DOLUTEGRAVIR = DTG oral

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 Last updated: October 2024

 

Prescription under medical supervision

 

Therapeutic action

  • Antiretroviral, inhibitor of HIV integrase

Indications

  • HIV infection, in combination with other antiretrovirals 

Forms and strengths

  • 10 mg dispersible tablet 
  • 50 mg tablet

Dosage

The daily dose is administered once daily.

  • Child 1 month and over and adult:

 

Weight Daily dose Tablets 

3 to < 6 kg 

5 mg

½ disp tab 10 mg

6 to < 10 kg 

15 mg

1 ½ disp tab 10 mg

10 to < 14 kg 

20 mg

2 disp tab 10 mg

14 to < 20 kg 

25 mg

2 ½ disp tab 10 mg

≥ 20 kg

30 mg

or 50 mg

3 disp tab 10 mg

or 1 tab 50 mg

 

Duration

  • Depending on the efficacy and tolerance of dolutegravir.

Contra-indications, adverse effects, precautions

  • Administer with caution to patients with severe hepatic impairment or coinfection with hepatitis B or hepatitis C virus.
  • May cause: 
    • insomnia, depression, anxiety, dizziness, headache, skin rash, gastrointestinal disturbances (nausea, vomiting, diarrhoea, etc.); 
    • rarely: hepatotoxicity, hypersensitivity reactions. 
  • Do not administer simultaneously with antacids (aluminium or magnesium hydroxide, etc.), ferrous salts, calcium and zinc salts (effect of dolutegravir decreased). Take these drugs at least 6 hours before or 2 hours after dolutegravir.
  • In patients taking:
    • metformin: monitor closely blood glucose level and renal function and adjust dose as needed (effect of metformin increased). Do not exceed 1 g of metformin daily.
    • enzyme-inducing drug (e.g. rifampicin, carbamazepine, phenytoin, phenobarbital, efavirenz, nevirapine): double the daily dose of dolutegravir (effect of dolutegravir decreased), e.g. 30 mg 2 times daily rather than 30 mg once daily, and maintain the double dose for 2 weeks after enzyme-inducing drug treatment completion. 
  • In adolescents and women of childbearing age, offer hormonal contraception or an intrauterine device.
  • Pregnancy: small increased risk of neural tube defects but the benefits outweigh the risks. The administration of folic acid during the first trimester may reduce this risk.

Remarks

  • Three 10 mg dispersible tablets are equivalent to one 50 mg tablet.
  • In children 20 kg and over, preferably use 50 mg tablet unless they cannot swallow tablets.
  • Do not cut, crush or chew dispersible tablets. They can be swallowed or dispersed in a small amount of water.
  • Dolutegravir is also used for HIV post-exposure prophylaxis in combination with other antiretrovirals.
  • Also comes in fixed-dose combinations:
    • 300 mg tenofovir /300 mg lamivudine /50 mg dolutegravir. Preferably use this formulation when available in adolescents 30 kg and over and adults. In patients taking enzyme-inducing drugs, administer the fixed-dose combination in the morning and dolutegravir 50 mg in the evening.
    • 60 mg abacavir/30 mg lamivudine/5 mg dolutegravir dispersible tablet. Preferably use this formulation when available in children 3 months of age and over and weighing from 6 to under 25 kg.

Storage

 
–  
 
–  Below 25 °C