How does the dolutegravir component of Triumeq affect metformin concentrations?

Dolutegravir in Triumeq increases metformin concentrations; consider metformin dose adjustment when starting or stopping coadministration, monitor renal function, and strongly consider metformin dose reduction in moderate renal impairment (CrCl 45–59 mL/min), where lactic acidosis risk may increase.