Triumeq interactions: Alcohol, medications, and other factors

Before you start treatment with Triumeq, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Triumeq interacts with supplements, herbs, or vitamins, see the “Triumeq and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Triumeq. Keep in mind that this table doesn’t include all drugs that may interact with Triumeq. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* For details about this interaction, see the “When to avoid Triumeq” section below.
† For details about Triumeq’s side effects, see this article.
‡ For details about this interaction, see the “Drug interactions in depth” section below.

In some cases, factors or conditions could prevent your doctor from prescribing Triumeq due to the risk of harm. These are known as contraindications. The Triumeq contraindications include:

Taking dofetilide

Doctors typically will not prescribe Triumeq in combination with dofetilide (Tikosyn), which is prescribed to treat an irregular heart rhythm.

This is because Triumeq can affect the kidneys’ ability to remove dofetilide from your system. This can cause the level of dofetilide to build up in your body, increasing your risk of side effects from the drug. Some of these side effects, such as QT prolongation, may be serious and life threatening.

Before you start treatment with Triumeq, it’s important to tell your doctor if you take dofetilide. They can recommend other treatments that may be better choices for you.

Having liver disease

Doctors typically won’t prescribe Triumeq for people with moderate or severe liver disease, including liver failure. It isn’t known for certain whether Triumeq is safe for people with moderate or severe liver disease.

If you have liver disease, talk with your doctor before taking Triumeq. They can determine whether to prescribe Triumeq.

Having a certain genetic factor

Doctors typically won’t prescribe Triumeq for people with the HLA-B*5701 allele. This is a genetic factor that increases the risk of allergic reaction to abacavir, one of the active ingredients in Triumeq. (The other active ingredients are dolutegravir and lamivudine.)

In fact, Triumeq has a boxed warning about the risk of allergic reaction. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see “Boxed warnings” at the beginning of this article.

Your doctor will likely test you for this genetic factor before starting treatment with Triumeq. If you have the HLA-B*5701 allele, your doctor will prescribe a treatment other than Triumeq.

Having had an allergic reaction to Triumeq or any of its ingredients

If you have had an allergic reaction to Triumeq or any of its ingredients, your doctor will likely not prescribe Triumeq. Taking the drug could cause another allergic reaction.

In fact, Triumeq has a boxed warning about the risk of allergic reaction. A boxed warning is the most serious warning from the FDA. For details, see “Boxed warnings” at the beginning of this article.

You can ask your doctor about other treatments that may be better choices for you.

Note: Before you start treatment with Triumeq, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Triumeq.

Your doctor will likely recommend that you avoid combining Triumeq and alcohol. They’ll also usually advise you not to take any prescription or over-the-counter drugs that contain alcohol during Triumeq treatment.

This is because drinking alcohol while taking the drug could prevent your body from breaking down Triumeq as well as it should. This can lead to high levels of Triumeq in your system, increasing your risk of side effects from the drug. (For details about the side effects of Triumeq, see this article.)

If you have concerns about avoiding alcohol while you’re taking Triumeq, talk with your doctor before starting treatment.

Here’s a closer look at certain drug interactions of Triumeq.

Metformin

Metformin (Fortamet, Glumetza) is prescribed to treat type 2 diabetes.

Interaction result: Taking Triumeq with metformin could increase the risk of side effects from metformin.

Interaction explained: Triumeq can affect your kidneys’ ability to remove metformin from your system. This can lead to a high level of metformin in your body, which may increase your risk of side effects from the drug. Examples include diarrhea, low blood sugar, and lactic acidosis (a high level of lactic acid in the blood).

Steps you or your doctor may take: Before starting Triumeq treatment, tell your doctor if you’re taking metformin. They can recommend whether it’s safe to take these medications together.

If your doctor prescribes Triumeq with metformin, they may lower your metformin dosage. Doing so could help reduce your risk of side effects from metformin when these drugs are taken together.

To learn more about Triumeq and metformin, talk with your doctor or pharmacist.

Certain antacids

Antacids are used to ease symptoms of conditions such as heartburn and indigestion.

Interaction result: Taking Triumeq with certain antacids can make Triumeq less effective. This includes antacids that contain aluminum, calcium, or magnesium.

Interaction explained: When taken with Triumeq, the aluminum, calcium, or magnesium in the antacid may attach to Triumeq. This can prevent your body from absorbing Triumeq as well as it should. As a result, the level of Triumeq in your body may be too low for the drug to be effective.

Examples of antacid drugs: Here are some antacids that may interact with Triumeq:

• calcium carbonate (TUMS)
• aluminum hydroxide/magnesium hydroxide (Maalox)
• calcium carbonate/magnesium hydroxide (Rolaids)

Steps you or your doctor may take: Due to this risk, you should take Triumeq at least 2 hours before or 6 hours after taking an antacid that contains aluminum, calcium, or magnesium. Doing so may help prevent the antacid from affecting the level of Triumeq in your body.

Before taking any antacids with Triumeq, talk with your doctor or pharmacist. They can tell you whether a specific antacid contains aluminum, calcium, or magnesium.

Certain laxatives

Laxatives are used to ease constipation.

Interaction result: Taking Triumeq with laxatives that contain magnesium can make Triumeq less effective.

Interaction explained: The magnesium in the laxative may attach to Triumeq and prevent your body from absorbing Triumeq. This could lead to a low level of Triumeq in your system, which could make the drug less effective.

Examples of laxative drugs: Some laxatives that may interact with Triumeq include magnesium citrate (Citroma, OneLax, others) and magnesium hydroxide (PediaLax, others).

Steps you or your doctor may take: Because of this risk, you’ll take Triumeq at least 2 hours before or 6 hours after taking a magnesium-containing laxative. This will help prevent the laxative from affecting the level of Triumeq in your system.

Before taking any laxatives with Triumeq, talk with your doctor or pharmacist. They can tell you whether the laxative contains magnesium.

Triumeq may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Triumeq.

Triumeq interactions with supplements

Triumeq may interact with iron or calcium supplements. These supplements may attach to Triumeq and prevent your body from absorbing the drug. As a result, the level of Triumeq in your body may be too low for the drug to be effective.

Before taking Triumeq with an iron or calcium supplement, talk with your doctor or pharmacist. They can recommend options for preventing the supplement from affecting the level of Triumeq in your body.

For example, they may have you take Triumeq at least 2 hours before or 6 hours after taking the iron or calcium supplement. Or they might recommend taking the supplements with food to help prevent it from interfering with Triumeq.

Before you start treatment with Triumeq, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Triumeq interactions with herbs

Triumeq may interact with the herbs below:

• echinacea, which may be used to boost the immune system
• St. John’s wort, which may be used to ease symptoms of depression and other conditions

Taking Triumeq with either herb may decrease the effectiveness of Triumeq. Your doctor can suggest alternatives to these herbs.

Triumeq interactions with vitamins or minerals

There are no reports of vitamins interacting with Triumeq. However, the following minerals could make Triumeq less effective:

• chromium
• magnesium
• calcium
• iron

If you take these minerals with Triumeq, they could decrease the level of the drug in your body. This may make Triumeq less effective at treating your condition.

Due to this risk, you should take Triumeq at least 2 hours before or 6 hours after taking products that contain chromium, magnesium, calcium, or iron. Doing so may help prevent these minerals from affecting the level of Triumeq in your body.

It’s also important to note that some multivitamins may also contain minerals. Talk with your doctor to determine which multivitamin is best for you.

Triumeq and food

There were no reports of food interactions with Triumeq. If you’d like to learn more about eating certain foods during treatment with Triumeq, talk with your doctor.

Triumeq and vaccines

There aren’t any known interactions between Triumeq and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Triumeq and lab tests

Triumeq isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

TRIUMEQ INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been reported to interact with Triumeq. Taking Triumeq with cannabis products may increase the risk of side effects from Triumeq. (For details about the side effects of Triumeq, see this article.)

Before you start treatment with Triumeq, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Triumeq. Before you take this drug, be sure to talk with your doctor about your health history. Triumeq may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Triumeq include:

• Liver disease: Doctors typically won’t prescribe Triumeq for people with moderate or severe liver disease, including liver failure. For details, see the “When to avoid Triumeq” section above.
• Certain genetic factor: Doctors typically won’t prescribe Triumeq for people with a genetic factor that increases the risk of allergic reaction. For details, see the “When to avoid Triumeq” section above.
• Kidney disease: Triumeq can cause kidney-related side effects. The drug may worsen existing kidney disease, such as kidney failure. If you have kidney disease, your doctor can recommend whether Triumeq is a safe treatment option.
• Mental health conditions: In rare cases, Triumeq may increase the risk of suicidal thoughts or behaviors in people who have mental health conditions, such as depression. If you have a mental health condition, talk with your doctor before starting Triumeq treatment. They can advise whether Triumeq is the right treatment option.
• Heart-related conditions: Triumeq may increase the risk of a heart attack. People with heart-related conditions may have an increased risk of this side effect. Examples of these conditions include high blood pressure and type 1 or type 2 diabetes. Your doctor can recommend whether Triumeq is a safe treatment option.
• Allergic reaction: If you’ve had an allergic reaction to Triumeq or any of its ingredients, your doctor will likely not prescribe Triumeq. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you. Triumeq has a boxed warning about the risk of allergic reaction. This is a serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous. For details, see the boxed warning at the top of this article.
• Risk of lamivudine-resistant hepatitis B virus (HBV) and worsening of hepatitis B: Triumeq has a boxed warning about the risk of lamivudine-resistant HBV and worsening of hepatitis B. For details, see the boxed warning at the top of this article.
• Breastfeeding: It’s recommended that you avoid breastfeeding while taking Triumeq. The drug may pass into breast milk and cause side effects in a child who is breastfed. If you’re breastfeeding or planning to do so, talk with your doctor before taking Triumeq. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: Triumeq may not be safe to take during the first 3 months of pregnancy. The drug may cause congenital anomalies (commonly known as birth defects) if it’s taken during this time. If you’re pregnant or planning to become pregnant, tell your doctor before starting Triumeq. They can advise you on the right treatment plan and whether it’s safe to take the drug during later months of pregnancy. If you are prescribed Triumeq during pregnancy, consider enrolling in the drug’s pregnancy registry. This registry collects information about any pregnancy issues that may be reported with Triumeq. To learn more, talk with your doctor. You can also visit the registry website or call 800-258-4263.

You can take certain steps to help prevent interactions with Triumeq. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Triumeq label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Triumeq doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Triumeq by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Triumeq. These resources might help:

• Overview of Triumeq: For a general overview of Triumeq, you can see this article.
• Side effects: If you’re interested in the side effects of Triumeq, see this article. Another option is to refer to the Triumeq prescribing information.
• Dosage specifics: To learn about the dosage of Triumeq, see this article.
• Facts about HIV: To learn more about HIV, see our HIV and AIDS hub and our list of HIV and AIDS articles.

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.