potency and tolerability. Dolutegravir itself has no major disadvantage. People who have used DTG as an initial regimen have not exhibited resistance to the drug.
Dolutegravir works by inhibiting the HIV enzyme integrase, which occurs when its active metabolite binds to the integrase active site and blocks the strand transfer stage of retroviral DNA integration. Carbovir triphosphate, the active metabolite of abacavir, inhibits the activity of HIV-1 enzyme reverse transcriptase. Lamivudine is introduced within cells to be converted into its metabolite, lamivudine triphosphate. It works by inhibiting the activity of reverse transcriptase through DNA chain termination.

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