Dolutegravir

Dolutegravir is an antiretroviral medication used in the treatment of HIV (human immunodeficiency virus) infection. It belongs to the integrase strand transfer inhibitor (INSTI) class of drugs, which work by inhibiting the action of integrase, an enzyme that HIV uses to integrate its genetic material into the host's DNA. Dolutegravir is an antiretroviral medication used, together with other medication, to treat HIV/AIDS. It is HIV integrase strand transfer inhibitor which blocks the functioning of HIV integrase which is needed for viral replication. The use of Dolutegravir  in integrase strand transfer inhibitor (INSTI)-experienced patients should be guided by the number and type of baseline INSTI substitutions.

Indications

-Dolutegravir is indicated for the treatment of HIV-1 infection in adults and pediatric patients weighing at least 30 kg. It is often used in combination with other antiretroviral medications. -In combination with other antiretroviral agents for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in adults and pediatric patients weighing at least 30 kg.

Dosage

-The recommended dosage of dolutegravir may vary based on factors such as the patient's age, weight, renal function, and other concomitant medications. It is typically taken orally once daily with or without food. Dosing adjustments may be necessary in certain patient populations. -Oral; 50 mg once or twice daily depending upon the level of substitution of INSTI (Naïve or resistant).

Contra-Indications

-Dolutegravir is contraindicated in individuals with a known hypersensitivity to the drug or any of its components. It should not be co-administered with dofetilide due to the risk of serious adverse reactions. -With dofetilide, known hypersensitivity.

Special Precautions

-Patients with a history of psychiatric disorders should be monitored closely. -Dolutegravir may cause changes in liver enzyme levels, so liver function tests should be performed regularly. -It is important to assess patients for the risk of hypersensitivity reactions. Paediatric: Safety and efficacy have not been established in pediatric patients weighing less than 30 kg or in any pediatric patients who are INSTI-experienced. Pregnancy: Data not sufficient. Lactation: Data not sufficient. Elderly: Use with caution.

Side Effects

-Common side effects of dolutegravir may include insomnia, headache, nausea, and diarrhea. Serious side effects may include hypersensitivity reactions, liver problems, and psychiatric symptoms such as depression or suicidal ideation. -Insomnia, headache, allergic reactions and abnormal liver function in patients who were also infected with hepatitis B or C, impaired renal function.

Drug Interactions

-Dolutegravir may interact with other medications, potentially affecting their efficacy or causing adverse effects. Some drugs that may interact with dolutegravir include rifampin, certain antacids, and medications that affect renal function. -Etravirine, Efavirenz Nevirapine, ritonavira, Carbamazepinea , Metformin, Rifampin.