Guides

Triumeq (dolutegravir + abacavir + 3TC)

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

Triumeq image

 TRI-you-mek

  • Triumeq is a single pill that combines three different HIV drugs. These are an integrase inhibitor called dolutegravir plus two RTIs (nukes) called abacavir and 3TC (lamivudine).
  • Triumeq was approved on 22 August 2014 in the US and on 3rd September 2014 in the EU.
  • NHS England announced guidelines for prescribing Triumeq (and dolutegravir) on 15 January 2015.
  • Standard adult dose (age 12 and older): 1 pill once-daily.
  • Can be taken with or without food.
  • It is best taken after you have woken up (rather than before you sleeo). This is because it can stop you sleeping if you take it before you sleep. For most people this will be in the morning or during the day. If you are on shift work and work at night you would take it before you go to work.
  • Before using Triumeq you need a blood test to check you are not likely to get a reaction to abacavir. If you test positive for a gene called HLA*B-5701 you should not use any combinations that include abacavir. This includes Kivexa and Triumeq.
  • An additional dose of dolutegravir is needed if Tirumeq is used with the following drugs: efavirenz, fosamprenavir/ritonavir, tipranavir/ritonavir, or rifampin.
  • Side effects are generally mild and uncommon. For example. the most commonly reported side effects in studies were insomnia, headache and feeling tired (in 3%, 2% and 2% of people. These were similar to other HIV combinations. They were not reported by most people and they caused very few people to stop treatment.
  • Since approval there have been more reports of CNS side effects (similar to efavirenz). These includes mood changes and difficulty sleeping. Although these are not common, case reports include needing to change to another drug.
  • Since approval dolutegravir has also been linked to weight gain but more recent research is now questioning this.
  • Taking Triumeq after you wake up (rather than before you go to sleep) improves sleep for most people. Try this first as this often makes things much better.
  • Drug interactions: There is a caution for interactions 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.