Generic ARVs

30 August 2024. Related: ARVs, Fixed dose combinations, Integrase inhibitors, NNRTIs, Nukes, PIs.

A generic drug is one that is manufactured by a different pharmaceutical company to the company that invented the medicine.

Generic drugs are widely used in all countries.

In the UK about 60% to 85% of all NHS prescriptions are for generic drugs.

The percentage varies depending on whether this is based on number of prescriptions or overall cost of drugs. This includes medicines for heart disease, diabetes, blood pressure, statins to lower cholesterol, pain relief, cancer and now HIV.

Generic medicines contain the same active ingredients as the original drugs.

Generic combination pills are also widely used in low income countries, even when patents are still in place in high-income countries.

Generic drugs are also widely used in high-income countries after the patents end.

There are many generic versions of tenofovir DF (TD), lamivudine (3TC) and dolutegravir coformulated into a single pill (TLD). These include Acriptega, Damicava, Dovimil, Emdolten, Lanograv, Lavern, Luvigen, Milutin, Nuvaco, Odystra, Ranega, Reydin, Telado, Telatri, Temiv, Tladeez, Viripil and Volutrip. See this website for generics in South Africa. These versions are not available yet in high-income countries where dolutegravir is still in patent.

Widely used generic versions of TLD include:

* Some generic versions of TLD  include emtricitabine (FTC) instead of lamivudine, (i.e. Kocitaf, Vonavir etc). These combinations are just as good. FTC and 3TC are very similar medicines.

The first generic version of Biktarvy is made by Hetero Pharma with a brand name Taffic. This is another integrase-based FDC. It includes tenofovir AF, lamivudine (3TC) and bictegravir. Other companies are likely to produce versions later.

Generic versions of Atripla include the same active ingredients – efavirenz plus emtricitabine plus tenofovir-DF.

Widely used generic versions of Atripla include:

All these combination pills contain the same active ingredients as Atripla and are just as safe and effective.

Generic versions of Atripla that use lamivudine (3TC) instead of emtricitabine (FTC) include: Avonza (Mylan), Tenarenz (Aspen Pharma) and Eflaten.

Generic versions of Truvada include Adco-Entevir (made by Adcok-Ingram), Hetemcit (Activo Health), Tenvir-EM (made by Cipla), Ricovir-EM (Mylan), Telura (Mylan Pharma) and Tenemine. These medicines contain tenofovir-DF plus emtricitabine and are used as PrEP by HIV negative people to protect against HIV infection. It is legal in the UK to import generic medicines for personal use, even if the patent on the brand medicine has not yet expired.

Generic versions of Kivexa include Dumiva and Rilovia (made by Mylan) and Heteruam (Lupin).

Although not a generic, Kaletra (lopinavir/ritonavir) is called Aluvia in many countries.

Generic versions of efavirenz include Adiva, Avifanz, Efamat, Efatec, Efavir, Efavirenz, Efcure, Eferven, Efrin, Erige, Estiva, Evirenz, Filginase, Stocrin, Sulfina V, Sustiva, Virorrever, and Zuletel.

Generic versions of nevirapine include Brinoprin (Hetero Pharma), Nevir (Forrester Pharma), Nevivir (Activo Health), Viropon (Novagen Pharma) and many generics also called Nevirapine.

Rather than using the brand name, look for the list of active ingredients. This is usually in smaller text on the box or leaflet that comes with your meds.

This website in South Africa has a good search engine for looking for generic versions of many different medicines. For example, this include different antibiotics, as well as HIV meds.
http://www.generic.co.za

Drug interactions with HIV meds, including dolutegravir

• Drug interactions: There is a caution for interactions between dolutegravir (included in TLD) with some supplements (containing calcium, magnesium or aluminium), antacids and multivitamins. This also includes antacids that include magnesium or aluminium.
  This requires separating the dolutegravir dose. These products need to be taken a minimum of two hours after dolutegravir or six hours before. Another important interaction is that dolutegravir doubles levels of metformin, and requires careful monitoring.
• This is only for supplements – it is NOT a concern for foods like milk and cheese that contain calcium.
• Drug interactions. Please tell your doctor or pharmacist about any other drugs or supplements before taking them with TLD. Drug interactions can also be checked using the online checker at Liverpool University HIV Interaction website:
  https://www.hiv-druginteractions.org/checker
• See information about the individual drugs in Triumeq for more information on side effects.

Further information

The European patient information and detailed Product Information for Triumeq are available from this link on the European Medicines Agency (EMA) website.

The Patient Information is a simplified summary: what the drug is, why it is used, results from studies and cautions including side effects.

The Product Information is a detailed technical summary that you can access as a PDF file by clicking the ‘Product Information’ tab. It describes more precisely how the drug works and how it is processed by your body. This includes, for example, reported food interaction studies in terms of calories or fat content. It includes more details of the study results and a full list of side effects and drug interactions.