TRIUMEQ (Abacavir/Dolutegravir/ Lamivudine)

What is this medication?

TRIUMEQ (Abacavir/Dolutegravir/Lamivudine)
Antiretroviral, Integrase Inhibitor (Anti-HIV); Antiretroviral, Reverse Transcriptase Inhibitor, Nucleoside (Anti-HIV)

ALERT: WARNING
Serious and sometimes fatal hypersensitivity reactions, with multiple organ involvement, have occurred with abacavir. Patients who carry the HLA-B*5701 allele are at a higher risk of a hypersensitivity reaction to abacavir; although, hypersensitivity reactions have occurred in patients who do not carry the HLA-B*5701 allele. TRIUMEQ (Abacavir/Dolutegravir/Lamivudine) is contraindicated in patients with a prior hypersensitivity reaction to abacavir and in HLA-B*5701-positive patients. All patients should be screened for the HLA-B*5701 allele prior to initiating therapy with abacavir/dolutegravir/lamivudine or reinitiation of therapy with abacavir/dolutegravir/lamivudine unless patients have a previously documented HLA-B*5701 allele assessment. Discontinue abacavir/dolutegravir/lamivudine immediately if a hypersensitivity reaction is suspected, regardless of status and even when other diagnoses are possible.  Following a hypersensitivity reaction to abacavir/dolutegravir/lamivudine, never restart abacavir/dolutegravir/lamivudine or any other abacavir-containing product because more severe symptoms, including death, can occur within hours. 

Severe acute exacerbations of hepatitis B have been reported in patients who are coinfected with hepatitis B virus (HBV) and human immunodeficiency virus (HIV-1) and have discontinued lamivudine. Hepatic function should be monitored closely with both clinical and laboratory follow-up for at least several months in patients who discontinue abacavir/dolutegravir/lamivudine and are coinfected with HIV-1 and HBV.

How does this medication work?

TRIUMEQ, contains a combination of dolutegravir (integrase strand transfer inhibitor), abacavir, and lamivudine (both nucleoside analogue reverse transcriptase inhibitors). Dolutegravir blocks the integrase active site and prevents the step of retroviral integration resulting in inhibition of HIV integrase.  Abacavir is converted to the active metabolite, carbovir triphosphate which inhibits the activity of HIV-1 reverse transcriptase both by competing with dGTP and by its incorporation into viral DNA. Lamivudine is phosphorylated within the cell to its active 5′-triphosphate metabolite, lamivudine triphosphate. This active metabolite inhibits reverse transcriptase via DNA chain termination after incorporation of the nucleotide analogue.

How should I take this medication?

Oral: Take one tablet (abacavir 600 mg/dolutegravir 50 mg/lamivudine 300 mg) once daily. 

How to Take: Administer with or without food. If patient is also taking certain medications, an additional daily single-component dolutegravir tablet should be administered 12 hours after TRUIMEQ. Administer 2 hours before or 6 hours after cation-containing antacids or laxatives, sucralfate, oral supplements containing iron or calcium, or buffered medications. It may be administered with supplements containing calcium or iron at the same time if administered together with food.

What should I watch for while using this medication?

Before starting TRIUMEQ (Abacavir/Dolutegravir/ Lamivudine) make sure your physician is aware of any allergies or medications you currently take, if you have the HLA-B*5701 allele, if you have chronic hepatitis B, coronary heart disease, lamivudine resistant hepatitis B, liver disease, or kidney disease. TRIUMEQ (Abacavir/Dolutegravir/ Lamivudine) use has been associated with rare but serious adverse events such as hepatotoxicity, hypersensitivity reactions, immune reconstitution syndrome, lactic acidosis, hepatomegaly, pancreatitis.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication?

Hyperglycemia, increased serum lipase, increased creatine phosphokinase, headache, fatigue, malaise, parethsia, peripheral neuropathy, neuropathy, sleep disorders, rash, nausea, diarrhea, pancreatitis, sore throat, vomiting, neutropenia, increased liver enzymes, increased rate of infection, myalgia, cough, nasal congestion, fever.

Note this is not a complete list of side effects for TRIUMEQ (Abacavir/Dolutegravir/Lamivudine), only common ones.