Daily Medication Pearl: Dolutegravir and Rilpivirine (Juluca) for HIV

Medication Pearl of the Day: Dolutegravir and Rilpivirine (Juluca)

Indication: Juluca, a 2-drug combination of dolutegravir, an HIV-1 integrase strand transfer inhibitor (INSTI), and rilpivirine, a HIV-1 non-nucleoside reverse transcriptase inhibitor (NNRTI), is indicated as a complete regimen for the treatment of HIV-1 infection in adults.

Insight:

  • Dosing: One tablet taken orally once daily with a meal.
  • Dosage form: Each tablet contains 50 mg of dolutegravir (equivalent to 52.6 mg dolutegravir sodium) and 25 mg of rilpivirine (equivalent to 27.5 mg rilpivirine hydrochloride).
  • Adverse events (AEs): The most common AEs (all grades) observed in at least 2% of subjects were diarrhea and headache.
  • Mechanism of action: Dolutegravir inhibits HIV integrase by binding to the integrase active site and blocking the strand transfer step of retroviral DNA integration, which is essential for the HIV replication cycle. Rilpivirine is a diarylpyrimidine NNRTI of HIV-1 and inhibits HIV-1 replication by noncompetitive inhibition of HIV-1 reverse transcriptase.
  • Manufacturer: ViiV Healthcare

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