Dolutegravir/lamivudine/tenofovir

This article is about the combination medication dolutegravir/lamivudine/tenofovir disoproxil. For the combination medication dolutegravir/lamivudine/tenofovir alafenamide, see Tenofovir alafenamide § combinations.
Dolutegravir/lamivudine/tenofovir
Combination of
DolutegravirIntegrase strand transfer inhibitor
LamivudineNucleoside reverse transcriptase inhibitor
Tenofovir disoproxilNucleoside reverse transcriptase inhibitor
Clinical data
Other namesTenofovir/lamivudine/dolutegravir (TLD)
Routes of
administration		By mouth
ATC code

Dolutegravir/lamivudine/tenofovir (DTG/3TC/TDF) is a fixed-dose combination antiretroviral medication used to treat HIV/AIDS.[1] It is a combination of dolutegravir, lamivudine, and tenofovir disoproxil.[1] As of 2019, it is listed by the World Health Organization (WHO) as the first line treatment for adults, with tenofovir/lamivudine/efavirenz as an alternative.[2] It is taken by mouth.[3]

Side effects may include trouble sleeping, weight gain, and rash.[2][3] While there are concerns that use during pregnancy results in a 0.2% increased risk of neural tube defects in the baby, this does not rule out its use.[2] Use remains recommended after the first trimester.[2] Use is not recommended in those with kidney problems.[3] The combination is a type of antiretroviral therapy.[2]

It is on the World Health Organization's List of Essential Medicines.[4] In some countries it is available as a generic medication.[5] It is tentatively approved in the United States as of 2019, full approval is pending expiration of the US patents on dolutegravir (Tivicay) and tenofovir disoproxil (Viread).[6][7]

Medical uses

As of 2019, it is listed by the World Health Organization (WHO) as the first-line treatment for adults with HIV/AIDS, with tenofovir/lamivudine/efavirenz as an alternative.[2] It may be used in people with both HIV and tuberculosis, however if the person is on rifampicin a larger dose of dolutegravir is needed.[2]

Side effects

Side effects may include trouble sleeping and weight gain.[2] While there are concerns that use during pregnancy results in a 0.2% increased risk of neural tube defects in the baby, this does not rule out its use.[2] Use remains recommended after the first trimester.[2] It should not be used with dofetilide.[3]

Society and culture

Economics

In the developing world it costs about US$75 per year.[8] It is considered more cost effective than tenofovir/lamivudine/efavirenz as of 2019.[2]

References

  1. ^ a b "Dolutegravir (DTG) and the fixed dose combination (FDC) of tenofovir/lamivudine/dolutegravir (TLD)" (PDF). World Health Organization (WHO). Retrieved 15 November 2019.
  2. ^ a b c d e f g h i j k World Health Organization (2019). "Policy brief: update of recommendations on first- and second-line antiretroviral regimens" (Document). World Health Organization. hdl:10665/325892. WHO/CDS/HIV/19.15; License: CC BY-NC-SA 3.0 IGO.
  3. ^ a b c d "WHO-PQ Recommended summary of product characteristics" (PDF). July 2019. Archived from the original (PDF) on November 16, 2019. Retrieved 16 November 2019.
  4. ^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  5. ^ "TDF/3TC/DTG" (PDF). Retrieved 16 November 2019.
  6. ^ "NDA 209618 Tentative Approval" (PDF). U.S. Food and Drug Administration (FDA). 25 March 2019. Retrieved 16 November 2019.
  7. ^ "NDA 210796 Tentative Approval" (PDF). U.S. Food and Drug Administration (FDA). 18 August 2017.
  8. ^ Vitoria M, Hill A, Ford N, Doherty M, Clayden P, Venter F, et al. (July 2018). "The transition to dolutegravir and other new antiretrovirals in low-income and middle-income countries: what are the issues?". AIDS. 32 (12): 1551–1561. doi:10.1097/QAD.0000000000001845. PMID 29746295. S2CID 13674631.