Dolutegravir/rilpivirine is used to help control HIV
infection. It helps to decrease the amount of HIV in your body so your
immune system can work better. This lowers your chance of getting HIV
complications (such as new infections, cancer) and improves your quality of
life. Dolutegravir is an integrase inhibitor while rilpivirine is a
non-nucleoside reverse transcriptase inhibitor (NNRTI). Both drugs block
the virus from growing and infecting more cells.
Dolutegravir/rilpivirine is not a cure for HIV
infection. To decrease your risk of spreading HIV disease to others,
continue to take all HIV medications exactly as prescribed by your doctor.
Use an effective barrier method (latex or polyurethane condoms/dental dams)
during sexual activity as directed by your doctor. Do not share personal
items (such as needles/syringes, toothbrushes, and razors) that may have
contacted blood or other body fluids. Consult your doctor or pharmacist for
more details.
This section contains uses of this drug that are not
listed in the approved professional labeling for the drug but that may be
prescribed by your health care professional. Use this drug for a condition
that is listed in this section only if it has been so prescribed by your
health care professional.
This product may also be used to reduce the risk of
getting HIV infection after contact with the virus. Consult your doctor for
more details.
Read the Patient Information Leaflet if available from
your pharmacist before you start using dolutegravir/rilpivirine and each
time you get a refill. If you have any questions, ask your doctor or
pharmacist.
Take this medication by mouth with a meal as directed by
your doctor, usually once daily. The dosage may be based on other
medications you are taking. Be sure to tell your doctor and pharmacist
about all the products you use (including prescription drugs,
nonprescription drugs, and herbal products).
Medications which reduce or block stomach acid (such as
proton pump inhibitors/PPIs, H2 blockers, antacids) may reduce the
absorption of rilpivirine, making this product work less well. Do not take
PPIs (such as omeprazole, lansoprazole) while using this medication. If you
take antacids, take the antacids at least 6 hours before or at least 4
hours after this product. If you take H2 blockers (such as famotidine,
ranitidine), take them at least 12 hours before or at least 4 hours after
this product.
Sucralfate and products containing aluminum or magnesium
(such as antacids, laxatives, buffered medications) may reduce the
absorption of dolutegravir, making this product work less well. Take these
products 6 hours before or 4 hours after this medication.
Calcium or iron supplements (including vitamins/minerals
that contain calcium or iron) may also reduce the absorption of
dolutegravir, making this product work less well. Take these products 6
hours before or 4 hours after this medication. Or you can take this
medication and the calcium or iron supplements together at the same time
with a meal.
It is very important to keep taking this medication
exactly as prescribed by your doctor. Do not skip any
doses.
For the best effect, take this medication at evenly
spaced times. To help you remember, take this medication at the same time
every day.
Do not take more or less of this drug than prescribed or
stop taking it even for a short time unless directed to do so by your
doctor. Doing so may cause the amount of virus to increase, make the
infection more difficult to treat (resistant), or worsen side
effects.
Headache or diarrhea may occur. If either of these
effects lasts or gets worse, tell your doctor or pharmacist
promptly.
Remember that this medication has been prescribed
because your doctor has judged that the benefit to you is greater than the
risk of side effects. Many people using this medication do not have serious
side effects.
As your immune system gets stronger, it can begin to
fight off infections you already had, possibly causing disease symptoms to
come back. You could also have symptoms if your immune system becomes
overactive. This reaction may happen at any time (soon after starting HIV
treatment or many months later). Get medical help right away if you have
any serious symptoms, including:
- unexplained weight loss
- severe tiredness
- muscle aches/weakness that doesn't go away
- headaches that are severe or don't go away
- joint pain
- numbness/tingling of the hands/feet/arms/legs
- vision changes
- signs of infection (such as fever, chills, swollen lymph
nodes, trouble breathing, cough, non-healing skin sores)
- signs of an overactive thyroid (such as irritability,
nervousness, heat intolerance, fast/pounding/irregular heartbeat, bulging
eyes, unusual growth in the neck/thyroid known as a goiter)
- signs of a certain nerve problem known as Guillain-Barre
syndrome (such as unsteadiness, loss of coordination, trouble
swallowing/speaking/chewing, trouble moving your eyes)
- signs of liver disease (such as nausea/vomiting that doesn't
stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark
urine)
Tell your doctor right away if you have any serious side
effects, including:
- mental/mood changes (such as depression, thoughts of
suicide)
Changes in body fat may occur while you are taking this
medication (such as increased fat in the upper back and stomach areas,
decreased fat in the arms and legs). The cause and long-term effects of
these changes are unknown. Discuss the risks and benefits of treatment with
your doctor, as well as the possible use of exercise to reduce this side
effect.
Rilpivirine can commonly cause a rash that is usually
not serious. However, you may not be able to tell it apart from a rare rash
that could be a sign of a severe reaction. Get medical help right away if
you develop any rash.
A very serious allergic reaction to this drug is rare.
However, get medical help right away if you notice any symptoms of a
serious allergic reaction, including:
- rash
- itching/swelling (especially of the face/tongue/throat)
- severe dizziness
- trouble breathing
This is not a complete list of possible side effects. If
you notice other effects not listed above, contact your doctor or
pharmacist.
In the US - Call your doctor for medical advice about side effects.
You may report side effects to FDA at 1-800-FDA-1088 or at
www.fda.gov/medwatch.
In Canada - Call your doctor for medical advice about
side effects. You may report side effects to Health Canada at
1-866-234-2345.
Before taking this product, tell your doctor or
pharmacist if you are allergic to dolutegravir or rilpivirine; or if you
have any other allergies. This product may contain inactive ingredients,
which can cause allergic reactions or other problems. Talk to your
pharmacist for more details.
Before using this medication, tell your doctor or
pharmacist your medical history, especially of:
- kidney disease
- liver disease (such as hepatitis B, hepatitis C)
- mental/mood disorders (such as depression)
Before having surgery, tell your doctor or dentist about
all the products you use (including prescription drugs, nonprescription
drugs, and herbal products).
Tell your doctor if you are pregnant before using this
medication. Treatment can lower the risk of passing HIV infection to your
baby. Discuss the risks and benefits with your doctor.
This medication passes into breast milk. Because breast
milk may transmit HIV, consult your doctor before
breastfeeding.
See also How to Use section.
Drug interactions may change how your medications work
or increase your risk for serious side effects. This document does not
contain all possible drug interactions. Keep a list of all the products you
use (including prescription/nonprescription drugs and herbal products) and
share it with your doctor and pharmacist. Do not start, stop, or change the
dosage of any medicines without your doctor's approval.
Some products that may interact with this drug
are:
- dofetilide
- orlistat
- proton pump inhibitors (PPIs such as esomeprazole,
lansoprazole, omeprazole, pantoprazole, rabeprazole)
Do not take this medication with other products that
treat HIV infection. Do not take this medication with other products that
contain rilpivirine, unless you are also taking rifabutin.
Other medications can affect the removal of rilpivirine
from your body, which may affect how rilpivirine works. Examples include
dexamethasone, certain macrolide antibiotics (such as clarithromycin,
erythromycin), rifamycins (such as rifampin, rifapentine), St. John's wort,
certain drugs used to treat seizures (such as carbamazepine, oxcarbazepine,
phenobarbital, phenytoin, primidone), a certain combination product used to
treat chronic hepatitis C (ombitasvir/paritaprevir/ritonavir/dasabuvir),
among others.
If someone has overdosed and has serious symptoms such
as passing out or trouble breathing, call 911. Otherwise, call a poison
control center right away. US residents can call 1-800-222-1222. Canada
residents can call 1-844-764-7669. Symptoms of overdose may include:
fast/irregular heartbeat, severe dizziness, fainting.
Do not share this medication with others.
Lab and/or medical tests (such as viral load, T-cell
counts, liver function) should be done while you are taking this
medication. Keep all medical and lab appointments. Consult your doctor for
more details.
If you miss a dose, take it with a meal as soon as you
remember. If it is near the time of the next dose, skip the missed dose.
Take your next dose at the regular time. Do not double the dose to catch
up.
Store in the original bottle at room temperature away
from light and moisture. Do not store in the bathroom. Keep the drying
agent (desiccant) in the bottle. Tightly close the bottle when not in use.
Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them
into a drain unless instructed to do so. Properly discard this product when
it is expired or no longer needed. Consult your pharmacist or local waste
disposal company.