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Dolutegravir and Rilpivirine (Monograph)

Brand name: Juluca
Drug class: HIV Integrase Inhibitors

Medically reviewed by Drugs.com on Mar 10, 2024. Written by ASHP.

Introduction

Antiretroviral; fixed combination of dolutegravir and rilpivirine (dolutegravir/rilpivirine). Dolutegravir is an HIV integrase strand transfer inhibitor (INSTI) and rilpivirine is an HIV nonnucleoside reverse transcriptase inhibitor (NNRTI).

Uses for Dolutegravir and Rilpivirine

Treatment of HIV Infection

Used as a complete regimen for the treatment of HIV-1 infection in antiretroviral-experienced (previously treated) adults to replace the current antiretroviral regimen in those who are virologically suppressed (i.e., plasma HIV-1 RNA levels <50 copies/mL) on a stable antiretroviral regimen for ≥6 months, have no known history of treatment failure, and are infected with HIV-1 with no known substitutions associated with resistance to dolutegravir or rilpivirine.

Selection of an antiretroviral regimen should be individualized based on factors such as virologic efficacy, toxicity, pill burden, dosing frequency, drug-drug interaction potential, resistance test results, comorbid conditions, access, and cost.

Dolutegravir and rilpivirine are available as a fixed-combination preparation (dolutegravir/rilpivirine) and as separate single-entity products. Refer to the full prescribing information of the single-entity products for information on specific uses.

Dolutegravir and Rilpivirine Dosage and Administration

General

Pretreatment Screening

Patient Monitoring

Administration

Oral Administration

Administer orally once daily with a meal. A protein drink alone does not constitute a meal.

Dosage

Available as fixed-combination tablets containing dolutegravir sodium and rilpivirine hydrochloride; dosages expressed in terms of dolutegravir and rilpivirine, respectively.

Each fixed-combination tablet contains 50 mg of dolutegravir and 25 mg of rilpivirine.

Adults

Treatment of HIV-1 Infection
Antiretroviral-experienced Adults
Oral

1 tablet of dolutegravir/rilpivirine (dolutegravir 50 mg and rilpivirine 25 mg) once daily with a meal.

Antiretroviral-experienced Adults Receiving Rifabutin
Oral

1 tablet of dolutegravir/rilpivirine (dolutegravir 50 mg and rilpivirine 25 mg) and a 25-mg tablet of single-entity rilpivirine once daily with a meal to provide a total rilpivirine dosage of 50 mg daily for the duration of rifabutin coadministration.

Special Populations

Hepatic Impairment

Mild or moderate hepatic impairment (Child-Pugh class A or B): Dosage adjustments not needed.

Severe hepatic impairment (Child-Pugh class C): No specific dosage recommendations.

Renal Impairment

Mild or moderate renal impairment (Clcr ≥30 mL/minute): Dosage adjustments not needed.

Severe renal impairment (Clcr <30 mL/minute) or end-stage renal disease: No specific dosage recommendations; increased monitoring for adverse effects recommended.

Geriatric Patients

No specific dosage recommendations; use with caution because of age-related decreases in hepatic, renal, and/or cardiac function and potential for concomitant disease and drug therapy.

Detailed Dolutegravir / rilpivirine dosage information

Cautions for Dolutegravir and Rilpivirine

Contraindications

Warnings/Precautions

Skin and Hypersensitivity Reactions

Hypersensitivity reactions (e.g., rash, constitutional findings, and sometimes organ dysfunction including liver injury) reported in patients receiving dolutegravir.

Severe skin and hypersensitivity reactions, including cases of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), reported during postmarketing experience with rilpivirine-containing regimens. Some skin reactions were accompanied by constitutional symptoms; other skin reactions were associated with organ dysfunction, including elevated hepatic enzyme concentrations.

Immediately discontinue dolutegravir/rilpivirine if signs or symptoms of severe skin or hypersensitivity reactions occur (including, but not limited to, severe rash or rash accompanied by fever, general malaise, fatigue, muscle or joint aches, blisters or peeling of the skin, mucosal involvement [oral blisters or lesions], conjunctivitis, facial edema, hepatitis, eosinophilia, angioedema, difficulty breathing). Monitor clinical status, including laboratory parameters with liver aminotransferases, and initiate appropriate therapy.

Delay in stopping dolutegravir/rilpivirine treatment after onset of hypersensitivity reaction may result in a life-threatening reaction.

Hepatotoxicity

Adverse hepatic effects reported in patients receiving dolutegravir- or rilpivirine-containing regimens.

HIV-infected patients with HBV or HCV coinfection or markedly elevated serum aminotransferase concentrations prior to initiation of dolutegravir/rilpivirine may be at increased risk for development or worsening of aminotransferase elevations. In some patients receiving a dolutegravir-containing regimen, serum aminotransferase elevations were consistent with immune reconstitution syndrome or HBV reactivation, particularly in the setting where HBV therapy had been discontinued.

Cases of hepatic toxicity, including elevated serum liver biochemistries and hepatitis, also reported in patients receiving dolutegravir- or rilpivirine-containing regimens who had no preexisting hepatic disease or other identifiable risk factors.

Drug-induced liver injury leading to acute liver failure reported with dolutegravir-containing regimens; drug-induced liver injury leading to liver transplant reported with the fixed combination of abacavir, dolutegravir, and lamivudine (abacavir/dolutegravir/lamivudine).

Monitor for hepatotoxicity in patients receiving dolutegravir/rilpivirine.

Depressive Disorders

Depressive disorders (depressed mood, depression, dysphoria, major depression, altered mood, negative thoughts, suicide attempt, suicidal ideation) reported in patients receiving dolutegravir and/or rilpivirine.

Promptly evaluate patients experiencing severe depressive symptoms to determine the likelihood that symptoms are related to dolutegravir/rilpivirine and to determine if benefits of continued dolutegravir/rilpivirine therapy outweigh risks.

Fetal/Neonatal Morbidity and Mortality

Data from an observational study in Botswana showed an association between dolutegravir and an increased risk of neural tube defects when the drug is administered at the time of conception and during early pregnancy.

Because there is only a limited understanding of reported types of neural tube defects associated with dolutegravir use, inform individuals of reproductive potential, including those actively trying to become pregnant, about the potential increased risk of neural tube defects with dolutegravir/rilpivirine.

Assess risks and benefits of dolutegravir/rilpivirine and discuss with the patient to determine if an alternative treatment should be considered at the time of conception through the first trimester of pregnancy or if pregnancy is confirmed in the first trimester.

Perform pregnancy testing in individuals of reproductive potential before initiation of dolutegravir/rilpivirine; counsel on consistent use of effective contraception.

May consider dolutegravir/rilpivirine during second and third trimesters of pregnancy if expected benefits justify potential risks to pregnant woman and fetus.

Drug Interactions

Concomitant use with certain drugs may result in drug interactions. May lead to loss of therapeutic effects and possible development of resistance or possible adverse effects from increased exposures of concomitant drugs.

Because rilpivirine may prolong QT interval corrected for rate (QTc), consider alternatives to dolutegravir/rilpivirine in patients receiving drugs with known risk of torsades de pointes.

Consider potential for drug interactions prior to and during treatment with dolutegravir/rilpivirine and monitor for adverse effects associated with concomitant drugs.

Use of Fixed Combinations

Consider cautions, precautions, contraindications, and interactions associated with both components of dolutegravir/rilpivirine.

Consider cautionary information applicable to specific populations (e.g., pregnant or nursing women, individuals with hepatic or renal impairment, geriatric patients) for each drug in the fixed combination.

Specific Populations

Pregnancy

Antiretroviral Pregnancy Registry (APR) at 800-258-4263 or [Web].

Dolutegravir and rilpivirine cross the placenta.

Reports from pregnancy registry suggest higher prevalence of birth defects in live births following exposure to dolutegravir compared to background birth defect rate in US; no difference between overall risk of birth defects for rilpivirine compared with background birth defect rate.

Results of an observational study in Botswana showed an increased risk of neural tube defects with dolutegravir-containing regimens at time of conception and during early pregnancy compared with antiretroviral regimens not containing dolutegravir.

Advise individuals of reproductive potential, including those actively trying to become pregnant, of the potential risk of neural tube defects.

Assess risks and benefits of dolutegravir/rilpivirine and discuss with the patient to determine if alternative treatment should be considered at the time of conception through the first trimester of pregnancy or if pregnancy is confirmed in the first trimester. Benefit-risk assessment should address factors such as feasibility of switching to a different regimen, tolerability, ability to maintain viral suppression, and risk of HIV transmission to the infant versus risk of neural tube defects.

HHS Panel reports that more recent data from Botswana indicate that the prevalence of neural tube defects in infants born to pregnant women with HIV receiving dolutegravir at conception is no longer statistically different than in those receiving other antiretrovirals. HHS states that a 2-drug regimen of dolutegravir/rilpivirine is not recommended in antiretroviral-naïve or antiretroviral-experienced pregnant women or women of reproductive potential trying to conceive because data not available regarding use of 2-drug regimens for treatment of HIV-1 infection during pregnancy.

Lactation

Dolutegravir distributed into human milk. Unknown whether rilpivirine distributed into human milk; detected in milk of lactating rats.

Not known whether dolutegravir or rilpivirine affects human milk production or affects breast-fed infant.

Instruct HIV-infected women not to breastfeed because of potential for HIV‑1 transmission in HIV-negative infants, development of viral resistance in HIV-positive infants, and adverse reactions in the breastfed infant.

Females and Males of Reproductive Potential

Perform pregnancy testing in all individuals of reproductive potential before initiating dolutegravir/rilpivirine.

In individuals of reproductive potential currently on dolutegravir/rilpivirine who are actively trying to become pregnant or if pregnancy is confirmed in the first trimester, assess the risks and benefits of continuing dolutegravir/rilpivirine and discuss possible alternative treatments with the patient.

Advise individuals of reproductive potential to consistently use effective contraception during dolutegravir/rilpivirine therapy.

Pediatric Use

Safety and efficacy not established in pediatric patients. Pharmacokinetics not evaluated.

Geriatric Use

Insufficient experience in patients ≥65 years of age to determine whether they respond differently to dolutegravir/rilpivirine compared with younger adults. Population pharmacokinetic analyses indicate age has no clinically important effect on pharmacokinetics of dolutegravir or rilpivirine.

Caution advised because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy.

Hepatic Impairment

Dosage adjustments not needed in patients with mild or moderate hepatic impairment (Child-Pugh class A or B).

Effect of severe hepatic impairment on pharmacokinetics not known.

Renal Impairment

Dosage adjustments not needed in patients with mild or moderate renal impairment (Clcr ≥30 mL/minute).

Increased monitoring for adverse effects recommended in patients with severe renal impairment (Clcr <30 mL/minute) or end-stage renal disease.

Common Adverse Effects

Common adverse effects (≥2%): diarrhea, headache, nausea.

Drug Interactions

CYP3A plays minor role in dolutegravir metabolism; rilpivirine primarily metabolized by CYP3A4.

Dolutegravir: Does not inhibit CYP1A2, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6, or 3A; does not induce CYP1A2, 2B6, or 3A4.

Dolutegravir: Metabolized by UGT1A1; substrate for UGT1A3 and UGT1A9. Does not inhibit UGT1A1 or UGT2B7.

Dolutegravir: Substrate of P-glycoprotein (P-gp) transport system and breast cancer resistance protein (BCRP); does not inhibit P-gp or BCRP.

Dolutegravir: Inhibits multidrug and toxin extrusion transporter (MATE) 1.

Dolutegravir: Inhibits renal organic anion transporter (OAT) 1 and OAT3. Does not inhibit organic anion transporter polypeptide (OATP) 1B1 or OATP1B3; not a substrate of OATP1B1 or 1B3.

Dolutegravir: Inhibits renal organic cation transporter (OCT) 2; does not inhibit OCT1.

Dolutegravir: Does not inhibit bile salt export pump (BSEP) or multidrug resistance protein (MRP) 2 or MRP4.

The following drug interactions are based on studies using the individual components of dolutegravir/rilpivirine or are predicted to occur with the fixed combination. When dolutegravir/rilpivirine is used, consider interactions associated with both drugs in the fixed combination.

Drugs Affecting Hepatic Microsomal Enzymes

CYP3A inducers: Possible decreased dolutegravir and rilpivirine plasma concentrations; may lead to decreased therapeutic effect of the drugs and resistance to rilpivirine or other HIV NNRTIs.

CYP3A inhibitors: Possible increased dolutegravir and rilpivirine plasma concentrations.

Drugs Affecting UGT

UGT1A1, 1A3, or 1A9 inducers: Possible decreased dolutegravir plasma concentrations and decreased therapeutic effect of dolutegravir.

UGT1A1 inhibitors: Possible increased dolutegravir concentrations.

Drugs Affecting P-glycoprotein Transport

P-gp inducers: Possible decreased dolutegravir plasma concentrations and decreased therapeutic effects of dolutegravir.

P-gp inhibitors: Possible increased dolutegravir plasma concentrations.

Drugs Affecting Breast Cancer Resistance Protein

BCRP inducers: Possible decreased dolutegravir plasma concentrations.

BCRP inhibitors: Possible increased dolutegravir plasma concentrations.

Drugs Affected by Multidrug and Toxin Extrusion Transporter

Drugs eliminated by MATE1: Dolutegravir may increase plasma concentrations of MATE1 substrates.

Drugs Affected by Renal Organic Cation Transporters

Drugs eliminated by OCT2: Dolutegravir may increase plasma concentrations of OCT2 substrates.

Specific Drugs

Drug

Interaction

Comments

Acetaminophen

Rilpivirine: No clinically important pharmacokinetic interactions

Aluminum preparations

Possible decreased dolutegravir absorption and decreased dolutegravir concentrations

Give dolutegravir/rilpivirine ≥4 hours before or ≥6 hours after aluminum

Antacids, aluminum-, calcium-, or magnesium-containing

Decreased dolutegravir concentrations and AUC; decreased rilpivirine concentrations expected, may result in loss of therapeutic response and lead to resistance to rilpivirine or other HIV NNRTIs

Give dolutegravir/rilpivirine ≥4 hours before or ≥6 hours after aluminum-, calcium-, or magnesium-containing antacids

Antiarrhythmic agents

Dofetilide: Possible increased dofetilide concentrations and increased risk of serious and/or life-threatening adverse effects if used with dolutegravir/rilpivirine

Dofetilide: Concomitant use with dolutegravir/rilpivirine contraindicated

Anticonvulsants

Carbamazepine: Decreased dolutegravir concentrations and AUC; substantially decreased rilpivirine exposures expected, which may lead to loss of virologic response

Oxcarbazepine, phenobarbital, phenytoin: Possible decreased dolutegravir and rilpivirine exposures; possible loss of virologic response

Carbamazepine, oxcarbazepine, phenobarbital, phenytoin: Concomitant use with dolutegravir/rilpivirine contraindicated

Antidiabetic agents

Metformin: Increased metformin concentrations and AUC if used with dolutegravir

Metformin: Assess risk and benefit of concomitant use with dolutegravir/rilpivirine; some experts state, when started during dolutegravir therapy, use lowest initial metformin dose and titrate dosage based on glycemic control while monitoring metformin adverse effects; may need to adjust metformin dosage when starting or stopping dolutegravir-containing regimens

Antimycobacterial agents (rifabutin, rifampin, rifapentine)

Rifabutin: Concomitant use with rilpivirine decreases rilpivirine concentrations and AUC; no clinically important effect on dolutegravir pharmacokinetics

Rifampin: Concomitant use with rilpivirine decreases rilpivirine concentrations and AUC and may result in loss of virologic response; concomitant use with dolutegravir decreases dolutegravir concentrations and AUC

Rifapentine: Decreased dolutegravir and rilpivirine concentrations expected; may result in loss of rilpivirine virologic response

Rifabutin: Administer 1 tablet of the fixed combination (50 mg of dolutegravir and 25 mg of rilpivirine) and a 25-mg tablet of single-entity rilpivirine once daily to provide total rilpivirine dosage of 50 mg daily

Rifampin, rifapentine: Concomitant use with dolutegravir/rilpivirine contraindicated

Buffered preparations

Buffered preparations containing polyvalent cations: Possible decreased dolutegravir absorption and decreased dolutegravir concentrations

Buffered preparations containing polyvalent cations: Give dolutegravir/rilpivirine ≥4 hours before or ≥6 hours after such preparations

Calcium supplements

Possible decreased dolutegravir concentrations when given concomitantly in fasted state

Give dolutegravir/rilpivirine ≥4 hours before or ≥6 hours after oral calcium supplements; alternatively, may be given concomitantly if taken with food

Corticosteroids (dexamethasone, prednisone)

Dexamethasone (multiple systemic doses): Possible decreased rilpivirine concentrations and possible loss of virologic response

Prednisone: No clinically important effect on dolutegravir pharmacokinetics

Dexamethasone: Concomitant use of more than a single dose of dexamethasone with dolutegravir/rilpivirine contraindicated

Dalfampridine

Possible increased dalfampridine concentrations and increased risk of seizures if used with dolutegravir

Weigh potential benefits of concomitant dalfampridine and dolutegravir therapy against risk of seizures

Estrogens and progestins

Oral contraceptives containing ethinyl estradiol and norgestimate: Dolutegravir has no effect on pharmacokinetics of ethinyl estradiol or norgestimate

Oral contraceptives containing ethinyl estradiol and norethindrone: Concomitant rilpivirine does not have a clinically important effect on rilpivirine, ethinyl estradiol, or norethindrone pharmacokinetics

Oral contraceptives containing ethinyl estradiol and norgestimate: Dosage adjustments not needed

Histamine H2-receptor antagonists

Rilpivirine: Concomitant famotidine decreases rilpivirine concentrations and AUC; other H2-receptor antagonists (e.g., cimetidine, nizatidine) may decrease rilpivirine concentrations, resulting in loss of therapeutic response, and leading to resistance to rilpivirine or other HIV NNRTIs

Dolutegravir: Pharmacokinetic interactions not expected

Give dolutegravir/rilpivirine ≥4 hours before or ≥12 hours after H2-receptor antagonist

Iron preparations

Possible decreased dolutegravir concentrations when given concomitantly in fasted state

Give dolutegravir/rilpivirine ≥4 hours before or ≥6 hours after oral iron; alternatively, may be given concomitantly if taken with food

Laxatives containing polyvalent cations

Possible decreased dolutegravir absorption and decreased dolutegravir concentrations

Give dolutegravir/rilpivirine ≥4 hours before or ≥6 hours after laxatives containing polyvalent cations

Macrolides

Clarithromycin, erythromycin: Possible increased rilpivirine concentrations; no effect on dolutegravir concentrations expected

Clarithromycin, erythromycin: Consider alternative macrolides (e.g., azithromycin)

Magnesium preparations

Possible decreased dolutegravir absorption and decreased dolutegravir concentrations

Give dolutegravir/rilpivirine ≥4 hours before or ≥6 hours after magnesium

Methadone

Dolutegravir: No clinically important effect on methadone pharmacokinetics

Rilpivirine: Decreased methadone concentrations; no clinically important effect on rilpivirine concentrations or AUC

Adjustment of initial methadone dosage not needed; closely monitor clinically and adjust methadone maintenance dosage if needed

Multivitamins

Possible decreased dolutegravir concentrations when given concomitantly in fasted state

Give dolutegravir/rilpivirine ≥4 hours before or ≥6 hours after multivitamins; alternatively, may be given concomitantly if taken with food

Proton-pump inhibitors

Rilpivirine: Concomitant omeprazole decreases rilpivirine concentrations and AUC; other proton-pump inhibitors (e.g., esomeprazole, lansoprazole, pantoprazole, rabeprazole) also may decrease rilpivirine concentrations, resulting in loss of therapeutic response, and leading to resistance to rilpivirine or other HIV NNRTIs

Dolutegravir: Omeprazole does not have clinically important effect on dolutegravir pharmacokinetics

Concomitant use with dolutegravir/rilpivirine contraindicated

Sofosbuvir

No clinically important interactions in cirrhotic patients with HIV and HCV coinfection receiving dolutegravir and rilpivirine concomitantly with simeprevir (no longer available in US) and sofosbuvir (with or without ribavirin)

St. John's wort (Hypericum perforatum)

Possible decreased dolutegravir and rilpivirine concentrations; may lead to loss of rilpivirine virologic response

Concomitant use with dolutegravir/rilpivirine contraindicated

Sucralfate

Possible decreased dolutegravir concentrations

Give dolutegravir/rilpivirine ≥4 hours before or ≥6 hours after sucralfate
Dolutegravir / rilpivirine drug interactions (more detail)

Dolutegravir and Rilpivirine Pharmacokinetics

Absorption

Bioavailability

Dolutegravir: Absolute bioavailability not established.

Rilpivirine: Absolute bioavailability not established.

Food

Dolutegravir: Administration with moderate- or high-fat meal increases AUC by approximately 1.9-fold; not considered clinically important.

Rilpivirine: Administration with moderate- or high-fat meal increases AUC by approximately 1.6- or 1.7-fold, respectively. If taken with only a protein-rich nutritional drink, exposures are 50% lower than when taken with a meal.

Plasma Concentrations

Dolutegravir: Peak plasma concentrations attained 3 hours after a dose.

Rilpivirine: Peak plasma concentrations attained 4 hours after a dose.

Distribution

Extent

Dolutegravir: Crosses placenta. Distributed into human milk.

Rilpivirine: Crosses placenta. Not known whether distributed into human milk; distributed into milk in rats.

Plasma Protein Binding

Dolutegravir: Approximately 99%.

Rilpivirine: Approximately 99%.

Elimination

Metabolism

Dolutegravir: Primarily metabolized by UGT1A1; CYP3A plays only minor role.

Rilpivirine: Primarily metabolized by CYP3A.

Elimination Route

Dolutegravir: 64% of an oral dose eliminated in feces (53% as unchanged drug); 31% eliminated in urine (<1% as unchanged drug).

Rilpivirine: 85% of an oral dose eliminated in feces (25% as unchanged drug); 6.5% eliminated in urine (<1% as unchanged drug).

Half-life

Dolutegravir: 14 hours.

Rilpivirine: 50 hours.

Special Populations

Mild hepatic impairment (Child-Pugh class A): Rilpivirine exposures 47% higher than matched controls.

Moderate hepatic impairment (Child-Pugh class B): Dolutegravir exposures similar to those in healthy individuals; rilpivirine exposures 5% higher than matched controls.

Severe hepatic impairment (Child-Pugh class C): Effect on dolutegravir and rilpivirine pharmacokinetics not evaluated.

Mild renal impairment: No clinically important effect on dolutegravir or rilpivirine pharmacokinetics.

Moderate renal impairment: No clinically important effect on dolutegravir pharmacokinetics; effect on rilpivirine pharmacokinetics not known.

Severe renal impairment: Dolutegravir AUC, peak plasma concentrations, and plasma concentrations measured 24 hours after dosing are 40, 23, and 43% lower, respectively, compared with healthy individuals; effect on rilpivirine pharmacokinetics not known.

End-stage renal disease: Effect on rilpivirine pharmacokinetics not known.

Dialysis: Effect on dolutegravir or rilpivirine pharmacokinetics not known.

Race, gender: No clinically important effects on dolutegravir or rilpivirine pharmacokinetics.

HCV coinfection: No clinically important effects on dolutegravir or rilpivirine exposures.

Pregnancy: Rilpivirine exposure approximately 30–40% lower during pregnancy (similar for second and third trimesters) compared with postpartum (6–12 weeks after delivery). Protein binding of rilpivirine similar during second trimester, third trimester, and postpartum period.

Stability

Storage

Oral

Tablets

20–25°C (excursions permitted between 15–30°C).

Store and dispense in original package; do not remove desiccant and protect from moisture.

Actions and Spectrum

Advice to Patients

Additional Information

The American Society of Health-System Pharmacists, Inc. represents that the information provided in the accompanying monograph was formulated with a reasonable standard of care, and in conformity with professional standards in the field. Readers are advised that decisions regarding use of drugs are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and that the information contained in the monograph is provided for informational purposes only. The manufacturer’s labeling should be consulted for more detailed information. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information contained in the monograph is not a substitute for medical care.

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

Dolutegravir Sodium and Rilpivirine Hydrochloride

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Tablets, film-coated

Dolutegravir Sodium 50 mg (of dolutegravir) and Rilpivirine Hydrochloride 25 mg (of rilpivirine)

Juluca

ViiV

AHFS DI Essentials™. © Copyright 2024, Selected Revisions March 10, 2024. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

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