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Generic Name:

abacavir-dolutegravir-lamivudine, Oral tablet

All Brands

  • TRIUMEQ
SECTION 1 of 4

Highlights for abacavir-dolutegravir-lamivudine

Oral tablet
1

Abacavir/dolutegravir/lamivudine is a combination of three drug ingredients.

2

This drug is used to treat HIV infection. In many cases, it provides all of the drugs you need to fight HIV infection in one daily tablet. If you have a resistant form of the virus, you may need additional antiretroviral drugs to control your HIV infection.

3

Abacavir/dolutegravir/lamivudine is only available as the brand-name drug Triumeq. There is no generic form available.

IMPORTANT INFORMATION

FDA warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). Though the medication can still be sold and used, a black box warning alerts doctors and patients to potentially dangerous effects.

May cause severe and potentially fatal drug hypersensitivity reaction. Symptoms of a hypersensitivity reaction may include:

  • fever
  • rash
  • nausea
  • diarrhea
  • vomiting
  • stomach pain
  • fatigue
  • achiness
  • trouble breathing
  • cough
  • sore throat

Your doctor may give you a blood test for the gene HLA-B*5701. People with this allele are at much higher risk of hypersensitivity. If you have this allele, your doctor may give you a different drug. 

If you stop taking this drug, you could be at risk of hypersensitivity again when you restart taking it.

If you have a hypersensitivity reaction to abacavir, you should never take it again. The second time could lead to dangerously low blood pressure and can even be fatal.

If you have a hypersensitivity reaction to this drug, be sure to properly dispose of any unused drug right away. This will prevent you from restarting treatment with the drug, which would be dangerous.

May cause lactic acidosis and liver enlargement. Lactic acidosis is a severe change in your body’s chemical balance. Lactic acid builds up in your blood and the amount of oxygen in your blood drops. This can cause nausea and weakness. If you have these symptoms in addition to swelling or enlargement of your abdomen, see your doctor right away. Some cases of lactic acidosis have been serious or fatal.

May increase risk of heart attack

If you have a history of coronary heart disease, you may be at higher risk for a heart attack if you take abacavir. Tell your doctor about your heart disease before you take this drug.

May cause immune reconstitution syndrome

This drug may cause immune reconstitution syndrome. In this condition, your recovering immune system causes past infections to return. Examples of past infections that may return include fungal infections, pneumonia, or tuberculosis. Your doctor may need to re-treat the old infection if this happens. Watch for returning symptoms of past infections.

May worsen hepatitis B virus infection

If you have hepatitis B virus infection and take this drug, your infection could worsen. Your doctor may test you before you start this drug and periodically while you take it. You might need to restart treatment for hepatitis B.

What is abacavir/dolutegravir/lamivudine?

Abacavir/dolutegravir/lamivudine is a prescription drug that comes as an oral tablet. It’s only available as the brand-name drug Triumeq. A generic form is not available.

This medication comes as a single tablet that contains three drugs: abacavir, dolutegravir, and lamivudine. It’s important to know about all the drugs in the combination because each drug may affect you in a different way.

Why it's used

Abacavir/dolutegravir/lamivudine is a combination drug used to treat HIV infection. In many cases, it provides all of the drugs you need to fight HIV infection in one daily tablet. It may be a complete treatment for people who aren’t resistant to any of its ingredients.

This drug doesn’t cure HIV, but it may help control it.

How it works

The three drugs in this tablet all work together to slow down the multiplication of HIV in your body. The tablet works by blocking the action of an enzyme called integrase. HIV needs this enzyme to make copies of itself. It also works by blocking reverse transcriptase, another enzyme HIV needs to make copies of itself.

If your HIV infection is resistant to any of these three drug ingredients, you may need to take an additional drug for complete treatment.

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SECTION 2 of 4

abacavir-dolutegravir-lamivudine Side Effects

Oral tablet

Most Common Side Effects

The most common side effects that occur with this drug include:

  • insomnia

  • headache

  • fatigue

  • changes in the distribution of body fat, such as an increasing amount of fat on your neck and back

These side effects should disappear in time. If they persist or are bothersome, call your doctor.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Serious and possibly fatal drug hypersensitivity reaction: Call your doctor or 911 if you have several of these symptoms at the same time, especially if they happen suddenly:

    • fever
    • rash
    • nausea
    • diarrhea
    • vomiting
    • stomach pain
    • fatigue
    • achiness
    • trouble breathing
    • cough
    • sore throat 
  • Lactic acidosis and liver enlargement: Symptoms include nausea and weakness. If you have these symptoms in addition to swelling or enlargement of your abdomen, see your doctor right away.

  • Immune reconstitution syndrome: In this condition, your recovering immune system can cause past infections to return, such as fungal infections, pneumonia, or tuberculosis. Your doctor may need to re-treat the old infection if this happens. Watch for returning symptoms of past infections. 

  • Increased risk of heart attack: This may happen in people with a history of coronary heart disease.

  • Severe liver problems: Call your doctor right away if you experience any of the following:

    • yellowing of the skin or eyes
    • dark urine
    • loss of appetite
    • abdominal pain
  • Worsened hepatitis B virus infection: Symptoms can include:

    • yellowing of the skin or eyes
    • dark urine
    • loss of appetite
    • abdominal pain
  • Increased risk of liver toxicity: This can occur in people with hepatitis C who take this drug with interferon or ribavirin. This effect can be fatal. Symptoms can include:

    • yellowing of the skin or eyes
    • dark urine
    • loss of appetite
    • abdominal pain
    • dark stools
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Abacavir/dolutegravir/lamivudine does not cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

abacavir-dolutegravir-lamivudine May Interact with Other Medications

Oral tablet

This drug can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Alcohol Interaction

Abacavir, one of the drugs contained in abacavir/dolutegravir/lamivudine, interacts with alcohol. If they’re combined, the drug level of abacavir could go up and you could be at risk of increased side effects. Don’t drink alcohol while taking abacavir/dolutegravir/lamivudine.

Medications that might interact with this drug:

Antacids

Abacavir/dolutegravir/lamivudine can be taken 2 hours before or 6 hours after antacids such as:

  • aluminum- or magnesium-containing antacids
  • milk of magnesia
  • sucralfate

Antibiotics
  • rifampin (Rifadin)
  • sulfamethoxazole/trimethoprim (Septra, Cotrim)

Buffered drugs

Abacavir/dolutegravir/lamivudine can be taken 2 hours before or 6 hours after buffered aspirin.

Calcium supplements

Abacavir/dolutegravir/lamivudine can be taken 2 hours before or 6 hours after calcium supplements.

Dofetilide (Tikosyn)

This drug should not be taken with abacavir/dolutegravir/lamivudine. Taking abacavir/dolutegravir/lamivudine with dofetilide can increase the amount of dofetilide in your body to dangerous levels. Do not take these drugs together.

Epilepsy drugs
  • oxcarbazepine
  • phenytoin
  • phenobarbital
  • carbamazepine

HIV drugs
  • abacavir (Ziagen)
  • etravirine (Intelence)
  • efavirenz (Sustiva)
  • lamivudine (Epivir)
  • nelfinavir (Viracept)
  • nevirapine (Viramune)
  • fosamprenavir/ritonavir (Lexiva)
  • tipranavir/ritonavir

Interferon, with or without ribavirin

Combining these medications could have toxic effects. You may need to stop taking abacavir/dolutegravir/lamivudine or take reduced doses of these drugs.

Iron supplements

Abacavir/dolutegravir/lamivudine can be taken 2 hours before or 6 hours after iron supplements.

Multivitamins containing iron

Abacavir/dolutegravir/lamivudine can be taken 2 hours before or 6 hours after multivitamins containing iron.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
coronary heart disease
People with coronary heart disease

If you have a history of coronary heart disease, you may be at higher risk for a heart attack while taking this medication. Tell your doctor about your heart disease before you take it.

liver disease
People with liver disease

If you have liver disease and require the combination of the three drugs in this tablet, you may need to take the drugs individually. The dose of abacavir in this tablet is too high for your liver to process, and taking it may cause a build up of abacavir in your body. This could lead to toxic effects.

hepatitis C virus infection
People with hepatitis C virus infection

In some people who had been taking interferon alfa with or without ribavirin to treat hepatitis C virus infection experienced a severe liver reaction (hepatic decompensation) when they took antiretroviral drugs, like one of the drugs in the abacavir/dolutegravir/lamivudine tablet. Some of these cases were fatal. Talk to your doctor before taking abacavir/dolutegravir/lamivudine if you have hepatitis C virus infection.

reduced kidney function
People with reduced kidney function

If you have reduced kidney function and require the combination of the three drugs in this tablet, you may need to take the drugs individually. The dose of lamivudine in this tablet is too high for your kidneys, and they may not be able to filter out drugs quickly enough. This could lead to increased drug levels in your body, which can cause toxic effects. 

pregnant woman
Pregnant women

This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Abacavir/dolutegravir/lamivudine should be used during pregnancy only if the potential benefit outweighs the risks.

breastfeeding
Women who are breast-feeding

It’s not recommended to breastfeed while you take this medication. According to the U.S. Department of Health and Human Services, you shouldn’t breastfeed your infant if you have human immunodeficiency virus (HIV). There is a risk of passing HIV to your baby.

Additionally, lamivudine, one of this drug’s ingredients, is passed through breast milk. This can cause serious side effects in the child. 

seniors
For seniors

There isn’t enough research of people over the age of 65 years to know how this drug may affect them. Older adults are more likely to have reduced kidney and liver function and may have more difficulty processing this drug. A build up of this drug in your body can cause toxic effects. If you’re a senior, tell your doctor about all the drugs you take and your other health conditions before taking this medication.

telephone
When to call the doctor

Call your doctor if you experience:

  • fever
  • weakness
  • chills
  • night sweats
  • sore throat
  • joint pain

These symptoms may be a sign the drug isn’t working, and you may need a different treatment.

allergies
Allergies

Serious and sometimes fatal drug hypersensitivity reactions have happened to people taking abacavir, which is one of the drugs in this tablet. Call your doctor or 9-1-1 if you experience a combination of these symptoms:

  • fever
  • rash
  • nausea
  • diarrhea
  • vomiting
  • stomach pain
  • fatigue
  • achiness
  • trouble breathing
  • cough
  • sore throat
SECTION 4 of 4

How to Take abacavir-dolutegravir-lamivudine (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What Are You Taking This Medication For?

Human immunodeficiency virus (HIV) infection

Brand: Triumeq

Form: Oral Tablet
Strength: 600 mg abacavir/50 mg dolutegravir/300 mg lamivudine
Adult dosage (ages 18-64 years)

One tablet per day.

Child dosage (ages 0-17 years)

Dosage for people younger than 18 years has not been established.

Senior dosage (ages 65 years and older)

People older than 65 years may require a dosage lower than the amounts in the abacavir/dolutegravir/lamivudine tablet. If you are older than 65 years, your doctor may test your liver and kidney function before starting you on this tablet.

  • If you take abacavir/dolutegravir/lamivudine with any of the following drugs, you may need to take an extra 50 mg dose of dolutegravir each day. This extra dose is usually taken 12 hours after the abacavir/dolutegravir/lamivudine dose. These drugs include:
    • efavirenz (Sustiva)
    • fosamprenavir/ritonavir (Lexiva)
    • tipranavir/ritonavir (Aptivus)
    • rifampin (Rifadin)
Special considerations

Liver Disease: If you have liver disease and require the combination of the three drugs in this tablet, you may need to take the drugs individually. The dose of abacavir in this tablet is too high for your liver to process, and taking it may cause a build up of abacavir in your body. This could lead to toxic effects.

Reduced Kidney Function: If you have reduced kidney function and require the combination of the three drugs in this tablet, you may need to take the drugs individually. The dose of lamivudine in this tablet is too high for your kidneys, and they may not be able to filter out drugs quickly enough. This could lead to increased drug levels in your body, which can cause toxic effects.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Keeping human immunodeficiency virus (HIV) infection under control requires lifelong treatment. There can be serious health consequences if you don’t take this drug exactly how your doctor tells you.

If you don't take it at all

If you don’t take it at all, your HIV infection will eventually reduce your immunity to a point that your body won’t be able to defend itself against many types of infections, even infections that are commonly cured in people who don’t have HIV infection.

If you stop or miss doses

If you stop taking this medication, miss doses, or don’t take it on schedule, the amount of medication in your body fluctuates. This can allow the HIV in your body to become resistant to the drug, which means the drug stops working.

If you don't take it on schedule

Taking your drug at the same time every day keeps a constant amount of the drug in your body. This helps make the drug as effective as possible at keeping the virus under control.

What to do if I miss a dose

If you miss a dose, take it as soon as you remember. If it is within a few hours of the time for your next dose, skip the missed dose and only take a single dose at the next dosing time. Never double up on doses. This can lead to an increased risk of toxicity and side effects.

How can I tell if the drug is working?

To see how well the drug is working, your doctor will check your:

  • virus count. A virus count measures the number of copies of HIV in your body. A decreased virus count is an indication that the treatment is working.
  • CD4 cell count. A CD4 cell count measures the number of CD4 cells in your body. CD4 cells are white blood cells that fight infection. An increased CD4 cell count is a sign that your treatment is working.

Abacavir/dolutegravir/lamivudine is a long-term drug treatment.

The tablet is film-coated, so it can’t be cut or crushed

Tell your doctor if you have trouble swallowing the tablets. They may be able to change your prescription to the individual drugs, which may be smaller or crushable.

Store this drug in its original package

Keep the bottle tightly closed and away from moisture. Don’t store it in your bathroom or another damp location. Don’t remove the desiccant (the packet in the bottle), which helps keep moisture away from the drug tablets. 

Store the medication at 77°F (25°C). You can briefly store it in temperatures as low as 59°F (15°C) and as high as 86°F (30°C).

Self-management

Make sure that you follow the directions carefully if you take calcium, iron, or antacids. Taking these over-the-counter drugs incorrectly can prevent abacavir/dolutegravir/lamivudine from being absorbed well. Ask your doctor or pharmacist about how to take all of these correctly.

Clinical monitoring

Your doctor may check your liver and kidney function before you start taking this medication.

To see how well your treatment is working, your doctor will check your:

  • symptoms
  • virus count. The virus count measures the number of copies of the human immunodeficiency virus (HIV) in your body. A decreased virus count is a sign that your treatment is working.
  • CD4 cell count. A CD4 cell count measures the amount of CD4 cells in your body. CD4 cells are white blood cells that play a role in your immune system. An increased CD4 cell count is a sign that your treatment is working.

Not every pharmacy stocks this drug, so call ahead

If you only need a few tablets, you should call and ask if your pharmacy dispenses only a small number of tablets. Some pharmacies can't dispense only part of a bottle.

This drug is often available from specialty pharmacies through your insurance plan. These pharmacies operate like mail order pharmacies and ship the drug to you.

In larger cities, there will often be human immunodeficiency virus (HIV) pharmacies where you can have your prescriptions filled. Ask your doctor if there's an HIV pharmacy in your area.

Insurance

Many insurance companies will require a prior authorization before they approve the prescription and pay for abacavir/dolutegravir/lamivudine. Your doctor may need to do paperwork for you, which could take a week or two.

Are there any alternatives?

There are many drugs and combinations that can treat human immunodeficiency virus (HIV) infection. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.


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Content developed in collaboration with Susan J. Bliss, RPh, MBA

Medically reviewed by University of Illinois-Chicago, Drug Information Group on June 15, 2017

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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