doravirine + lamivudine + tenofovir disoproxil fumarate at a glance
Medicine class
An NNRTI combined with two nucleoside/nucleotide reverse transcriptase inhibitors.
Main use
HIV-1 treatment when there is no past or present relevant resistance.
Food
May be taken with or without food.
What is doravirine + lamivudine + tenofovir disoproxil fumarate used for?
UK-licensed uses are:
HIV-1 infection in adults without past or present evidence of resistance to the NNRTI class, lamivudine or tenofovir.
HIV-1 infection in adolescents aged at least 12 years and weighing at least 35 kg, without relevant resistance, when toxicities preclude other regimens that do not contain tenofovir disoproxil.
How does doravirine + lamivudine + tenofovir disoproxil fumarate work?
All three components block HIV-1 reverse transcriptase, an enzyme the virus needs to copy its genetic material. Doravirine inhibits the enzyme directly; activated lamivudine and tenofovir metabolites enter viral DNA and stop the chain growing.
doravirine + lamivudine + tenofovir disoproxil fumarate preparations and strengths
Tablet
Route: Oral
Strengths: 100 mg + 300 mg + 245 mg
How to take doravirine + lamivudine + tenofovir disoproxil fumarate
Follow the HIV specialist’s instructions. It may be taken with or without food.
Swallow the tablet whole; do not crush or chew it.
Check with the HIV team before starting any prescription, non-prescription or herbal product.
Do not stop or allow the supply to run out without contacting the HIV team, particularly if you also have hepatitis B.
doravirine + lamivudine + tenofovir disoproxil fumarate side effects
Common or expected effects
- Nausea, vomiting, diarrhoea, abdominal pain or wind
- Headache, dizziness or sleepiness
- Difficulty sleeping or abnormal dreams
- Cough or nasal symptoms
- Rash or hair loss
- Tiredness
- Muscle-related symptoms or reduced bone mineral density
Get urgent medical advice
- Blistering or peeling rash, skin pain, or ulcers affecting the mouth, eyes or genitals
- Facial or throat swelling, or difficulty breathing
- Reduced urine, swelling, marked weakness, or persistent bone or muscle pain suggesting kidney tubular injury
- Severe persistent abdominal pain, which may indicate pancreatitis
- New or worsening suicidal thoughts
- Profound weakness with rapid or difficult breathing, which may indicate severe lactic acidosis
doravirine + lamivudine + tenofovir disoproxil fumarate in pregnancy
Doravirine pregnancy data are limited, although more reassuring information exists for lamivudine and tenofovir disoproxil. Product information advises avoiding this combination during pregnancy as a precaution. Obtain prompt specialist review if pregnant or planning pregnancy, but do not stop effective HIV treatment without advice.
doravirine + lamivudine + tenofovir disoproxil fumarate while breastfeeding
Product information recommends not breastfeeding because doravirine exposure is uncertain and HIV can pass through breast milk. In the UK, formula feeding is the safest option. Discuss any consideration of breastfeeding with the specialist HIV maternity team before birth.
doravirine + lamivudine + tenofovir disoproxil fumarate interactions
A full check of medicines and herbal products is essential. Important examples include:
Carbamazepine, oxcarbazepine, phenobarbital or phenytoin
These strongly reduce doravirine exposure and must not be used with this combination.
Rifampicin or rifapentine
These strongly reduce doravirine exposure and are contraindicated.
St John’s wort
It can markedly reduce doravirine exposure and must not be taken with this combination.
Common questions about doravirine + lamivudine + tenofovir disoproxil fumarate
Answers are fully visible for fast scanning and source review.
Can it be taken with food?
Yes. Food is not required.
Can I stop it suddenly?
Do not stop without speaking to the HIV team. HIV may rebound, and hepatitis B can worsen after stopping lamivudine and tenofovir in people with HIV/HBV coinfection.
Can it affect the kidneys?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.