Dosage & Administration
Once-Daily TRIUMEQ Makes Dosing and Administration Simple for Your Patients
Recommended dosing 1*†‡
(for adults and adolescents above 12 years of age weighing at least 40 kg)
One pill, once daily
TRIUMEQ is indicated for the treatment of HIV-infected adults and adolescents above 12 years of age weighing at least 40 kg.
Before initiating treatment with abacavir-containing products, screening for carriage of the HLA-B*5701 allele should be performed in any HIV-infected patient, irrespective of racial origin. Abacavir should not be used in patients known to carry the HLA-B*5701 allele.
Convenient dosing regimen 1
![Convenient dosing: one pill, QD; No time or food restrictions; no boosting/additional renal monitoring; few significant DDIs](/content/dam/global/hcpportal/master/images/homepage/products/triumeq/dosing_regimen_table.png)
For further information, please see the Summary of Product Characteristics.
*TRIUMEQ is a fixed-dose pill and should not be prescribed for patients requiring dose adjustments. Separate preparations of dolutegravir, abacavir, and lamivudine are available in cases where discontinuation or dose adjustment is required. 1
†TRIUMEQ is not recommended for patients with integrase inhibitor resistance. 1
‡TRIUMEQ is not recommended for co-administration with efavirenz, nevirapine, rifampicin, or tipranavir/ritonavir. 1
References:
![Discontinuations due to AEs--SINGLE trial: Triumeq vs Atripla at 48 (2% vs 10%), 96 (3% vs 10%), and 144 weeks (4% vs 10%).](/content/dam/global/hcpportal/master/images/homepage/products/triumeq/single_adverse_events_leading_to_discontinuation.jpg)
![Adverse Events ≥5% in SINGLE trial (Triumeq vs Atripla): Triumeq is generally well tolerated vs Atripla through 96 weeks](/content/dam/global/hcpportal/master/images/homepage/products/triumeq/single_adverse_events.png)
Changes in laboratory chemistries
Increases in serum creatinine occurred within the first week of treatment with dolutegravir and remained stable through 96 weeks (Mean change from baseline to 96 weeks: 12.6 μmol/L) 4
- These changes are not considered to be clinically relevant as the glomerular filtration rate remained unchanged
HLA-B*5701 Screening
Review the requirements for HLA-B*5701 screening and reducing the risk of abacavir-related hypersensitivity reactions.
For further information, please see the Summary of Product Characteristics.
*In studies supporting TRIUMEQ, DTG 50 mg + ABC 600 mg/ 3TC 300 mg were used. Bioequivalence has been demonstrated. 2
In some markets, Atripla® is not licensed for initial use in treatment-naive patients.
Atripla is a registered trademark of Bristol-Myers Squibb & Gilead Sciences, LLC.
DTG=dolutegravir.
ABC=abacavir.
3TC=lamivudine.
EFV=efavirenz.
TDF=tenofovir.
FTC=emtricitabine.
References:
- Walmsley S, Antela A, Clumeck N, et al; for the SINGLE Investigators. Dolutegravir plus abacavir-lamivudine for the treatment of HIV-1 infection. N Engl J Med. 2013;369(19):1807-1818.
- Walmsley S, Berenguer J, Khuong-Josses M, et al. Dolutegravir regimen statistically superior to efavirenz/tenofovir/emtricitabine: 96-week results from the SINGLE study (ING114467). Poster presented at: 21st Conference on Retroviruses and Opportunistic Infections; March 3-6, 2014; Boston, MA. Poster 543.
- Pappa K, Baumgarten A, Felizarta F, et al. Once-daily dolutegravir + abacavir/lamivudine is superior to efavirenz/tenofovir/emtricitabine in treatment-naïve HIV subjects: 144-week results SINGLE (ING114467). Presented at: 54th Interscience Conference on Antimicrobial Agents and Chemotherapy; September 5-9, 2014; Washington, DC, USA.
- TRIUMEQ Summary of Product Characteristics.
TRIUMEQ Has Few Significant DDIs 1
Commonly used medications | Interactions |
Oral contraceptives | No |
H2-antagonists (including ranitidine, cimetidine) | No |
Hepatitis C protease inhibitors (telaprevir, boceprevir) | No |
Prednisone | No |
Rifabutin | No |
Methadone | Dosing adjustment likely not needed for most patients |
Metformin | Close monitoring is recommended when starting or stopping TRIUMEQ and metformin together as a dose adjustment may be needed for metformin |
Multivitamins, calcium supplements, iron supplements | TRIUMEQ is recommended to be administered 2 hours before or 6 hours after taking these agents |
Magnesium/aluminium-containing antacids | TRIUMEQ is recommended to be administered 2 hours before or 6 hours after taking these agents |
Rifampicin, efavirenz, nevirapine, and tipranavir/r | Since the recommended dose of dolutegravir is 50 mg twice daily when co-administered with these agents, the use of TRIUMEQ is not recommended for patients taking these medicines |
- Co-administration with dofetilide is contraindicated 1
- Co-administration with oxcarbazepine, phenytoin, phenobarbital, carbamazepine, or St John’s Wort should be avoided because there are insufficient data to make dosing recommendations 1
- Co-administration with etravirine is not recommended unless patient is also receiving atazanavir/r, lopinavir/r or darunavir/r 1
Dolutegravir is eliminated primarily by UGT1A1. Abacavir and lamivudine are not significantly metabolised by CYP enzymes. 1
For further information, please see the Summary of Product Characteristics.
DDIs=drug-drug interactions.
References:
Screening for the HLA-B*5701 Allele Should Be Performed Before Prescribing TRIUMEQ 1
HLA-B*5701 screening significantly reduces the risk of an ABC hypersensitivity reaction (HSR) 2
Prospective HLA-B*5701 screening: No immunologically confirmed HSR and significant reduction of clinically suspected HSR in the PREDICT-1 study 2
![](/content/dam/global/hcpportal/master/images/homepage/products/triumeq/triumeq-hla-screening-graph.png)
Clinical description of ABC HSRs: 1
- Almost all patients developing ABC HSRs will have fever and/or rash
- Other key symptoms include: gastrointestinal, respiratory, or constitutional symptoms such as lethargy and malaise
If suspected: 1
- TRIUMEQ must be stopped without delay, even in the absence of the HLA-B*5701 allele
- After stopping treatment with TRIUMEQ for a suspected HSR, TRIUMEQ or any other medicinal product containing ABC or DTG, must never be re-initiated
- EACS and DHHS guidelines recommend screening for HLA-B*5701 before starting ABC-containing antiretroviral therapy, if not previously tested
For further information, please see the Summary of Product Characteristics.
ABC=abacavir.
DTG=dolutegravir.
EACS=European AIDS Clinical Society.
DHHS=Department of Health and Human Services.
References:
- TRIUMEQ Summary of Product Characteristics.
- Mallal S, Phillips E, Carosi G, et al; for the PREDICT-1 Study Team. HLA-B*5701 screening for hypersensitivity to abacavir. N Engl J Med. 2008;358:568-579.
- European AIDS Clinical Society Guidelines, version 7.02; http://www.eacsociety.org/Portals/0/140601_EACS%20EN7.02.pdf. Updated June 2014.
- Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. http://www.aidsinfo.nih.gov/ContentFiles/ AdultandAdolescentGL.pdf. Updated May 1, 2014.
TRIUMEQ, TIVICAY, ZIAGEN, EPIVIR, KIVEXA, EPZICOM, TRIZIVIR, COMBIVIR
son marcas registradas del grupo de compañías ViiV Healthcare