Dovato is a brand-name prescription medication. It’s FDA-approved to treat HIV in certain adults who:
- haven’t taken HIV medication before or
- are replacing their current treatment and have a low level of HIV virus in their blood*
HIV is a virus that can weaken your immune system.
* Other criteria apply. For more information about who can take Dovato, see the “Dovato for HIV” section below.
Drug details
Dovato comes as a tablet that you take by mouth. It’s made of two different drugs: dolutegravir and lamivudine. Each tablet contains 50 milligrams (mg) of dolutegravir and 300 mg of lamivudine.
Dolutegravir is in a class of drugs called integrase inhibitors. A class of drugs is a group of medications that work in a similar way. Lamivudine is in a class of drugs called nucleoside reverse transcriptase inhibitors. The drugs in Dovato work together to lower the level of HIV in your blood. This eases the symptoms caused by HIV.
FDA approval
Dovato was approved for use by the Food and Drug Administration (FDA) in 2019.
Most HIV treatments involve at least three drugs. Dovato is the first FDA-approved complete treatment for HIV that consists of just two medications. This may cause fewer side effects than treatments with three drugs.
Effectiveness
For information about the effectiveness of Dovato, see the “Dovato for HIV” section below.
Dovato is available only as a brand-name medication. It’s not currently available in generic form.
A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.
Dovato consists of two active drugs: dolutegravir and lamivudine.
Dovato can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Dovato. These lists don’t include all possible side effects.
For more information about the possible side effects of Dovato, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.
Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Dovato, you can do so through MedWatch.
Mild side effects
Mild side effects* of Dovato can include:
- headache
- nausea
- diarrhea
- insomnia (trouble falling asleep or staying asleep)
- fatigue (lack of energy)
- anxiety
Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.
* This is a partial list of mild side effects from Dovato. To learn about other mild side effects, talk with your doctor or pharmacist, or view Dovato’s Patient Information.
Serious side effects
Serious side effects from Dovato aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.
Serious side effects, explained in more detail below in “Side effect details,” can include:
- allergic reaction
- hepatitis B virus that’s resistant to certain drugs*
- worsening of hepatitis B*
- lactic acidosis (occurs when lactic acid in your body builds up too fast, and your body can’t remove it quickly enough)
- liver problems, such as increased liver enzyme levels, liver failure, and liver toxicity
- immune reconstitution syndrome (a sudden increase of activity in your immune system that causes it to overwork)
- depression or thoughts of suicide
* Dovato has
Side effect details
You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.
Allergic reaction
As with most drugs, some people can have an allergic reaction after taking Dovato. In clinical trials, fewer than 1% of people taking Dovato had an allergic reaction to one of the drugs in it: dolutegravir. It’s not known how many people taking a different medication to treat their HIV also may have had an allergic reaction.
Symptoms of allergic reactions in the clinical trials included a rash and blistering of the skin or mouth. Other symptoms were eye swelling or redness, and liver injury.
In general, symptoms of a mild allergic reaction can include:
- skin rash
- itchiness
- flushing (warmth, swelling, or redness in your skin)
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:
- swelling under your skin, typically in your eyelids, lips, hands, or feet
- swelling of your tongue, mouth, or throat
- trouble breathing
Call your doctor right away if you have an allergic reaction to Dovato, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.
Hepatitis B virus that’s resistant to certain drugs
Dovato has
Before or when you start taking Dovato, your doctor will test you for a liver infection caused by the hepatitis B virus. This infection is also known as hepatitis B. If you have hepatitis B and HIV, one of the active drugs in Dovato (lamivudine) could make the hepatitis B virus resistant to lamivudine. This means that hepatitis B is harder to treat than usual. Your doctor may recommend different treatments for hepatitis B or a medication other than Dovato to treat HIV.
Dovato hasn’t been tested in people with both HIV and hepatitis B. Therefore, it isn’t known if the drug is safe or effective in this group of people. It’s also not known how many people, after starting Dovato treatment, may have developed hepatitis B virus that’s resistant to certain drugs.
In some cases, hepatitis B worsened in people with HIV who stopped taking drugs, such as Dovato, that contain lamivudine. Symptoms of worsening hepatitis B can include:
- jaundice (yellowing of the skin or white of the eyes)
- belly pain
- nausea and vomiting
If you have both hepatitis B and HIV, and you stop taking Dovato, your doctor may monitor your blood levels more often than before. This is to check your liver function and how hepatitis B may be affecting you. Your doctor may also prescribe medication to treat hepatitis B.
If you have hepatitis B and develop any symptoms of it worsening while taking Dovato, talk with your doctor. (See above for symptoms.) They can recommend the best treatment plan for you.
Lactic acidosis
Dovato may cause a serious side effect called lactic acidosis. Lactic acidosis occurs when you have too much acid in your blood. In clinical trials, it’s not known how many people may have experienced lactic acidosis.
In rare cases, lactic acidosis may occur along with swelling of the liver and steatosis (fat buildup in the liver). People taking lamivudine, one of the active drugs in Dovato, did have this side effect. But it’s not known how often it occurred with lamivudine, which wasn’t compared with a different drug or a placebo. (A placebo is a treatment with no active drug in it.)
You may be at an increased risk for developing lactic acidosis and swelling of the liver if you’re female* or have obesity.
While you’re taking Dovato, your doctor will likely monitor your blood for any changes in your liver function. If you develop symptoms of lactic acidosis or if your blood levels change, your doctor may have you stop taking Dovato.
Symptoms of lactic acidosis include:
- stomach pain
- diarrhea
- muscle pain
- feeling very tired
- feeling dizzy or lightheaded
- fast or irregular heart rate
- trouble breathing
These side effects can be very serious, and in rare cases, may lead to death. Lactic acidosis is a serious medical emergency. If you’re taking Dovato and have any mild symptoms of lactic acidosis, tell your doctor right away. Otherwise, call 911 or your local emergency number, or go to the nearest emergency room right away.
* Use of the terms “female” or “male” within this article refers to a person’s gender assigned at birth.
Liver problems
One of the drugs in Dovato, dolutegravir, may cause liver side effects. In clinical trials, increased liver enzyme levels, liver failure, and liver toxicity were reported. Increased liver enzyme levels may indicate decreased function of your liver.* And liver toxicity refers to liver problems that may occur from exposure to medications or other substances.
The trials included people taking either:
- dolutegravir (Tivicay) and lamivudine (Epivir)
- dolutegravir and emtricitabine/tenofovir disoproxil fumarate (Truvada)
Dovato contains both dolutegravir and lamivudine.
The trial results showed that increased levels of liver enzymes occurred in:
- between 1% and 4% of people taking Tivicay and Epivir
- between 1% and 4% of people taking Tivicay and Truvada
It wasn’t reported how many people had liver failure or liver toxicity.
Also, liver injury has been reported in people taking a called drug called abacavir/dolutegravir/lamivudine (Triumeq). This medication contains two of the active drugs, dolutegravir and lamivudine, that are in Dovato. Therefore, it’s possible that Dovato may also cause liver injury.
Symptoms of liver problems
Symptoms of liver problems can include jaundice (yellowing of the skin or white of the eyes), belly pain, and nausea and vomiting.
If you develop any symptoms of liver problems while using Dovato, be sure to talk with your doctor. They may give you blood tests to see if the drug is the cause.
* If you have HIV and hepatitis, you may have worsening of your liver function while taking Dovato. (To learn more, see “Liver problems” in the “Dovato precautions” section below.)
Immune reconstitution syndrome
During Dovato treatment, changes may take place in the immune system. This is called immune reconstitution syndrome. It isn’t known how many people may have experienced this side effect in clinical trials.
When you have HIV that isn’t being treated or if your treatment isn’t working, your immune system can become weaker. Once you start taking medication to treat your HIV, your immune system may become stronger again. Immune reconstitution syndrome occurs when your immune system gets stronger. It may begin to fight infections that it didn’t used to fight. This can cause swelling of your lymph nodes, fever, or trouble breathing.
It’s also possible to develop other immune system conditions, such as Graves’ disease, which involves the thyroid. These conditions can occur because of an overactive immune system as well.
If you develop symptoms of immune reconstitution syndrome while using Dovato, talk with your doctor. They may do some testing to see if your immune system is causing the symptoms.
Depression or thoughts of suicide
It is possible, but rare, that people taking Dovato may develop depression or have thoughts of suicide. In clinical trials:
- fewer than 2% of people taking dolutegravir and lamivudine (the two active ingredients in Dovato) experienced depression
- fewer than 2% of people had thoughts of suicide
It isn’t known how often these side effects occurred in people taking a different HIV medication or a placebo. (A placebo is a treatment with no active drug in it).
Symptoms of depression include:
- loss of interest in activities that used to excite you
- feeling sad or lonely
- weight loss or weight gain
- sleeping too much or too little
People with suicidal thoughts may feel hopeless, ashamed, or preoccupied with death. However, they may keep these thoughts and feelings to themselves.
If you develop symptoms of depression or have thoughts of suicide while taking Dovato, be sure to tell your doctor right away. They should be able to help you with your symptoms. Your doctor may also recommend that you stop taking Dovato and take a different medication to treat your HIV.
Suicide prevention
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
As with all medications, the cost of Dovato can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.
Keep in mind that you may be able to get a 90-day supply of Dovato. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor or your insurance company.
Before approving coverage for Dovato, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.
If you’re not sure if you’ll need to get prior authorization for Dovato, contact your insurance company.
Financial and insurance assistance
If you need financial support to pay for Dovato, or if you need help understanding your insurance coverage, help is available.
ViiV Healthcare, the manufacturer of Dovato, offers a program called the Patient Assistance Program. For more information and to find out if you’re eligible for support, call 844-588-3288 or visit the program website.
Mail-order pharmacies
Dovato may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.
If recommended by your doctor, you may be able to receive a 90-day supply of Dovato, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor and your insurance company. Some Medicare plans may help cover the cost of mail-order medications.
If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.
Generic version
Dovato isn’t available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.
The Food and Drug Administration (FDA) approves prescription drugs such as Dovato to treat certain conditions. Dovato may also be used off-label for other conditions. Off-label drug use means using a drug for a purpose other than what it’s been approved for by the FDA.
Treating HIV with Dovato
Dovato is FDA-approved to treat HIV in certain adults who fall into one of the following two categories:
- Those who haven’t taken HIV medication before.
- Those who are replacing their current treatment and have fewer than 50 copies of HIV per milliliter of blood. (This is considered a low level of HIV.) For this purpose, both of the following must apply:
- They haven’t had a treatment failure (treatment that didn’t work to reduce the level of HIV in their blood).
- They haven’t had viral resistance to lamivudine or dolutegravir (the two active drugs in Dovato). Resistance occurs when the HIV virus changes, causing medications to work less well than usual in treating the infection.
If you’re replacing your current HIV treatment with Dovato, your doctor will test your blood before you switch to Dovato. This is done to see if you have a low level of HIV in your blood. Dovato is approved for use in people with fewer than 50 copies of HIV per mL of blood. This value refers to your viral load, which is a measure of how much HIV is present in your blood. The lower your viral load, the fewer effects you should have from HIV.
If you’ve taken an HIV medication in the past that didn’t reduce your viral load, Dovato may not be right for you. Your doctor may recommend a different medication to treat your HIV.
In addition, if you’re switching to Dovato from another HIV medication, the HIV must not be resistant to either lamivudine or dolutegravir. When HIV is resistant to a drug, it means it’s harder for the drug to treat HIV.
You may have tried taking either lamivudine or dolutegravir in the past. If one of those drugs stopped working for you, it’s unlikely that Dovato could effectively treat your HIV. Therefore, your doctor may recommend an HIV medication other than Dovato.
HIV explained
HIV is a virus that can weaken your immune system by attacking cells that fight infection.
HIV can be transmitted through blood, semen, breast milk, and other bodily fluids. This can occur by sharing needles or having sex without a condom or other barrier method, for example. HIV isn’t transmitted through tears or saliva.
Symptoms of HIV can include:
- rashes
- night sweats
- fever and chills
- fatigue (lack of energy)
- sore throat
- swollen lymph nodes
If left untreated, HIV can progress into AIDS. With AIDS, your immune system may weaken further. As a result, you may get infections more easily than other people.
Effectiveness for HIV
In clinical trials, Dovato was shown to be effective in reducing the level of HIV in the blood. In these studies, Dovato was tested in two groups of adults:
- those who hadn’t taken HIV medication before
- those who were replacing their current treatment with Dovato and had a low level of HIV in their blood
Adults who hadn’t taken HIV medication before
Adults who hadn’t taken HIV medication before used one of the following drug combinations:
- lamivudine (Epivir) and dolutegravir (Tivicay)
- dolutegravir and emtricitabine/tenofovir disoproxil fumarate (Truvada)
Dovato contains both dolutegravir and lamivudine.
The goal of this study was to have fewer than 50 copies of HIV per milliliter (mL) of blood. This value refers to viral load, which is a measure of how much HIV is present in blood. The lower the viral load, the fewer effects from HIV.
After 48 weeks of treatment, the goal of fewer than 50 copies of HIV per mL of blood was achieved in:
- 91% of adults taking Epivir and Tivicay
- 93% of adults taking Tivicay and Truvada
After 96 weeks of treatment, the goal of fewer than 50 copies of HIV per mL of blood was achieved in:
- 86% of adults taking Epivir and Tivicay
- 90% of adults taking Tivicay and Truvada
Certain adults who switched from other HIV treatments to Dovato
Dovato is approved in certain adults with HIV. This includes those who are currently taking other HIV medication and want to switch to Dovato. For specific information on who can use Dovato, see the “Treating HIV with Dovato” section above.
In a clinical trial, people taking Dovato were compared with people taking an HIV treatment that included the drug tenofovir alafenamide. The goal of this trial was to have fewer than 50 copies of HIV per mL of blood in the body.
The results showed that after 48 weeks of treatment, the goal of fewer than 50 copies of HIV per mL of blood was achieved in:
- 93% of people taking Dovato
- 93% of people taking a treatment with the drug tenofovir alafenamide in it
Dovato and children
Dovato isn’t approved to be used in children. The drug is approved for use only in adults.
The Dovato dosage your doctor prescribes will depend on several factors. These include:
- other medications that you take
- other medical conditions you may have
The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Drug forms and strengths
Dovato is available as a tablet that is taken by mouth. It comes in one strength, and contains 50 milligrams (mg) of dolutegravir and 300 mg of lamivudine.
Dosage for HIV
The dosage for HIV is one Dovato tablet taken by mouth once daily.
If you’re taking medications that can lower the level of dolutegravir in your body, you may need to take a separate tablet containing dolutegravir. (This is in addition to Dovato.) The medications include carbamazepine (Tegretol) and rifampin (Rifadin, Rimactane). To learn more, see the “Dovato interactions” section below.
If you have certain kidney or liver problems, your doctor may recommend taking a medication other than Dovato to treat your HIV. For more information, see the “Dovato precautions” section below.
Dosage questions
Below are answers to questions you may have about taking Dovato.
What if I miss a dose?
If you miss your dose of Dovato, take it as soon as you remember. However, don’t take two doses at once to make up for a missed dose.
To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. A kitchen timer can work, too.
What happens if I miss several doses of Dovato?
If you miss more than one dose of Dovato, talk with your doctor or pharmacist. They can advise you on the best time to take your next dose. They may also be able to suggest other ways to remember to take your medication.
Dovato works best when you take it at about the same time every day. Missing multiple doses means the drug may not work as well as it should to treat your HIV.
Will I need to use this drug long term?
Dovato is meant to be used as a long-term treatment. If you and your doctor determine that Dovato is safe and effective for you, you’ll likely take it long term.
Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Dovato, talk with your doctor. They can tell you about other medications that may work well for you.
Alternatives for HIV
Examples of other drugs that may be used to treat HIV include:
- abacavir (Ziagen)
- lamivudine (Epivir)
- tenofovir disoproxil fumarate (Viread)
- efavirenz (Sustiva)
- darunavir (Prezista)
- ritonavir (Norvir)
- dolutegravir (Tivicay)
- dolutegravir/rilpivirine (Juluca)
- raltegravir (Isentress)
- cobicistat (Tybost)
- abacavir/lamivudine (Epzicom)
- abacavir/dolutegravir/lamivudine (Triumeq)
- emtricitabine/rilpivirine/tenofovir disoproxil fumarate (Complera)
- elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (Genvoya)
- bictegravir/emtricitabine/tenofovir alafenamide (Biktarvy)
- darunavir/cobicistat (Prezcobix)
- efavirenz/emtricitabine/tenofovir disoproxil fumarate (Atripla)
- emtricitabine/rilpivirine/tenofovir alafenamide (Odefsey)
- emtricitabine/tenofovir alafenamide (Descovy)
- emtricitabine/tenofovir disoproxil fumarate (Truvada)
You may wonder how Dovato compares with other medications that are prescribed for similar uses. Here we look at how Dovato and Biktarvy are alike and different.
Ingredients
Dovato contains two active drugs: dolutegravir and lamivudine. Dolutegravir is in a group of drugs called integrase inhibitors. Lamivudine is in a group of drugs called nucleoside reverse transcriptase inhibitors.
Biktarvy contains three active drugs: bictegravir, emtricitabine, and tenofovir alafenamide. Bictegravir is an integrase inhibitor. Emtricitabine and tenofovir alafenamide are both nucleoside reverse transcriptase inhibitors.
Uses
Dovato is a brand-name prescription medication. It’s FDA-approved to treat HIV in certain adults who:
- haven’t taken HIV medication before or
- are replacing their current treatment and have a low level of HIV virus in their blood*
HIV is a virus that can weaken your immune system.
Dovato is approved for use in adults. Biktarvy is approved for use in adults as well as children who weigh at least 55 pounds (25 kilograms).
For more information on Biktarvy’s uses, talk with your doctor.
* Other criteria apply. For more information about who can take Dovato, see the “Dovato for HIV” section above.
Drug forms and administration
Both Dovato and Biktarvy are tablets that are taken by mouth. Either medication is taken once daily.
Side effects and risks
Dovato and Biktarvy both contain HIV drugs. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.
Mild side effects
These lists contain up to 10 of the most common mild side effects that can occur with either Dovato or Biktarvy, as well as mild side effects that both drugs may share.
- Can occur with Dovato:
- Can occur with Biktarvy:
- abnormal dreams
- Can occur with both Dovato and Biktarvy:
- insomnia (trouble falling asleep or staying asleep)
- fatigue (lack of energy)
Serious side effects
These lists contain examples of serious side effects that can occur with either Dovato or Biktarvy, as well as serious side effects that both drugs may share.
- Can occur with Dovato:
- hepatitis B virus that’s resistant to certain drugs*
- worsening of hepatitis B*
- Can occur with Biktarvy:
- kidney problems, such as decreased kidney function
- worsening of hepatitis B†
- Can occur with both Dovato and Biktarvy:
- immune reconstitution syndrome (a sudden increase of activity in your immune system that causes it to overwork)
- lactic acidosis (occurs when lactic acid in your body builds up too fast, and your body can’t remove it quickly enough)
- liver problems
* Dovato has
† Biktarvy has a boxed warning for severe worsening of hepatitis B.
Effectiveness
The only condition both Dovato and Biktarvy are used to treat is HIV.
These drugs haven’t been directly compared in clinical studies. But studies have found both Dovato and Biktarvy to be effective for treating HIV in certain adults.
Costs
Dovato costs significantly less than Biktarvy. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.
Dovato and Biktarvy are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.
Here are answers to some frequently asked questions about Dovato.
Does Dovato cure HIV?
No, Dovato doesn’t cure HIV. At this time, there’s no cure for HIV. However, Dovato does work to reduce your viral load. This is a measure of how much HIV is present in your blood. If you have less HIV in your blood, you’re likely to have fewer HIV symptoms.
The lower your viral load, the fewer problems you’ll likely have from HIV. When your HIV viral load is lower, it also lowers your risk for transmitting HIV to other people.
If you have questions about how Dovato works, talk with your doctor or pharmacist. You can also see the “How Dovato works” section below.
Can Dovato be used for PrEP?
No, the Food and Drug Administration (FDA) hasn’t approved Dovato to be used as PrEP. This stands for pre-exposure prophylaxis. PrEP is the use of a drug to prevent someone at high risk for HIV from contracting it. People considered to be high risk include those who share needles or have sex without a condom or other barrier method.
At this time, only two medications are FDA-approved as PrEP:
If you think PrEP might be helpful to you, talk with your doctor about which medication might be best.
Does Dovato cause weight gain?
In clinical trials, people taking Dovato didn’t report weight gain as a side effect of the medication. However, in postmarketing studies, weight gain was reported as a side effect. Postmarketing studies are done after a drug has already been approved by the Food and Drug Administration (FDA). It’s not known how many people may have experienced weight gain with Dovato.
However, other clinical trials have shown that dolutegravir (one of the active ingredients in Dovato) may increase weight.
It’s also possible that as your HIV is treated, you may gain weight as your body becomes stronger.
If you experience unexpected weight gain while taking Dovato, talk with your doctor. They can help determine the cause and what a healthy weight is for you.
Can I take Dovato if I have HIV and hepatitis?
It depends. In some cases, you may be able to take Dovato if you have both HIV and hepatitis. However, Dovato can cause your hepatitis infection to change or become drug-resistant.* (A drug-resistant infection is one that doesn’t respond well to treatment.)
Your doctor may monitor your liver by giving you regular blood tests while you’re taking Dovato. If your liver enzyme levels start to increase, it may be a sign that your liver isn’t working as well as it should. In this case, your doctor may switch you to a different medication to treat your HIV.
If you have HIV and hepatitis, talk with your doctor. They can tell you if Dovato is a safe option for you.
* Dovato has a
Can HIV become resistant to Dovato?
It’s not likely that HIV will become resistant to Dovato. Over an 8-month period in clinical trials, no one taking Dovato developed HIV resistance to the drug.
Resistance can occur when HIV changes so that a medication doesn’t work as well as usual to fight it. This means that if you develop HIV resistance to Dovato, the drug will be less effective at treating your condition.
Your doctor will likely monitor your blood throughout your Dovato treatment. This is to see if the medication is working well for you. If you have concerns about developing HIV resistance to Dovato, talk with your doctor or pharmacist.
If I take Dovato as prescribed by my doctor, will it prevent transmission of HIV to a sexual partner?
Taking Dovato exactly as prescribed can reduce your risk for transmitting HIV to a sexual partner. The risk of transmission is reduced if you have a “suppressed” viral load.
A viral load is a measure of how much HIV is present in your blood. A suppressed viral load is fewer than 200 copies of HIV per milliliter of blood. The less HIV in your blood, the lower the risk of passing HIV to someone else through sex.
Clinical trials looked at people taking medications other than Dovato to treat HIV. There were no cases of sexual transmission of HIV between someone with a suppressed viral load and their HIV-negative partner.
Keep in mind that it takes time to lower your viral load. You shouldn’t assume that because you’re taking Dovato your viral load is lower. Your doctor will give you blood tests to determine your viral load.
If you have concerns about passing HIV to your partner during sex, talk with your doctor. They can address your concerns and may also recommend that your partner takes PrEP. For more information on PrEP, see the question above, “Can Dovato be used for PrEP?”
Dovato is approved to treat HIV in certain adults. For details, see the “Dovato for HIV” section above.
HIV is a virus that can weaken your immune system by attacking cells that fight infection. To be specific, HIV targets immune cells known as CD4 cells. HIV uses the cells to reproduce (make copies of itself).
HIV can be transmitted through blood, semen, breast milk, and other bodily fluids.
What Dovato does
Dovato contains two different active drugs: dolutegravir and lamivudine. Together, these drugs work to decrease how quickly HIV reproduces (copies itself) in your blood. The drugs block different steps in the reproduction of HIV. By doing so, the drugs help lower your viral load. This is a measure of how much HIV is present in your blood.
With a lower viral load, your HIV symptoms should ease. You should also have fewer and less severe overall effects from HIV.
How long does it take to work?
Dovato begins working in your body right away to treat your HIV. But it may take time to decrease your viral load. (This is a measure of how much HIV is present in your blood.)
In clinical trials, people took either:
- Dovato, which includes two drugs: dolutegravir and lamivudine
- dolutegravir and tenofovir disoproxil fumarate/emtricitabine (Truvada)
After 4 weeks, 70% of people in both groups had a viral load so low that it couldn’t be detected. The lower your viral load, the fewer symptoms of HIV you’re likely to have.
Dovato can interact with several other medications. It can also interact with certain supplements as well as certain foods.
No studies on drug interactions were done of people taking Dovato. However, separate studies were done of people taking just one of the two active drug ingredients in Dovato (either dolutegravir or lamivudine).
Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.
Dovato and other medications
Below are examples of medications that can interact with Dovato. This section doesn’t contain all drugs that may interact with Dovato.
Before taking Dovato, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Dovato and other HIV drugs
You shouldn’t take Dovato with other medications to treat HIV because the drugs may interact with each other. It’s not known what side effects may occur if you take Dovato with other HIV medications.
Examples of HIV medications include:
- nevirapine (Viramune)
- efavirenz (Sustiva)
- etravirine (Intelence)
- rilpivirine (Edurant)
For lists of other HIV medications, you can refer to this article.
If you’re taking other HIV drugs, talk with your doctor before using Dovato. They can help decide on the right treatment plan for you.
Dovato and dofetilide
You shouldn’t take Dovato if you’re using dofetilide (Tikosyn). Dofetilide is a drug used to treat irregular heart rates or rhythms.
Taking Dovato with dofetilide may cause dofetilide to build up in your body. A high level of dofetilide may cause other heart rhythm problems or a heart attack.
If you’re taking dofetilide, talk with your doctor before using Dovato. They can recommend the right treatment plan for you.
Dovato and dalfampridine
Dovato may increase the level of dalfampridine (Ampyra) in your body, which may increase your risk for seizures. Dalfampridine is used to treat multiple sclerosis, which is a disease affecting the brain and spinal cord.
If you’re taking dalfampridine, be sure to talk with your doctor before using Dovato. They can discuss your seizure risk. In some cases, they may monitor your dalfampridine level more often than usual. In other cases, your doctor may recommend a different medication to treat your HIV.
Dovato and certain seizure medications
Some seizure drugs may lower the level of dolutegravir in your body. (Dolutegravir is one of the active ingredients in Dovato.) If the level of dolutegravir is too low, Dovato may not work as well as it should to treat your HIV.
Examples of seizure medications that may lower the level of dolutegravir in your body include:
- carbamazepine (Tegretol)
- oxcarbazepine (Trileptal)
- phenytoin (Dilantin)
- phenobarbital
If you’re using carbamazepine, your doctor may have you take a separate dolutegravir tablet along with Dovato. This should help increase the dolutegravir to the correct level.
If you’re taking oxcarbazepine, phenytoin, or phenobarbital, your doctor may recommend a medication other than Dovato to treat your HIV. This is because it’s not known how much more dolutegravir you may need.
Before you start taking Dovato, talk with your doctor about any seizure medications you’re taking.
Dovato and metformin
Dovato may increase the level of metformin in your body. (Metformin is a drug used to treat type 2 diabetes.) This increased level may raise the risk of side effects of metformin, including nausea, vomiting, and diarrhea.
Before you start taking Dovato, tell your doctor if you’re using metformin. If you are, your doctor may monitor you more often than usual to check for any side effects of metformin. Or they may recommend a medication other than Dovato to treat your HIV.
Dovato and rifampin
An antibiotic called rifampin (Rifadin, Rimactane) may decrease the level of dolutegravir in your body. Dolutegravir is one of the active ingredients in Dovato. With less of the medication, dolutegravir may not work as well as usual to treat your HIV.
If you’re taking rifampin, talk with your doctor before you start using Dovato. In some cases, your doctor may give their approval for you to use rifampin and Dovato. If they do, they may recommend that you take a separate dolutegravir tablet 12 hours apart from Dovato. This should help increase the level of dolutegravir so you get the correct amount of the drug.
Dovato and certain stomach medications
Certain stomach medications may interact with Dovato. These drugs may lower the level of dolutegravir in your body. (Dolutegravir is one of the active ingredients in Dovato.) With less of the medication, dolutegravir may not work as well as usual to treat your HIV.
Examples of stomach medications that may decrease the level of Dovato in your body include:
- sucralfate (Carafate)
- calcium carbonate (Tums)
- aluminum hydroxide/magnesium hydroxide/simethicone (Maalox, Mylanta)
Your doctor may recommend taking Dovato at least 2 hours before or 6 hours after these stomach medications. This should help prevent the drugs from interacting with each other.
If you’re taking any stomach medications, talk with your doctor or pharmacist before using Dovato. They can advise you on the best time to take them.
Dovato and drugs that contain sorbitol
A sugar alcohol called sorbitol may interact with Dovato. Sorbitol is used to sweeten certain syrups and liquids. Sorbitol can lower the level of lamivudine in your body. (Lamivudine is one of the ingredients in Dovato.)
If you take Dovato with a drug that contains sorbitol, your body may not get enough lamivudine. This may keep Dovato from working as well as it should to treat your HIV.
Examples of drugs that contain sorbitol include:
- acetaminophen solution (Tylenol)
- loratadine solution (Claritin)
If you’re taking other medications, especially any liquid forms, tell your doctor before you start using Dovato. They can check whether the drug contains sorbitol and if it’s safe to take with Dovato.
During your Dovato treatment, try to avoid using drugs that include sorbitol, if possible. This may mean switching from a liquid medication to a capsule or tablet.
Dovato and herbs and supplements
Below are examples of herbs and supplements that can interact with Dovato.
Dovato and St. John’s wort
St. John’s wort is an herbal supplement that is sometimes used to help treat depression. St. John’s wort can lower the level of dolutegravir in your body. (Dolutegravir is one of the active ingredients in Dovato.) If this occurs, Dovato may not work as well as it should to treat your HIV.
Because of this risk, you shouldn’t take St. John’s wort if you’re using Dovato. It isn’t known how much St. John’s wort might affect your doses of Dovato.
Your doctor should be able to recommend other ways to treat your depression or other conditions you were taking St. John’s wort for.
Dovato and calcium and iron supplements
Dovato can interact with calcium and iron supplements.
If you take Dovato with food, you can take a calcium or iron supplement at the same time.
If you take Dovato on an empty stomach, you should take it at least 2 hours before or 6 hours after your calcium or iron supplement.
If you have questions about when to take a calcium or iron supplement while using Dovato, talk with your doctor or pharmacist.
Dovato and multivitamins
Dovato can interact with multivitamins that have calcium or iron in them.
If you take Dovato with food, you can take the multivitamin at the same time.
If you take Dovato on an empty stomach, you should take it at least 2 hours before or 6 hours after your multivitamin.
While you’re using Dovato, you may have questions about the best time to take a multivitamin that contains calcium or iron. You can talk with your doctor or pharmacist.
Dovato and foods
There aren’t any foods that have been specifically reported to interact with Dovato. If you have any questions about eating certain foods with Dovato, talk with your doctor.
There are no known interactions between Dovato and alcohol. However, drinking alcohol may worsen side effects of Dovato, such as headache or nausea. (For more about side effects, see the “Dovato side effects” section above.)
Drinking alcohol may also harm your liver. In addition, because Dovato is broken down by your liver, you shouldn’t use the drug if you have serious liver problems. (For more information, see the “Dovato precautions” section below.)
If you drink alcohol, talk with your doctor about how much is safe for you to consume while taking Dovato.
You should take Dovato according to your doctor’s or another healthcare professional’s instructions.
Dovato comes as a tablet that you take by mouth.
When to take
Dovato is typically taken once daily. You should try to take your dose of Dovato at about the same time each day.
To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. A kitchen timer can work, too.
Taking Dovato with food
Dovato can be taken with or without food.
Can Dovato be crushed, split, or chewed?
It’s recommended that you swallow Dovato tablets whole. There haven’t been any studies done to see how crushing, splitting, or chewing Dovato tablets may change how the drug works in the body.
If you have trouble swallowing Dovato tablets whole, your doctor may recommend splitting or crushing them right before taking your dose. They might also recommend a different medication to treat your HIV.
If you’re pregnant or trying to become pregnant, you shouldn’t take Dovato unless there are no other medications to treat your HIV.
One of the active drug ingredients in Dovato, dolutegravir, can cause neural tube defects. These are birth defects involving the brain and spinal cord. They usually occur during the first trimester (week 0 to 13) of pregnancy.
Lamivudine, the other drug ingredient in Dovato, doesn’t appear to cause birth defects.
There’s a pregnancy registry for Dovato and other antiretroviral drugs. An antiretroviral drug is a medication used to treat HIV. A pregnancy registry is a program that monitors the use of certain drugs during pregnancy. It reports any side effects that may affect either the mother or fetus. Your doctor can sign you up for the pregnancy registry by calling 800-258-4263.
Before starting Dovato treatment, talk with your doctor if you’re pregnant or planning to become pregnant. They may recommend a different medication to treat your HIV.
If you’re pregnant or trying to become pregnant, you shouldn’t take Dovato unless there are no other medications to treat your HIV. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Dovato.
For more information about taking Dovato during pregnancy, see the “Dovato and pregnancy” section above.
Note: Sex and gender exist on spectrums. Use of the terms “female” and “male” below refers to sex assigned at birth.
For females using Dovato
If you’re able to become pregnant, your doctor will likely give you a pregnancy test before you start Dovato treatment. This is because Dovato can be harmful to a developing fetus.
If you’re able to become pregnant, you should use an effective form of birth control to prevent pregnancy. This includes birth control pills, injections, patches, and condoms.
For males using Dovato
The manufacturers of Dovato don’t make any recommendations on birth control in males taking Dovato. If you’re a male taking Dovato, talk to your doctor about birth control.
If you have HIV, breastfeeding your child isn’t recommended. This is because HIV can be transmitted to a child through breast milk.
One of the two active ingredients in Dovato, lamivudine, is present in breast milk. However, it’s not known if the other active ingredient, dolutegravir, is also present in breast milk. In addition, it’s not known what effects Dovato may have on a breastfed child.
For information on healthy ways to feed your child, talk with your doctor.
This drug comes with several precautions.
FDA warnings
This drug has boxed warnings. These are the most serious warnings from the Food and Drug Administration (FDA). A
Hepatitis B virus that’s resistant to certain drugs. Before or when you start taking Dovato, your doctor will test you for a liver infection caused by the hepatitis B virus. This infection is also known as hepatitis B. If you have hepatitis B and HIV, one of the active drugs in Dovato (lamivudine) could make the hepatitis B virus resistant to lamivudine. This means that hepatitis B is harder to treat than usual. Your doctor may recommend different treatments for hepatitis B or a medication other than Dovato to treat HIV.
Worsening of hepatitis B. In some cases, hepatitis B worsened in people with HIV who stopped taking drugs, such as Dovato, that contain lamivudine. If you have both hepatitis B and HIV, and you stop using Dovato, your doctor will typically monitor your liver function. They may also prescribe medication to treat hepatitis B.
For more information, see “Hepatitis B virus that’s resistant to certain drugs” in the “Dovato side effects” section above.
Other precautions
Before taking Dovato, talk with your doctor about your health history. Dovato may not be right for you if you have certain medical conditions or other factors affecting your health. These include:
- Liver problems. If you have liver problems, such as hepatitis, talk with your doctor before taking Dovato. Your liver may not be able to break down Dovato as it should. This can cause the drug to build up and increase your risk for side effects, such as jaundice and belly pain. Your doctor can check the liver enzyme levels in your blood to see if it’s safe for you to take the drug. If you have severe liver problems, your doctor may recommend a different medication to treat your HIV. For more information, see the “Dovato side effects” section above.
- Kidney problems. If you have any kidney problems, such as kidney disease, be sure to tell your doctor before taking Dovato. With kidney disease, your body may not be able to properly break down lamivudine, one of the active drugs in Dovato. If you aren’t able to switch to a different HIV treatment, your doctor may prescribe the individual drugs that make up Dovato. They’ll likely have you take a lower dose of lamivudine than what’s in Dovato.
- Allergic reaction. If you’ve had an allergic reaction to Dovato or any of its ingredients, you shouldn’t take Dovato. Ask your doctor what other medications are better options for you.
- Pregnancy. If you’re pregnant or trying to become pregnant, you shouldn’t take Dovato unless there are no other medications to treat your HIV. For more information, see the “Dovato and pregnancy” section above.
- Breastfeeding. If you have HIV, breastfeeding your child isn’t recommended. This is because HIV can be transmitted to a child through breast milk. For more information, see the “Dovato and breastfeeding” section above.
Note: For more information about the potential negative effects of Dovato, see the “Dovato side effects” section above.
Do not use more Dovato than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.
What to do in case you take too much Dovato
If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.
When you get Dovato from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.
The expiration date helps guarantee that the medication is effective during this time. The
Storage
How long a medication remains good can depend on many factors, including how and where you store the medication.
Dovato tablets should be stored at room temperature, below 86°F (30°C), in a child-resistant container. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.
Disposal
If you no longer need to take Dovato and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.
This article provides several useful tips on medication disposal. You can also ask your pharmacist for information about how to dispose of your medication.
Disclaimer: Medical News Today 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 another 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.
