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Tivicay (dolutegravir) is an Integrase Strand Transfer Inhibitor (INSTI) used in the treatment of HIV infection. It is part of a combination regimen with other antiretrovirals for patients who are INSTI-naïve or have specific profiles of HIV resistance. Dolutegravir works by inhibiting the HIV replication enzyme integrase, disrupting the formation of infectious virions.
Benefits
Tivicay is effective in managing HIV infection as part of a combination therapy. It helps reduce the viral load in the body, improving immune function and reducing the risk of HIV-related complications.
How to Use
Tivicay is available in film-coated tablets and can be taken with or without food. It is always used in combination with other antiretroviral drugs. Dosage adjustments may be necessary when taken with certain medications. Patients with mild or moderate hepatic impairment can use Tivicay without dosage adjustment, but it is not recommended for those with severe hepatic impairment. Caution is advised for patients with severe renal impairment.
Possible Side Effects
- Osteonecrosis
- Hepatotoxicity
- Viral resistance
- Immune reactivation syndrome
- Rash
For a comprehensive list of potential adverse effects, refer to the product monograph.
Warnings and Precautions
Serious rashes and organ dysfunction due to hypersensitivity reactions have been reported. Tivicay may increase the risk of depression and suicidal thoughts, particularly in patients with pre-existing psychiatric conditions. Patients with HIV should be screened for HBV and HCV co-infections, and appropriate treatment should be initiated.
Drug Interactions
Tivicay has numerous drug-drug and herbal interactions. Consult the product monograph for detailed information.
Pregnancy and Lactation
During pregnancy, highly active antiretroviral therapy should be used regardless of viral load and CD4 count. Tivicay is associated with neural tube defects if used in the first trimester. Consult current guidelines for treating pregnant women. The excretion of dolutegravir in breast milk is unknown, and breastfeeding is not recommended for HIV-positive women to prevent virus transmission.
Overdosage
In case of overdose, standard supportive care and monitoring should be provided. Dolutegravir is likely not dialyzable.
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