Juluca (dolutegravir + rilpivirine)
WHAT IS JULUCA?
Juluca is a combined pill containing two HIV medicines: dolutegravir (Tivicay; see Fact Sheet 467) and rilpivirine (Edurant; see fact sheet 435). Juluca is the first full HIV regimen with two drugs. Juluca is manufactured by ViiV Healthcare and Janssen Pharmaceuticals.
Dolutegravir is an integrase inhibitor (or INSTI). Rilpivirine is a non-nucleoside reverse transcriptase inhibitor (a non-nucleotide NNRTI). These drugs prevent the multiplication of HIV by preventing the integrase virus and the reverse transcriptase enzymes, respectively, from working. These enzymes transform the genetic material from HIV (RNA) into DNA and incorporate the viral genes into the human chromosome. These processes are shown in the 106 Datasheet, steps 4 and 5. The drugs in Juluca block these processes.
WHO SHOULD TAKE JULUCA?
Juluca was approved in 2017 as a complete antiretroviral regimen for people who are currently on stable treatment with the virus suppressed for at least 6 months and have no history of treatment failure or resistance to viral drugs.
Although antiretroviral therapy (ART) is recommended for all people living with HIV, it does not matter what your symptoms or CD4 count (see Fact Sheet124), you and your doctor should consider your CD4 cell count, viral load (see Fact Sheet 125), any symptoms you have and your attitude toward taking HIV medications will need to inform your infectious physician immediately. A Fact sheet 404 contains more information on guidelines for the use of antiretroviral drugs (ART).
If you take Juluca, you can reduce your viral load to extremely low levels and increase your CD4 cell count. This may mean staying healthier for longer.
WHAT IS RESISTANCE TO MEDICINES?
Many new copies of HIV are mutations. They are slightly different from the original virus. Some mutations can continue to multiply even when you are taking an ARV. When that happens, the drug will stop working. This is called the "developing resistance" to the drug. see the 126 Technical Sheet for more information on resistance.
Resistance is something that should be avoided at all costs
Sometimes, if your virus develops resistance to a drug, it will also have resistance to others (ART - Antiretroviral Therapy). This is called "cross resistance." Cross-resistance between efavirenz, delavirdine, nevirapine, etravirine and rilpivirine (all NNRTIs) develop very easily. If you develop resistance to one of these NNRTIs, you probably will not be able to use any of them in your ARV.
Resistance can develop rapidly. It is very important to take the antiretroviral therapy (ART) according to the instructions, on schedule, and do not skip or reduce doses.
HOW JULUCA IS TAKEN
Juluca is taken orally as a tablet. The usual adult dose is one tablet once daily with a meal. Each tablet contains 50 milligrams (mg) of dolutegravir and 25 mg of rilpivirine.
Dolutegravir and rilpivirine are generally safe for patients with mild or moderate kidney or liver problems.
WHAT ARE THE COLLATERAL EFFECTS OF JULUCA?
Juluca is generally very well tolerated. The most common side effects seen among people taking it are headache and diarrhea.
When starting any ART, you may experience temporary side effects, such as headaches, high blood pressure or just feeling sick. These side effects usually improve or disappear over time.
The most common side effects of rilpivirine are depression, insomnia, headache and rash. Be sure to discuss any side effects with your doctor. Rilpivirine can cause liver damage. Make sure your doctor knows if you have hepatitis B or C.
HOW JULUCA INTERAGE WITH OTHER DRUGS?
Dolutegravir and rilpivirine may interact with other medicines or supplements you are taking. These interactions can alter the amount of each drug in your bloodstream and cause an under or overdose. New interactions are being identified all the time.
Antacids containing aluminum or magnesium and calcium or iron supplements must be taken 4 hours before or 6 hours after Juluca.
Methadone doses need to be adjusted when taken with Juluca.
Make sure your doctors and doctors know about all the medications and supplements you are taking.
Juluca is the first complete HIV regimen in two drugs.
It can be taken by people who have been under treatment for 6 months, with no history of treatment failure and whose virus has no drug resistance from the same classes
HELP MAINTAIN THIS BLOG RUNNING
It Seems Like No, But There Is A Big Volume Of Expenses To Keep This Site And Any Value You Can Donate, It Is Good! Even With The Idea Of Paying 11% On Donated, See Only. From $ 10,00 that you came to give, I would still have $ 8,90 and, even dripping is better than drying ....
In my view it is more for a "cost cut, even though I see many risks around it all (a combination of just two drugs) and I wonder if for people who have already spent 50 years like me, and what are we aging with HIV, if this would be "a good bet". I have read and translated what doses of methadone will have adjusted (upwards down) and, well, who knows what methadone (neuropathic pain relief) is used for, the idea of changing the dose of methadone sounds very unfriendly ...
Translated by Cláudio Souza in Original 17 / 06 / 2018 in Fact Sheet 477 Juluca (dolutegravir + rilpivirine)
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