TRIUMEQ TABLETS 30`S

Triumeq is a once-daily, fixed-dose antiretroviral tablet used to treat Human Immunodeficiency Virus type 1 (HIV-1) infection. It combines three different antiretroviral agents targeting different steps in the HIV replication cycle:

•       Dolutegravir (DTG): an integrase strand transfer inhibitor (INSTI) — blocks the HIV integrase enzyme, preventing HIV DNA from being inserted into the host cell's chromosomes.

•       Abacavir (ABC): a nucleoside reverse transcriptase inhibitor (NRTI) — acts as a faulty building block, incorporated into HIV DNA by reverse transcriptase and terminating viral DNA chain elongation.

•       Lamivudine (3TC): also an NRTI — same mechanism as abacavir, providing complementary antiviral coverage.

The three-drug, single-tablet regimen (STR) combines high efficacy, high genetic barrier to resistance (dolutegravir), and excellent tolerability in a once-daily tablet.

One tablet once daily — with or without food. Take at the same time every day. Do not crush or chew. If you also take antacids, calcium supplements, iron, or multivitamins, take Triumeq at least 2 hours before or 6 hours after these products.

Triumeq must not be given to: HLA-B*5701-positive patients; patients with known hypersensitivity to dolutegravir, abacavir, or lamivudine; and patients taking dofetilide or pilsicainide (serious cardiac arrhythmia risk).

Use with caution in: moderate to severe hepatic impairment; patients with or at risk of ischaemic heart disease (abacavir cardiovascular risk association — observational data); pre-existing neuropsychiatric conditions; renal impairment (lamivudine dose adjustment may be needed — separate-component formulations preferable if CrCl <50 mL/min).

•       Dofetilide: CONTRAINDICATED — dolutegravir significantly increases dofetilide levels (risk of fatal arrhythmia).

•       Antacids, calcium, iron, zinc, magnesium-containing products: chelate dolutegravir — separate by 2 hours before or 6 hours after.

•       Rifampicin: reduces dolutegravir levels by 54% — increase dolutegravir dose or switch regimen; Triumeq STR cannot provide adequate dolutegravir dose for rifampicin co-treatment.

•       Metformin: dolutegravir inhibits renal OCT2 transporter and increases metformin exposure — reduce metformin dose; monitor blood glucose.

•       St John's Wort: reduces dolutegravir levels — contraindicated.

•       Sorbitol-containing liquid formulations: may reduce lamivudine absorption — avoid.

Store at room temperature below 30°C. Keep in original packaging. Keep out of reach of children. Do not use after expiry date.

Triumeq is one of the most commonly prescribed HIV treatments because it is effective, well-tolerated, and simple — just one tablet once daily. When taken consistently, it suppresses HIV to undetectable levels in the blood, protects the immune system, prevents AIDS-defining illnesses, and dramatically extends life expectancy.

Suppressing HIV to undetectable levels also means you cannot sexually transmit the virus to partners — this is known as U=U (Undetectable = Untransmittable), confirmed by large-scale clinical studies. However, you should continue using barrier contraception to protect against other sexually transmitted infections.

Never share your medication with anyone — HIV medicines are prescribed based on individual factors including drug resistance testing and HLA typing. Giving your medicine to someone else could cause them serious harm.

Triumeq is the fixed-dose combination of the individual medicines dolutegravir (Tivicay), abacavir (Ziagen), and lamivudine (Epivir).

Dolutegravir has a high genetic barrier to resistance making regimen failure rare, especially in treatment-naive patients. HBsAg-positive patients: abacavir/lamivudine does not adequately treat HBV — use tenofovir-containing regimen instead.

For patients on metformin: assess baseline HbA1c/glucose before starting, reduce metformin dose, and monitor closely — dolutegravir consistently increases metformin AUC by ~79%.

For rifampicin co-administration: Triumeq STR is not suitable — switch to dolutegravir 50 mg twice daily (double dose) plus separate backbone, not available as STR. Neuropsychiatric adverse effects (insomnia, anxiety, depression) are class effects of integrase inhibitors — monitor, especially in patients with pre-existing mental health conditions.

Does Triumeq cure HIV?

No — Triumeq does not cure HIV. It suppresses the virus to undetectable levels in the blood, allowing your immune system to recover and preventing progression to AIDS. If you stop taking it, the virus will rebound. Treatment is lifelong.

Can I stop taking Triumeq if I feel completely well?

No — HIV has no symptoms when well-controlled. Stopping allows the virus to rebound rapidly, can damage your immune system, and can lead to resistance to multiple antiretroviral drugs. Continue Triumeq every day for life unless advised to change by your HIV specialist.

I take omeprazole and calcium supplements — can I still take Triumeq?

Omeprazole is fine with Triumeq. However, calcium supplements, iron, zinc, magnesium, and antacids can significantly reduce dolutegravir absorption. Take these products at least 2 hours before or 6 hours after Triumeq.

What does 'Undetectable = Untransmittable' mean?

U=U means that when HIV is suppressed to undetectable levels by effective antiretroviral therapy, the virus cannot be sexually transmitted to partners. This has been confirmed by large clinical studies. You still need to maintain consistent adherence to Triumeq to stay undetectable.

I am pregnant — can I continue Triumeq?

Triumeq (including dolutegravir) can be continued during pregnancy — it has excellent efficacy in preventing mother-to-child transmission. Earlier safety concerns about neural tube defects with periconceptional dolutegravir exposure have been substantially reassured by updated data showing no increased risk at standard clinical doses. Discuss with your HIV specialist and obstetrician.