Can Triumeq be used for PrEP?

Key Points

• Triumeq (dolutegravir, abacavir and lamivudine) is not approved to be used for HIV-1 pre-exposure prophylaxis (PrEP). Triumeq is used to treat (not prevent) HIV-1, the virus that causes acquired immunodeficiency syndrome (AIDS).
• The medications FDA-approved for PrEP are the two oral medicines Truvada (tenofovir disoproxil fumarate and emtricitabine) or Descovy (emtricitabine and tenofovir alafenamide), and the long-acting intramuscular injection called Apretude (cabotegravir).
• For many people who need treatment for HIV-1, Triumeq can be used as the only tablet they will need to take each day.

How is Triumeq used in HIV treatment?

Triumeq, from ViiV Health Care, contains three medicines in one oral tablet: dolutegravir, an integrase strand transfer inhibitor, and two nucleoside reverse transcriptase inhibitors - abacavir and lamivudine.

Triumeq can be used in both adults and children who weigh at least 40 kg (88 pounds) to treat HIV-1 infection. The recommended dose of Triumeq is one tablet once a day with or without food. It’s best to take it at the same time each day, whether you take it in the day or at night.

For many people, Triumeq can be used as the only tablet they will need to take each day for HIV-1 treatment. This treatment can help you reach and maintain an undetectable level of virus in your blood, although individual results may vary. Undetectable means that you have less than 50 copies of HIV-1 RNA in a milliliter (mL) of blood.

However, if you have resistance to any of the three drugs found in Triumeq (dolutegravir, abacavir and lamivudine), it should be used in combination with other HIV medications.

You should not use Triumeq if you have a type of gene variation called the HLA-B*5701 allele.

• Your doctor will order this genetic screening test for you. Patients with this gene variation are at greater risk for serious, possibly fatal allergic reactions with the use of abacavir, one of the drugs found in Triumeq.
• If you’ve had an allergic reaction to abacavir, or are positive for the HLA-B*5701 allele, you should not use Triumeq or any drug containing abacavir.
• If your genetic test is negative, you still might have an allergic reaction but the risk is much lower.
• However, if you do have an allergic reaction while receiving Triumeq, do not use Triumeq or other medicines containing abacavir or dolutegravir ever again.
• The most common side effects with Triumeq include trouble sleeping, headache, and tiredness (see Table 2).

Take Triumeq at least 2 hours before or 6 hours after you take any medicines that contain aluminum, magnesium, or buffered medicines such as antacids and laxatives.

Iron or calcium supplements can also lead to a drug interaction with Triumeq.

• If you take Triumeq with food, you can take these iron or calcium supplements at the same time as you take your Triumeq.
• If you take your Triumeq without food, you should take Triumeq at least 2 hours before or 6 hours after you take these supplements.

Do not take Triumeq if you take dofetilide (Tikosyn), a medicine used in people with certain heart rhythm disorders (known as arrhythmias). Also, do not take Triumeq with dalfampridine (Ampyra). Taking Triumeq with these drugs can cause serious side effects that may be serious or life-threatening. Do not stop using any medications, including Triumeq, without first talking to your doctor. If you are not sure if you are taking these medications, ask your doctor or pharmacist.

If you have heart disease, kidney or liver disease be sure to tell your doctor. Also, let your doctor know if you are pregnant or plan to become pregnant. This medication could harm an unborn baby.

How well does Triumeq work to treat HIV?

In the SINGLE clinical trial of Triumeq, 833 adults with HIV-1 who had never used HIV-1 treatment before were evaluated (see Table 1). Triumeq was compared to Atripla (efavirenz, emtricitabine, and tenofovir), another medicine used to treat HIV-1 infection.

Overall, more patients were found to reach undetectable levels of HIV-1 RNA at about three years compared to Atripla. The difference was mainly due to more patients on Atripla stopping their medicine because of side effects than patients on Triumeq.

Table 1. SINGLE Study: Triumeq Compared to Atripla at 144 Weeks

The most common medium to severe side effects of Triumeq (in at least 2% of patients) when compared to Atripla treatment were found to be similar for each group.

Table 2: SINGLE Study: Triumeq Side Effects at 144 Weeks

Bottom Line

• Triumeq is used to treat someone living with an HIV-1 infection. It is not used to prevent HIV-1 infection. Many patients can reach an undetectable level of virus in their blood with Triumeq.
• This medication is taken once a day at the same time each day, with or without food.
• Triumeq is well-tolerated. The most common side effects with Triumeq include trouble sleeping, headache, and tiredness, and occur in 3% or less of patients.

This is not all the information you need to know about Triumeq for safe use. Review the full information here, and speak to your health care provider if you have questions or concerns.