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Abacavir/Dolutegravir/Lamivudine

    Brands

    DEA Class; Rx

    Common Brand Names; Triumeq, Triumeq PD

    • HIV, ART Combos

    Combination of nucleoside analogue reverse transcriptase inhibitors (abacavir and lamivudine) and an integrase strand transfer inhibitor (dolutegravir)
    For the treatment of human immunodeficiency virus (HIV-1) infection
    Black Box warnings for fatal hypersensitivity reactions and exacerbations of hepatitis B

    Indicated for the treatment of human immunodeficiency virus (HIV) infection.

    Presence of HLA-B*5701 allele

    Previous hypersensitivity reaction to abacavir, dolutegravir, or lamivudine

    Coadministration with dofetilide

    Moderate or severe hepatic impairment 

    • Lipase (4-9%)
    • Hyperglycemia (2-7%)
    • Creatinine kinase (4-5%)
    • Insomnia (3%)
    • Decreased neutrophils (2-3%)
    • Increased AST (<1 to 3%)
    • Headache (2%)
    • Fatigue (2%)
    • Increased ALT (<1 to 2%)
    • Depression (1%)
    • Abnormal dreams
    • Dizziness
    • Nausea
    • Diarrhea
    • Rash

    Cases of hepatic toxicity, including elevated serum liver biochemistries, hepatitis, and acute liver failure, reported in patients, including pediatric patients receiving a dolutegravir-containing regimen who had no pre-existing hepatic disease or other identifiable risk factors; drug-induced liver injury leading to liver transplant reported with therapy; monitoring for hepatotoxicity recommended

    Hepatic adverse events reported in patients receiving dolutegravir-containing regimens; patients with underlying hepatitis B or C may be at increased risk for worsening or development of transaminase elevations

    Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, reported with nucleoside analogues, including abacavir and lamivudine; suspend treatment if patient develops clinical or laboratory findings suggestive of lactic acidosis or pronounced hepatotoxicity, including hepatomegaly and steatosis even if marked transaminase elevations are absent

    An ongoing observational study showed an association between dolutegravir and increased risk of neural tube defects when dolutegravir was administered at the time of conception and in early pregnancy

    Different formulations of abacavir/dolutegravir/lamivudine are not interchangeable; adjust dose if pediatric patients switch from tablets for oral suspension to the tablets

    Dolutegravir has been shown to cross the placenta; insufficient data related to abacavir/dolutegravir/lamivudine use during pregnancy regarding drug-associated risk of birth defects and miscarriage

    The Centers for Disease Control and Prevention does not recommend HIV-1-infected mothers in the United States breastfeed their infants to avoid the risk of postnatal transmission of HIV-1 infection

    Adults

    1 Triumeq tablet per day PO (abacavir 600 mg/day PO; dolutegravir 50 mg/day PO; lamivudine 300 mg/day PO).

    Geriatric

    1 Triumeq tablet per day PO (abacavir 600 mg/day PO; dolutegravir 50 mg/day PO; lamivudine 300 mg/day PO).

    Adolescents

    weight 25 kg or more: 1 Triumeq tablet per day PO (abacavir 600 mg/day PO; dolutegravir 50 mg/day PO; lamivudine 300 mg/day PO).

    Children

    weight 25 kg or more: 1 Triumeq tablet per day PO (abacavir 600 mg/day PO; dolutegravir 50 mg/day PO; lamivudine 300 mg/day PO).
    weight 20 to 24 kg: 6 Triumeq PD tablets per day PO (abacavir 360 mg/day PO; dolutegravir 30 mg/day PO; lamivudine 180 mg/day PO).
    weight 14 to 19 kg: 5 Triumeq PD tablets per day PO (abacavir 300 mg/day PO; dolutegravir 25 mg/day PO; lamivudine 150 mg/day PO).
    weight 10 to 13 kg: 4 Triumeq PD tablets per day PO (abacavir 240 mg/day PO; dolutegravir 20 mg/day PO; lamivudine 120 mg/day PO).
    weight less than 10 kg: Safety and efficacy have not been established.

    Infants

    weight 10 to 13 kg: 4 Triumeq PD tablets per day PO (abacavir 240 mg/day PO; dolutegravir 20 mg/day PO; lamivudine 120 mg/day PO).
    weight less than 10 kg: Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Abacavir/dolutegravir/lamivudine

    tablet for oral use

    • 600mg/50mg/300mg