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
| Triumeq | Atripla |
|---|---|
| *CD4+ T-cells (also called T-cells) are white blood cells that help fight infections; table adapted from manufacturer data. | |
| 71% of patients who took Triumeq reached undetectable levels. | 63% of patients who took Triumeq reached undetectable levels. |
| The average increase in CD4+ T-cell* count was 378 cells/mm3. | The average increase in CD4+ T-cell* count was 332 cells/mm3. |
| 4% of patients dropped out of the study due to side effects. | 4% of patients dropped out of the study due to side effects. |
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
| Side Effect | Triumeq | Atripla |
|---|---|---|
| Trouble Sleeping | 3% | 3% |
| Headaches | 2% | 2% |
| Tiredness | 2% | 2% |
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.
References
- Apretude (cabotegravir). Drugs.com. Accessed 12/31/2021 at https://www.drugs.com/apretude.html
- Triumeq [package insert]. Research Triangle Park, NC: ViiV Healthcare., 2020. https://www.gsksource.com/pharma/content/dam/GlaxoSmithKline/US/en/Prescribing_Information/Triumeq/pdf/TRIUMEQ-PI-MG.PDF
- Learn About Triumeq. ViiV Healthcare. April 2020. https://us.triumeq.com/
Read next
Does Triumeq cause erectile dysfunction?
Triumeq is unlikely to cause erectile dysfunction (ED), and ED is not listed as a side effect in the product information nor reported in post-marketing data – these are studies done after a drug has been approved. A review concluded that newer HIV combination treatments in use today have no clear-cut association with ED. Older HIV agents, such as zalcitabine (no longer in use) and enfuvirtide (rarely used) were known to cause ED. Using abacavir and raltegravir together had a weak association with ED, but no protease inhibitors appear to increase the risk. Triumeq contains three antivirals: abacavir and lamivudine and dolutegravir. Continue reading
Can Triumeq be crushed or split?
To ensure you receive the entire dose of Triumeq, the manufacturer recommends that ideally the tablet be swallowed whole. If you have trouble swallowing a whole tablet, crushing or splitting tablets may be an acceptable alternative, if approved by your healthcare provider. Do not chew, cut, or crush the Triumeq PD tablets. Continue reading
Triumeq vs Genvoya. How do they compare?
Both Triumeq and Genvoya are combination one-tablet-a-day medicines that are considered first-line treatments for HIV-1 by the HHS guidelines. Because Triumeq does not contain cobicistat, an antiviral booster, it is less likely to interact with other medications and may have fewer side effects than Genvoya. People taking Genvoya do not need to be tested for the HLA-B*5701 gene, because it does not contain abacavir. Continue reading
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Drug information
- Triumeq Information for Consumers
- Triumeq prescribing info & package insert (for Health Professionals)
- Side Effects of Triumeq (detailed)
- Triumeq user reviews (127)
Related support groups
- Triumeq (10 questions, 20 members)