dolutegravir sodium + rilpivirine hydrochloride at a glance
Medicine class
Integrase strand-transfer inhibitor plus non-nucleoside reverse-transcriptase inhibitor
Usual role
Maintenance treatment for selected adults with virologically suppressed HIV-1
Food
Take with a meal; a protein-rich nutritional drink alone is insufficient
Interaction check
Acid-reducing treatments, mineral supplements and several enzyme-inducing medicines can substantially affect treatment
What is dolutegravir sodium + rilpivirine hydrochloride used for?
Licensed as a complete HIV-1 treatment for adults who are already virologically suppressed on stable antiretroviral treatment, with no previous virological failure or known or suspected resistance to integrase inhibitors or non-nucleoside reverse-transcriptase inhibitors.
Maintenance of HIV-1 suppression after switching from a suitable stable regimen
How does dolutegravir sodium + rilpivirine hydrochloride work?
Dolutegravir blocks HIV integrase, preventing viral DNA from being inserted into human-cell DNA. Rilpivirine blocks HIV-1 reverse transcriptase, disrupting viral DNA production. Together they reduce HIV replication but do not cure HIV.
dolutegravir sodium + rilpivirine hydrochloride preparations and strengths
Tablet
Route: Oral
Strengths: 50 mg + 25 mg
How to take dolutegravir sodium + rilpivirine hydrochloride
Follow the HIV specialist’s instructions.
Take with a proper meal because food is needed for reliable rilpivirine absorption.
Swallow the film-coated tablet whole with water; do not chew or crush it.
Check with a pharmacist or HIV clinic before starting any prescription, non-prescription or herbal product.
dolutegravir sodium + rilpivirine hydrochloride side effects
Common or expected effects
- Headache or dizziness
- Nausea, diarrhoea or abdominal discomfort
- Difficulty sleeping, abnormal dreams or sleepiness
- Low mood, anxiety or depression
- Tiredness
- Rash or itching
- Changes in weight, cholesterol, triglycerides, glucose or liver-test results
Get urgent medical advice
- Severe allergic reaction, including extensive rash, blisters, mouth sores or facial swelling
- Liver inflammation or failure, potentially causing jaundice, dark urine or severe tiredness
- Suicidal thoughts or behaviour, particularly with previous psychiatric illness
- Inflammatory symptoms caused by immune reconstitution
dolutegravir sodium + rilpivirine hydrochloride in pregnancy
The fixed combination is not recommended during pregnancy because exposure to both components can fall and the combination has not been adequately studied. Current evidence about dolutegravir and birth defects is reassuring, but anyone pregnant or planning pregnancy should obtain prompt specialist review.
dolutegravir sodium + rilpivirine hydrochloride while breastfeeding
Product information recommends not breastfeeding because HIV can pass through breast milk. Dolutegravir enters milk in small amounts, while information about rilpivirine is limited. NHS information describes formula feeding as safest, although specialist-supported breastfeeding with detailed monitoring may be possible for some people with an undetectable viral load.
dolutegravir sodium + rilpivirine hydrochloride interactions
The HIV clinic or pharmacist should check all medicines, supplements and herbal products. Important examples include:
Proton-pump inhibitors, including omeprazole, lansoprazole and pantoprazole
Contraindicated because they can substantially reduce rilpivirine absorption and risk loss of HIV control.
H2-receptor antagonists, including famotidine
Must be separated because they can reduce rilpivirine absorption; follow specialist timing instructions.
Antacids containing aluminium, magnesium or calcium
Can reduce absorption and must be separated as directed by the HIV clinic or pharmacist.
Common questions about dolutegravir sodium + rilpivirine hydrochloride
Answers are fully visible for fast scanning and source review.
What is dolutegravir sodium + rilpivirine hydrochloride used for?
It maintains HIV-1 suppression in selected adults switching from a suitable stable regimen; it is not intended for untreated or unsuppressed HIV.
Does it cure HIV?
No. It suppresses HIV replication.
Why must it be taken with food?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.