Dolutegravir/lamivudine/tenofovir

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

Dolutegravir/lamivudine/tenofovir
Combination of
DolutegravirIntegrase strand transfer inhibitor
LamivudineNucleoside reverse transcriptase inhibitor
Tenofovir disoproxil fumarateNucleoside reverse transcriptase inhibitor
Clinical data
Other namesTenofovir/lamivudine/dolutegravir (TLD)

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]

The combination is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system.[4] In some countries it is available as a generic medication.[5] In the developing world it costs about US$75 per year.[6] Well it is tentatively approved in the United States as of 2019, full approval is pending expiration of the US patent on dolutegravir.[7]

Medical uses

As of 2019 it is listed by the World Health Organization 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]

Cost

In the developing world it costs about US$75 per year.[6] It is considered more cost effective than tenofovir/lamivudine/efavirenz as of 2019.[2]

References
  1. "Dolutegravir (DTG) and the fixed dose combination (FDC) of tenofovir/lamivudine/dolutegravir (TLD)" (PDF). WHO. Retrieved 15 November 2019.
  2. "UPDATE OF RECOMMENDATIONS ON FIRST- AND SECOND-LINE ANTIRETROVIRAL REGIMENS" (PDF). World Health Organization. July 2019. Retrieved 16 November 2019.
  3. "WHO-PQ RECOMMENDED SUMMARY OF PRODUCT CHARACTERISTICS" (PDF). July 2019. Retrieved 16 November 2019.
  4. "World Health Organization model list of essential medicines: 21st list 2019". iris. 2019. hdl:10665/325771.
  5. "TDF/3TC/DTG" (PDF). Retrieved 16 November 2019.
  6. Vitoria, M; Hill, A; Ford, N; Doherty, M; Clayden, P; Venter, F; Ripin, D; Flexner, C; Domanico, PL (31 July 2018). "The transition to dolutegravir and other new antiretrovirals in low-income and middle-income countries: what are the issues?". AIDS (London, England). 32 (12): 1551–1561. doi:10.1097/QAD.0000000000001845. PMID 29746295.
  7. "New Drng Application" (PDF). FDA. Retrieved 16 November 2019.
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