Dolutegravir/Lamivudine/Abacavir

Dosing

1 tab PO once daily

1 tab = Abacavir 600 mg/ Dolutegravir 50 mg/ Lamivudine 300 mg목동병원에서만 사용함

BW ≥40 kg 1 tab PO once daily

1 tab = Abacavir 600 mg/ Dolutegravir 50 mg/ Lamivudine 300 mg목동병원에서만 사용함

Mild or moderate hepatic impairment Not recommended

Moderate or severe hepatic impairment Contraindicated

CrCl 30-49CrCl <30If new or worsening symptoms, dose adjustment of lamivudine recommended; use individual components if reduced lamivudine dose is necessaryNot recommended

General Information

Treatment of HIV infection.

Black Box Warning: Serious and fatal hypersensitivity reactions have been reported with abacavir; discontinue if hypersensitivity reaction suspected; never restart an abacavir-containing product after hypersensitivity reaction as potentially fatal reactions may recur within hours. Patients with HLA-B*5701 allele have a higher risk for Abacavir-related hypersensitivity; screening for allele is recommended prior to initiating or reinitiation of therapy unless previous allele assessment is documented. Severe acute exacerbations of hepatitis B have been reported in patients co-infected with HBV and HIV-1 who have discontinued Lamivudine;monitor hepatic function closely for several months upon discontinuation of therapy; initiation of anti-HBV therapy may be needed.

Conduct HLA-B*5701 testing prior to initiation of abacavir sulfate or an abacavir-containing regimen.

Perform hepatitis B and C testing prior to initiation or modification of treatment.

Monitor viral load and CD4 cell counts prior to or with modification of treatment.

Monitor ALT, AST, total bilirubin, serum sodium, potassium, bicarbonate, chloride, BUN, creatinine, and creatinine-based estimated glomerular filtration prior to or modification of treatment.

Monitor CBC with differential and fasting lipid profile prior to or modification of treatment.

Obtain urinalysis prior to or modification of treatment, and annually thereafter.

Serious

  • Myocardial infarction

  • Lactic acidosis

  • Hepatitis B exacerbation

  • Hepatotoxicity

  • Hepatomegaly with steatosis

  • Hypersensitivity reaction

  • Immune reconstitution syndrome

Contraindications:

  • Dofetilide

Major drug-drug interactions

  • Abametapir

  • Products containing polyvalent cations

  • Amprenavir

  • Cabotegravir

  • Carbamazepine

  • Dabrafenib

  • Dalfampridine

  • Dasabuvir

  • Efavirenz

  • Eslicarbazepine acetate

  • Etravirine

  • Fosamprenavir

  • Fosphenytoin

  • Horsetail

  • Magaldrate

  • Metformin

  • Nevirapine

  • Orlistat

  • Oxcarbazepine

  • Phenobarbital

  • Phenytoin

  • Primidone

  • Ribalvirin

  • Rifampin

  • Sorbitol

  • St. John's wort

  • Sucralfate

  • Tipranavir

Antimicrobial class: Antiretroviral, Integrase inhibitor, Nucleoside reverse transcriptase inhibitor

Pregnancy category: C

Average serum half life: 1.54 hours (Abacavir), 14 hours (Dolutegravir), 5-7 hours (Lamivudine)

Precautions: Possible increased risk of myocardial infarction with abacavir-based antiretroviral regimens; assess coronary heart disease risk factors and minimize modifiable risk factors before initiation.

Monitor heaptic function in patients coinfected with hepatitis B or C.

Screen for presence of the HLA-B*5701 allele prior to initiation or reinitiation of therapy.

Discontinue if lactic acidosis, sever hepatomegaly with steatosis is suspected.

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