#最小單位貼紙

抗病毒藥品 Treatment of HIV-1 infection in adult and pediatric patients weighing ≥40 kg

Dolutegravir: Integrase Inhibitor (Anti-HIV)
Bind to the integrase active site and block the strand transfer step of retroviral DNA integration.
Abacavir: Nucleosid Reverse Transcriptase Inhibitor (Anti-HIV)
Abacavir --converted->Carbovir triphosphate (CBV-TP, active metabolite, an analogue of dGTP). CBV-TP inhibits the activity of HIV-1 reverse transcriptase both by competing with the natural substrate dGTP and by its incorporation into viral DNA.
Lamivudine: Nucleosid Reverse Transcriptase Inhibitor (Anti-HIV)
Lamivudine --phosphorylated-> Lamivudine triphosphate (3TC-TP, active 5′-triphosphate metabolite). The principal mode of action of 3TC-TP is inhibition of reverse transcriptase via DNA chain termination after incorporation of the nucleotide analogue.

Show no difference in values when compared to dolutegravir as a single agent given with abacavir and lamivudine as a combination product.

1. Hypersensitivity to abacavir, dolutegravir, lamivudine, or any component of the formulation
2. Patients with HLA-B*5701 allele
3. Concomitant dofetilide
4. Moderate or severe hepatic impairment
5. Known or clinically suspected integrase strand transfer inhibitor resistance because the dose of dolutegravir is insufficient in these subpopulations.

1. Pregnant female: An alternative regimen for whom are antiretroviral-naive, have had antiretroviral therapy (ART) in the past but are restarting, or require a new ART regimen
2. Become pregnant while taking: may continue if viral suppression is effective and the regimen is well tolerated

Abacavir, dolutegravir, and lamivudine are present in breast milk

1. Endocrine & metabolic: Hyperglycemia, Hypertriglyceridemia
2. Gastrointestinal: Increased serum lipase, abdominal pain, anorexia, flatulence, gastroesophageal reflux disease, vomiting
3. Neuromuscular & skeletal: Increased creatine phosphokinase (≥6.0 x ULN), Arthralgia, Myositis
4. Central nervous system: Drowsiness, nightmares, sleep disorder, suicidal ideation, depression, fatigue, headache, insomnia
5. Dermatologic: Pruritus
6. Hematologic: Decreased neutrophils
7. Hepatic: Hepatitis, increased serum ALT (>2.5 x ULN), increased serum AST (>2.5 x ULN)
8. Renal: Renal insufficiency
9. Miscellaneous: Fever

Dosage:
One tablet once daily
Administration:
1. If patient is on concomitant therapy with efavirenz, fosamprenavir/ritonavir, tipranavir/ritonavir, carbamazepine, or rifampin, an additional daily single-component dolutegravir tablet should be administered 12 hours after Triumeq.
2. Administer 2 hours before or 6 hours after cation-containing antacids or laxatives, sucralfate, oral supplements containing iron or calcium, or buffered medications.
3. Alternatively, may be administered with supplements containing calcium or iron at the same time if administered together with food.

1. Weighing <40 kg: Not recommended; product is a fixed-dose combination
2. Weighing ≥40 kg: One tablet once daily

1. CrCl <50 mL/minute: Not recommended
2. CrCl ≥50 mL/minute: No dosage adjustment necessary

1. Child-Pugh class B, C: Contraindicated
2. Child-Pugh class A: Not recommended