Triumeq is a brand-name prescription medication. It’s FDA-approved to treat HIV in adults as well as children who weigh 25 kilograms (kg) or more (about 55 pounds [lb] or more). HIV is a virus that attacks your immune system, which is your body’s defense against infection.

Another version of Triumeq, called Triumeq PD, is available to treat HIV in children who weigh from 10 kg (about 22 lb) to less than 25 kg (about 55 lb).

Triumeq and Triumeq PD have certain limitations of use. For more information, see the “Triumeq uses” section below.

Drug details

Triumeq and Triumeq PD are made up of three different drugs: abacavir, dolutegravir, and lamivudine.*

Abacavir and lamivudine are both in a class of drugs called nucleoside reverse transcriptase inhibitors (NRTIs). Dolutegravir is in a class of medications called integrase inhibitors. Together, these three drugs work to decrease the viral load of HIV in your body, which eases the effects of the virus. (The viral load is the level of HIV in your blood.)

Triumeq comes as an oral tablet. Each tablet contains:

  • 600 milligrams (mg) of abacavir
  • 50 mg of dolutegravir
  • 300 mg of lamivudine

Triumeq PD comes as a tablet that you mix with water to form an oral suspension. Each tablet contains:

  • 60 mg of abacavir
  • 5 mg of dolutegravir
  • 30 mg of lamivudine

Triumeq and Triumeq PD are usually taken once per day.

Note: Triumeq and Triumeq PD are very similar drugs. Information on Triumeq in this article also applies to Triumeq PD unless otherwise noted.

* Abacavir/lamivudine is available as a brand-name drug called Epzicom. Dolutegravir is available as a brand-name drug called Tivicay.

Effectiveness

For information about the effectiveness of Triumeq and Triumeq PD, see the “Triumeq uses” section below.

Triumeq can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Triumeq. These lists don’t include all possible side effects.

The side effects for Triumeq PD are expected to be the same as those for Triumeq listed below.

For more information about the possible side effects of Triumeq or Triumeq PD, see this article. Or 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 Triumeq (or your child has had with this drug or Triumeq PD), you can do so through MedWatch.

Mild side effects

Mild side effects of Triumeq can include:*

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 Triumeq. To learn about other mild side effects, talk with your doctor or pharmacist, or see Triumeq’s prescribing information.
† For more information on this side effect, see “Side effect details” below. The nausea, gas, and diarrhea side effects are grouped together in a section called “Digestive problems.”

Serious side effects

Serious side effects from Triumeq 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 and their symptoms can include:

  • Liver problems, such as liver failure, fatty liver disease, or changes in your liver function. Symptoms can include:
    • pain in the right side of the abdomen
    • nausea or vomiting
    • urine that’s dark or tea-colored
  • Lactic acidosis (too much acid in your blood). Symptoms can include:
    • muscle pain
    • trouble breathing
    • dizziness
    • increased heart rate
    • nausea or vomiting
  • Heart attack. Symptoms can include:
    • chest pain
    • dizziness
    • pain in your jaw, neck, back, or arms
    • trouble breathing
  • Kidney problems, such as decreased kidney function. Symptoms may include:
    • producing less urine than usual
    • confusion
    • swelling in your legs or feet
  • Immune reconstitution syndrome (flare-up of symptoms of a past or slow-developing disease or infection, such as tuberculosis or Guillain-Barré syndrome). Symptoms of immune reconstitution syndrome may vary depending on which disease or infection you had.
  • Depression.*
  • Allergic reaction.*†
  • Risk of lamivudine-resistant hepatitis B virus and worsening of hepatitis B.*†
  • Suicidal thoughts and behaviors.‡

* For more information about this side effect, see “Side effect details” below.
Triumeq has boxed warnings for this side effect. A boxed warning is the most serious warning from the FDA.
‡ This side effect was seen mostly in people with a history of a mental health condition, such as depression. For more information, see the “Triumeq precautions” section below.

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.

Click here for more links and local resources.

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Side effects in children

Side effects in children were the same as side effects in adults. In a clinical trial, children ages 3 months to 17 years took abacavir and lamivudine,* two of the three active drugs in Triumeq. In this trial, side effects weren’t any more severe or frequent in children than in adults who took Triumeq.

Dolutegravir,* the third active drug in Triumeq, was also studied in children ages 4 weeks to 18 years. The results showed that side effects of children taking dolutegravir were very similar to those of adults taking the drug.

* Abacavir/lamivudine is available as a brand-name drug called Epzicom. Dolutegravir is available as a brand-name drug called Tivicay.

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

Triumeq has a boxed warning for allergic reaction. A boxed warning is the most serious warning from the FDA. The warning alerts doctors and patients about drug effects that may be dangerous.

Allergic reaction to abacavir

People taking Triumeq or one of its active drugs, abacavir, have experienced allergic reactions. In some cases, these reactions were serious or even fatal. Allergic reactions usually occurred during the first 6 weeks of taking abacavir, but they can happen at any time. Serious symptoms included organ failure and trouble breathing.

When you first start taking Triumeq, your doctor or pharmacist will give you a medication guide and a warning card. This card will help you determine when you need to contact your doctor or seek emergency care. Be sure to carry your warning card with you at all times.

If you develop a symptom from two or more of the groups below while taking Triumeq, tell your doctor right away. You may be having an allergic reaction.

GroupSymptom
1fever
2• rash
3• abdomen pain
diarrhea
• nausea
• vomiting
4• feeling achy
• feeling ill
fatigue
5cough
sore throat
• shortness of breath

You’re more likely to have an allergic reaction if you have a specific gene called HLA-B*5701. Your doctor will test your blood for this gene before you start taking Triumeq. If you do have the gene, your doctor will likely recommend a different medication to treat your HIV.

In clinical trials of people with HIV taking abacavir, about 8% of people who weren’t tested for HLA-B*5701 reported an allergic reaction. In comparison, when people tested negative for the HLA-B*5701 gene, 1% reported an allergic reaction. It’s not known how many people taking a different medication in the clinical trial may have also experienced an allergic reaction.

In rare cases, if you stop taking Triumeq (even for a few days) for any reason and then restart treatment, you may develop an allergic reaction. These reactions can occur within hours of restarting and be very severe. They may occur even if you don’t have the HLA-B*5701 gene or if you’ve taken Triumeq in the past with no problems. It’s not known how many people may have had an allergic reaction after stopping and restarting Triumeq treatment.

If you’ve ever had an allergic reaction to Triumeq or abacavir in the past, you should not use Triumeq. Be sure to tell your doctor about any medications you’ve taken for HIV before starting Triumeq treatment.

Allergic reaction to dolutegravir

You may also experience an allergic reaction to another active drug in Triumeq called dolutegravir.

In clinical trials of people with HIV, less than 1% who took dolutegravir reported allergic reactions. These reactions included rash, liver problems such as hepatitis and changes in liver function tests, fever, and aching joints. The reactions also included blisters or peeling of the skin, and trouble breathing.

If you experience any of these symptoms while you’re taking Triumeq, talk with your doctor right away. They’ll probably have you stop taking Triumeq until they can determine what’s causing the reaction. Your doctor may also test your blood to see how the allergic reaction affected you.

Talking with your doctor

Call your doctor right away if you have an allergic reaction to Triumeq, 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.

If you have an allergic reaction to Triumeq, it’s not always easy to tell which one of its active drugs is causing the allergy. That’s why it’s important that you don’t take Triumeq or any other medication that contains abacavir or dolutegravir again.

Pancreatitis

In clinical trials of people taking Triumeq, pancreatitis wasn’t reported. (Pancreatitis is a swelling of your pancreas.)

However, after the FDA approved the drug, pancreatitis was reported as a side effect in post-marketing reports of the drug. These are studies done after a drug has been approved and is available for use. It’s not known how many people had pancreatitis in post-marketing reports of Triumeq.

Symptoms of pancreatitis include:

  • abdomen pain
  • weight loss
  • fever
  • nausea or vomiting

If you develop symptoms of pancreatitis, see a doctor right away. They’ll be able to determine what’s causing your symptoms and how to treat them.

Hair loss

Hair loss isn’t a common side effect of Triumeq. It wasn’t reported in clinical trials of people taking Triumeq. However, hair loss was reported as a side effect in post-marketing reports of the drug. Post-marketing reports occur after a drug has been approved and is available for use. It’s not known how many people had hair loss in post-marketing reports of Triumeq.

If you have hair loss while you’re taking Triumeq, talk with your doctor. They may be able to help determine what’s causing your hair loss and how to manage it.

Weight gain

Weight gain wasn’t a side effect that was reported during clinical trials of people taking Triumeq. However, weight gain was reported as a side effect in post-marketing reports of the drug. These are studies done after a drug has been approved and is available for use. It’s not known how many people had weight gain in post-marketing reports of Triumeq.

If you have unexpected weight gain while you’re taking Triumeq, talk with your doctor. They may be able to help determine what’s causing the weight gain and how to manage it.

Depression

In clinical trials, some people experienced depression while taking Triumeq to treat HIV. In these trials, people took either:

  • dolutegravir (Tivicay) and abacavir/lamivudine (Epzicom) or
  • efavirenz/emtricitabine/tenofovir disoproxil (Atripla)

The active drugs in the combination of Tivicay and Epzicom are the same active drugs that make up Triumeq.

The results showed that depression occurred in:

  • 1% of people taking Tivicay and Epzicom
  • 2% of people taking Atripla

Symptoms of depression may include feeling hopeless and having no interest in activities that used to excite you. Other symptoms may include weight loss, weight gain, and decreased energy.

If you develop symptoms of depression while taking Triumeq, talk with your doctor right away. They may have you stop taking Triumeq and try a different medication to treat your HIV.

Digestive problems

Triumeq may cause digestive problems, such as nausea, diarrhea, and gas.

In clinical trials, people with HIV took either:

  • dolutegravir (Tivicay) and abacavir/lamivudine (Epzicom) or
  • efavirenz/emtricitabine/tenofovir disoproxil (Atripla)

The active drugs in the combination of Tivicay and Epzicom are the same active drugs that make up Triumeq.

The results showed that nausea occurred in:

  • less than 1% of people taking Tivicay and Epzicom
  • 3% of people taking Atripla

Also in the clinical trials, diarrhea occurred in:

  • less than 1% of people taking Tivicay and Epzicom
  • 2% of people taking Atripla

Gas was a less common side effect that some people reported while taking Tivicay and Epzicom.

In clinical trials of Triumeq, gas was reported in less than 2% of people taking Triumeq for HIV. It’s not known how many people taking Atripla or a placebo (treatment with no active drug in it) had gas in the trials.

If you have digestive problems such as nausea, diarrhea, or gas during your Triumeq treatment, talk with your doctor. They may be able to recommend ways to help ease these side effects.

Risk of lamivudine-resistant hepatitis B virus and worsening of hepatitis B

Triumeq has a boxed warning for the risk of lamivudine-resistant hepatitis B virus (HBV) and worsening of hepatitis B, which is an infection caused by HBV. A boxed warning is the most serious warning from the FDA. The warning alerts doctors and patients about drug effects that may be dangerous.

It’s possible to have both HIV and hepatitis B. People with both conditions who take drugs containing lamivudine, such as Triumeq, may develop HBV that is resistant to lamivudine. Lamivudine treats hepatitis B as well as HIV. So having lamivudine-resistant HBV can make hepatitis B more difficult to treat.

Before starting Triumeq treatment, your doctor will likely give you an HBV test. If you have HIV and hepatitis B, your doctor may recommend treating the hepatitis B while taking Triumeq. Or they may recommend a treatment other than Triumeq for your HIV.

If you stop taking Triumeq and you have both HIV and hepatitis B, your hepatitis B may get worse. It’s not known whether or how often worsening of hepatitis B may have occurred during clinical trials of Triumeq. This is because the flare-ups occur after the drug treatment has stopped.

Because the lamivudine in Triumeq also treats hepatitis B, when you stop using Triumeq, your symptoms of hepatitis B may flare up. Most reported flare-ups of hepatitis B got better on their own without medication. However, there were some life threatening cases reported as well.

Your doctor will monitor your hepatitis B during your treatment to see if it gets worse.

Symptoms of worsening of hepatitis B may include:

  • nausea or vomiting
  • abdomen pain
  • feeling tired
  • yellowing of the skin or white of the eyes

If you stop Triumeq treatment and you have both HIV and hepatitis B, your doctor will measure your blood levels for a few months. This way, they can see if your hepatitis B is getting worse. Your doctor may also have you start taking medication to keep the hepatitis B from worsening.

Be sure to talk with your doctor before you stop taking Triumeq. They can help determine the best way for you to stop taking the drug so that your hepatitis B doesn’t worsen.

The Food and Drug Administration (FDA) approves prescription drugs such as Triumeq and Triumeq PD to treat certain conditions. Triumeq and Triumeq PD may also be used off-label for other conditions. Off-label drug use is when an FDA-approved drug is used for a purpose other than what it’s approved for.

Note: Because Triumeq and Triumeq PD are absorbed differently in the body, the forms of these drugs are not interchangeable. If your child needs to switch from Triumeq PD to Triumeq due to their growth, their doctor will adjust the dose of Triumeq accordingly.

Triumeq for HIV

Triumeq is FDA-approved to treat HIV in adults as well as children who weigh 25 kilograms (kg) or more (about 55 pounds [lb] or more).

Triumeq PD is FDA-approved to treat HIV in children who weigh from 10 kg (about 22 lb) to less than 25 kg (about 55 lb).

Triumeq and Triumeq PD are not recommended to be used alone in people with a history of resistance to abacavir, lamivudine, or dolutegravir.* (These are the three active drugs in Triumeq.) “Resistance” means that you tried the drug in the past, but it didn’t work to reduce your level of HIV.

The level of HIV in your blood is known as the viral load.

* Abacavir/lamivudine is available as a brand-name drug called Epzicom. Dolutegravir is available as a brand-name drug called Tivicay.

HIV explained

HIV is a virus that attacks your immune system (your body’s defense against infection). To be specific, HIV targets immune system cells known as CD4 cells, then multiplies itself.

HIV is transmitted through blood or other bodily fluids, such as breast milk or semen. This can occur by sharing needles, breastfeeding, or having sex without a condom or other barrier method, for example.

Some people with HIV may not have symptoms for years. But it’s common to have flu-like symptoms a few weeks after contracting HIV. Other early symptoms can include chills, swollen lymph nodes, night sweats, and fever.

With HIV, the body may not be able to fight off infection or a disease such as cancer as it usually would. If left untreated, HIV can progress to AIDS. This is the most severe stage of HIV. With AIDS, the immune system has been greatly damaged by HIV. As a result, it’s even harder for the body to fight off infection and disease.

For more information about HIV and AIDS, visit our hub and list of articles on these conditions.

Effectiveness for HIV

The goal of taking HIV medications, such as Triumeq and Triumeq PD, is to decrease the viral load. This is the level of HIV in your blood. With a lower level of HIV, your immune system may get stronger and help you stay healthier.

The effectiveness of Triumeq is discussed just below. For information on the effectiveness of Triumeq PD, see the “Triumeq and children” section below.

Study of adults who hadn’t taken HIV medication in the past

A clinical trial looked at adults who hadn’t ever taken medication for HIV. One group took dolutegravir (Tivicay) with abacavir/lamivudine (Epzicom). The drugs in the combination of Tivicay and Epzicom are the same drugs that make up Triumeq.

A second group took efavirenz/emtricitabine/tenofovir disoproxil (Atripla). Atripla is another medication used to treat HIV.

After 144 weeks (almost 3 years), the following percentages of people had fewer than 50 copies of HIV per milliliter (mL) of blood:

  • 71% of people who took Tivicay and Epzicom
  • 63% of people who took Atripla

For the FDA to approve an HIV treatment, a clinical trial has to show that the drug is effective at lowering a person’s viral load to a certain level. This level is fewer than 50 copies of HIV per mL of blood. At this level, any virus left in the blood can’t weaken your immune system.

Study of adults who had taken HIV medication in the past

Another clinical trial involved people who had been treated with HIV drugs in the past. One group took dolutegravir (an active drug in Triumeq) with one to two other HIV drugs. A second group took raltegravir (Isentress) with one to two other HIV drugs. The other HIV drugs were determined by the researchers in the study.

The results showed that the following percentages of people had fewer than 50 copies of HIV per mL of blood:

  • 71% of people who took dolutegravir and other selected medication(s)
  • 64% of people who took raltegravir and other selected medication(s)

Off-label use for Triumeq

In addition to the use listed above, Triumeq may also be used off-label for other conditions. Off-label drug use is when an FDA-approved drug is prescribed for a purpose other than what it’s approved for. Below is an example of an off-label use for Triumeq.

Triumeq for ALS

Triumeq isn’t approved to treat amyotrophic lateral sclerosis (ALS), but the drug may be used off-label for this condition.

ALS is a disease that affects the nerve cells in your brain and spinal cord. ALS is also known as Lou Gehrig’s disease.

A clinical trial* showed that Triumeq was safe in people with ALS. Researchers also found Triumeq decreased the progression of ALS symptoms. A larger study is also being conducted to look at the effects of Triumeq on people with ALS.

If you have ALS and you’re interested in using Triumeq, talk with your doctor.

* In this trial, Triumeq was studied for ALS. Triumeq PD, which is used in children, was not studied for ALS.

Triumeq and children

Triumeq is approved to treat HIV in children who weigh 25 kilograms (kg) or more (about 55 pounds [lb] or more). The drug has been shown to be an effective medication for children within this weight range.

Another version of Triumeq, Triumeq PD, is approved to treat HIV in children who weigh from 10 kg (about 22 lb) to less than 25 kg (about 55 lb).

One clinical trial looked at children ages 3 months to 17 years weighing at least 55 lb (25 kg). The children were given abacavir and lamivudine (two of the three active drugs in Triumeq and Triumeq PD) and a third medication for HIV.

After 96 weeks (almost 2 years) of treatment, 67% of the children had fewer than 80 copies* of HIV per milliliter (mL) of blood. It’s not known how many children taking other medications may have also had this result.

A different study was done in children ages 4 weeks up to 18 years. Researchers looked at dolutegravir, the third active drug ingredient in Triumeq and Triumeq PD. At 48 weeks, 67% of children who weighed at least 10 kg had fewer than 50 copies of HIV per mL of blood.

It’s not known how many children taking other medications may have also had this result.

* Studies of adults and older children have used a level of 50 copies of HIV per mL. This study used a level of 80 copies of HIV per mL because very young children were included. They have less blood to measure than adults and older children.

Triumeq and Triumeq PD contain three active drugs: abacavir, dolutegravir, and lamivudine.* The combination of these drugs only comes in the form of brand-name medications. This combination is 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.

* Abacavir/lamivudine is available as a brand-name drug called Epzicom. Dolutegravir is available as a brand-name drug called Tivicay.

As with all medications, the cost of Triumeq and Triumeq PD can vary. The actual price you’ll pay for either Triumeq or Triumeq PD depends on your insurance plan, your location, and the pharmacy you use.

Visit this page to access Optum Perks coupons and get price estimates for Triumeq when you use the coupons. These coupons can provide significant savings on your prescription costs.

Note: Optum Perks coupons cannot be used with any insurance copays or benefits.

Your doctor or pharmacist can give you pricing information on Triumeq PD.

Keep in mind that you may be able to get a 90-day supply of Triumeq or Triumeq PD. If approved by your insurance company, getting a 90-day supply of either 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 Triumeq or Triumeq PD, 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 Triumeq or Triumeq PD, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Triumeq or Triumeq PD, or if you need help understanding your insurance coverage, help is available.

Triumeq and Triumeq PD are manufactured by GlaxoSmithKline and packaged by ViiV Healthcare. ViiV Healthcare offers a ViiVConnect Savings Card that may help cover the copay for either drug if you have insurance. For more information and to find out if you’re eligible for support, call 844‐588‐3288 or visit the card website.

If you don’t have insurance coverage, ask your doctor or pharmacist if they can suggest ways to save on Triumeq or Triumeq PD.

Mail-order pharmacies

Triumeq and Triumeq PD may be available through a mail-order pharmacy. Using this service may help lower your cost for either drug 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 Triumeq or Triumeq PD, so there’s less concern about running out of the medication. If you’re interested in this option, talk 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

Triumeq and Triumeq PD are not available in generic forms. 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 Triumeq or Triumeq PD dosage a doctor prescribes will depend on several factors. These include:

  • other medical conditions a person may have
  • other drugs that a person may take

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

Triumeq comes as an oral tablet. Each tablet contains:

  • 600 milligrams (mg) of abacavir*
  • 50 mg of dolutegravir*
  • 300 mg of lamivudine*

Triumeq PD comes as a tablet that you mix with water to form an oral suspension. Each tablet contains:

  • 60 mg of abacavir
  • 5 mg of dolutegravir
  • 30 mg of lamivudine

* Abacavir/lamivudine is available as a brand-name drug called Epzicom. Dolutegravir is available as a brand-name drug called Tivicay.

Dosage for HIV

The typical dosage of Triumeq to treat HIV is one tablet, once daily. For Triumeq PD dosage information, see the “Children’s dosage” section below.

Before you start taking Triumeq, your doctor will test you for a specific gene called HLA-B*5701. People with this gene are at an increased risk for an allergic reaction* to Triumeq. If you do have the gene, your doctor will likely recommend a different medication instead.

In some cases, you may be taking other drugs that can interact with Triumeq. In these situations, you may need to take an additional dose of dolutegravir 12 hours apart from your dose of Triumeq. (Dolutegravir is one of the three active drugs in Triumeq.)

Before starting Triumeq treatment, talk with your doctor about any other medications that you take. For more information about drug interactions, see the “Triumeq interactions” section below.

* Triumeq and Triumeq PD have a boxed warning for allergic reaction. A boxed warning is the most serious warning from the FDA. The warning alerts doctors and patients about drug effects that may be dangerous. To learn more, see “Allergic reaction” in the “Triumeq side effects” section above.

Children’s dosage

Triumeq is approved to treat HIV in children who weigh 25 kilograms (kg) or more (about 55 pounds [lb] or more). For children within this weight range, the dosage of Triumeq is one tablet, once daily.

Triumeq PD is approved to treat HIV in children who weigh from 10 kg (about 22 lb) to less than 25 kg (about 55 lb). In this case, the dose varies based on the weight of the child, as listed in the table below. The table also includes the number of tablets needed to make the liquid solution for each dose. Triumeq PD should be taken once daily.

Weight rangeRecommended dose of Triumeq PDNumber of Triumeq PD tablets
10 kg (about 22 lb) to less than 14 kg (about 31 lb)• 240 mg of abacavir
• 20 mg of dolutegravir
• 120 mg of lamivudine
4
14 kg (about 31 lb) to less than 20 kg (about 44 lb)• 300 mg of abacavir
• 25 mg of dolutegravir
• 150 mg of lamivudine
5
20 kg (about 44 lb) to less than 25 kg (about 55 lb)• 360 mg of abacavir
• 30 mg of dolutegravir
• 180 mg of lamivudine
6

Because Triumeq and Triumeq PD are absorbed differently in the body, the forms of these drugs are not interchangeable. If your child needs to switch from Triumeq PD to Triumeq, their doctor will adjust the dose of Triumeq accordingly.

If your child will be taking Triumeq or Triumeq PD, their doctor will test them for a specific gene called HLA-B*5701. People with this gene are at an increased risk for an allergic reaction* to Triumeq. If your child does have the gene, their doctor will likely recommend a different medication for treating HIV.

In some cases, your child may be taking other drugs that can interact with Triumeq or Triumeq PD. In these situations, your child may need to take an additional dose of dolutegravir 12 hours apart from their dose of Triumeq or Triumeq PD. (Dolutegravir is one of the three active drugs in these two medications.)

Before starting Triumeq or Triumeq treatment, talk with your child’s doctor about any other medications that your child takes. For more information about drug interactions, see the “Triumeq interactions” section below.

* Triumeq and Triumeq PD have a boxed warning for allergic reaction. A boxed warning is the most serious warning from the FDA. The warning alerts doctors and patients about drug effects that may be dangerous. To learn more, see “Allergic reaction” in the “Triumeq side effects” section above.

What if I miss a dose?

If you miss a dose of Triumeq, take it as soon as you remember. But you should not take a double dose to make up for a missed dose. Also, do not take more Triumeq than what your doctor prescribed.

It’s important that you try not to miss any doses of Triumeq. Missing a dose, even for a few days, may cause your HIV to worsen.

Missing a dose may also cause an allergic reaction* when you start taking the drug again. In rare cases, the reactions have been life threatening. They may occur within a few hours after taking Triumeq or drugs containing abacavir (one of the active drugs in Triumeq).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.

The same advice for missed doses of Triumeq above also applies to missed doses of Triumeq PD.

* Triumeq and Triumeq PD have a boxed warning for allergic reaction. A boxed warning is the most serious warning from the FDA. The warning alerts doctors and patients about drug effects that may be dangerous. To learn more, see “Allergic reaction” in the “Triumeq side effects” section above.

Will I need to use this drug long term?

Triumeq and Triumeq PD are meant to be used as long-term treatments. If you and your doctor determine that Triumeq is safe and effective for you, you’ll likely take it long term. If your child takes Triumeq PD and their doctor determines the drug is safe and effective for them, they’ll also take the treatment long term.

Note: Triumeq PD is prescribed based on a child’s weight. If your child takes Triumeq PD, as they grow, their doctor may eventually recommend switching to Triumeq. For more information, see the “Children’s dosage” section above.

You may wonder how Triumeq and Triumeq PD compare with other medications that are prescribed for similar uses. Here we look at how Triumeq, Triumeq PD, and Biktarvy are alike and different.

Ingredients

There are three active drugs that make up Triumeq and Triumeq PD: abacavir, lamivudine, and dolutegravir.* Abacavir and lamivudine are both in a class of drugs called nucleoside reverse transcriptase inhibitors (NRTIs). Dolutegravir is in a class of medications called integrase inhibitors.

Biktarvy is also made up of three active drugs: bictegravir, emtricitabine, and tenofovir alafenamide. Bictegravir is an integrase inhibitor. Emtricitabine and tenofovir alafenamide are both NRTIs.

* Abacavir/lamivudine is available as a brand-name drug called Epzicom. Dolutegravir is available as a brand-name drug called Tivicay.

Uses

The Food and Drug Administration (FDA) has approved Triumeq, Triumeq PD, and Biktarvy to treat HIV.

For this purpose, Triumeq is approved for use in adults as well as children who weigh 25 kilograms (kg) or more (about 55 pounds [lb] or more). Triumeq PD is approved for use in children who weigh from 10 kg (about 22 lb) to less than 25 kg (about 55 lb).

However, Triumeq and Triumeq PD are not recommended to be used alone in people with a history of resistance to abacavir, lamivudine, or dolutegravir. (These are the three active drugs in Triumeq.) “Resistance” means that you tried the drug in the past, but it didn’t work to reduce your level of HIV.

Biktarvy is approved for use in adults as well as children who weigh 14 kg or more (about 31 lb or more) who:

  • haven’t been treated for HIV before, or
  • are replacing their current HIV-1 medication and have fewer than 50 copies of HIV per milliliter (mL) of blood.

For the latter use, there should be no history of treatment failure or resistance to any of the active drugs in Biktarvy.

Drug forms and administration

Both Triumeq and Biktarvy are oral tablets. Triumeq PD comes as a tablet that you mix with water to form an oral suspension. All of these drugs are typically taken once daily.

Side effects and risks

Triumeq, Triumeq PD, and Biktarvy all contain a combination of drugs used to treat HIV. As a result, 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 Triumeq, Triumeq PD, or Biktarvy, as well as mild side effects that all drugs may share.

  • Can occur with Triumeq or Triumeq PD:
    • hair loss
    • weight gain
  • Can occur with Biktarvy:
    • no unique mild side effects
  • Can occur with Triumeq, Triumeq PD, and Biktarvy:
    • nausea
    • gas
    • rash

Serious side effects

These lists contain examples of serious side effects that can occur with either Triumeq or Biktarvy, as well as serious side effects that both drugs may share.

* Triumeq and Triumeq PD have a boxed warning for risk of lamivudine-resistant hepatitis B virus. A boxed warning is the most serious warning from the FDA. To learn more, see “Risk of lamivudine-resistant hepatitis B virus and worsening of hepatitis B” in the “Triumeq side effects” section above.
† Triumeq and Triumeq PD have a boxed warning for allergic reaction. For more information, see “Allergic reaction” in the “Triumeq side effects” section above.
‡ Triumeq, Triumeq PD, and Biktarvy have a boxed warning for the worsening of hepatitis B. To learn more, see “Risk of lamivudine-resistant hepatitis B virus and worsening of hepatitis B” in the “Triumeq side effects” section above.

Effectiveness

The only condition Triumeq, Triumeq PD, and Biktarvy are used to treat is HIV.

The use of Triumeq and Biktarvy in treating HIV has been directly compared in a clinical trial. The study found that these drugs were similarly effective in treating HIV.

Costs

The actual price you’ll pay for Triumeq, Triumeq PD, or Biktarvy depends on your insurance plan, your location, and the pharmacy you use.

Triumeq, Triumeq PD, and Biktarvy are all brand-name drugs. There are currently no generic forms of these drugs. Brand-name medications usually cost more than generics.

Other drugs are available that can treat HIV. Some may be a better fit for you than others. If you’re interested in finding an alternative to Triumeq, or an alternative to this drug or Triumeq PD for your child, talk with your doctor. They can tell you about other medications that may work well for you or your child.

Alternatives to treat HIV

Examples of other drugs that may be used to treat HIV include:

  • abacavir (Ziagen)
  • lamivudine (Epivir)
  • tenofovir disoproxil (Viread)
  • efavirenz (Sustiva)
  • darunavir (Prezista)
  • ritonavir (Norvir)
  • dolutegravir (Tivicay)
  • dolutegravir and rilpivirine (Juluca)
  • raltegravir (Isentress)
  • cobicistat (Tybost)
  • abacavir/lamivudine (Epzicom)
  • emtricitabine/rilpivirine/tenofovir disoproxil (Complera)
  • elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (Genvoya)
  • bictegravir/emtricitabine/tenofovir alafenamide (Biktarvy)
  • darunavir/cobicistat (Prezcobix)
  • dolutegravir/lamivudine (Dovato)
  • efavirenz/emtricitabine/tenofovir disoproxil (Atripla)
  • emtricitabine/rilpivirine/tenofovir alafenamide (Odefsey)
  • emtricitabine/tenofovir alafenamide (Descovy)
  • emtricitabine/tenofovir disoproxil (Truvada)

Triumeq can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Triumeq PD interactions are expected to be the same as those for Triumeq discussed below.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Triumeq and other medications

Below are examples of medications that can interact with Triumeq. This section does not contain all drugs that may interact with Triumeq.

Before taking Triumeq, 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.

Triumeq and rifampin

An antibiotic called rifampin (Rifadin, Rimactane) may decrease the level of dolutegravir in your body. Dolutegravir is one of the active drugs in Triumeq. This means that the dolutegravir may not work properly to treat your HIV.

If you need to take an antibiotic while using Triumeq, your doctor may recommend a drug other than rifampin.

However, if your doctor does prescribe rifampin, they may recommend that you take a separate dolutegravir tablet in addition to Triumeq. This will increase the level of dolutegravir in your body to the correct dose.

Triumeq and certain HIV medications

Triumeq is used to treat HIV. Some other medications used to treat HIV may decrease the level of dolutegravir in your body. Dolutegravir is one of the active drugs in Triumeq. This means that the dolutegravir may not work properly to treat your HIV.

Examples of HIV medications that may interact with Triumeq include:

  • etravirine (Intelence)
  • efavirenz (Sustiva)
  • nevirapine (Viramune)
  • fosamprenavir (Lexiva) and ritonavir (Norvir)
  • tipranavir (Aptivus) and ritonavir (Norvir)

Before taking Triumeq, tell your doctor if you’re taking any other HIV medications. If these drugs interact with Triumeq, your doctor may recommend a different treatment plan. It’s not recommended that you take etravirine and Triumeq without also taking either atazanavir and ritonavir or lopinavir and ritonavir. It’s also not recommended to take Triumeq with nevirapine.

With other medications, such as fosamprenavir and ritonavir, tipranavir and ritonavir, or efavirenz, you may be able to still take Triumeq, but with some adjustments. Your doctor may recommend that you take a separate dolutegravir tablet in addition to Triumeq. This will increase the level of dolutegravir in your body to the correct amount.

Triumeq and dofetilide

You should not use Triumeq if you’re taking dofetilide (Tikosyn). Dofetilide is used for certain heart conditions, such as atrial fibrillation.

Triumeq can cause the level of dofetilide in your body to increase. This can result in serious side effects such as an irregular heart rate. In some cases, this side effect may be life threatening.

Be sure to talk with your doctor about any other medications that you’re taking before you start taking Triumeq. If you’re taking dofetilide, they’ll recommend a different medication to treat your HIV instead of Triumeq.

Triumeq and dalfampridine

If you’re taking dalfampridine (Ampyra), be sure to talk with your doctor before starting Triumeq treatment. Dalfampridine is a drug that improves walking in people with multiple sclerosis.

Triumeq may cause the level of dalfampridine in your body to increase. An increased level of this drug can lead to seizures, which can be serious.

If you need to take both medications, your doctor may monitor you more often than usual to see if you’re having any seizures. They may also have you take a different medication instead of Triumeq to treat your HIV.

Triumeq and certain seizure medications

Some seizure medications may cause the level of dolutegravir in your body to decrease. Dolutegravir is one of the active drugs in Triumeq. With a reduced level of dolutegravir, the drug may not work as well as it should to treat your HIV.

Examples of seizure medications that may reduce the level of dolutegravir in your body include:

If you’re taking any seizure medications, talk with your doctor before you start using Triumeq. They can determine if your medications may interact.

If you’re taking carbamazepine, your doctor may recommend that you take a separate dolutegravir tablet in addition to Triumeq. This will increase the level of dolutegravir in your body to the correct dose.

If you’re taking any other seizure medication listed above, your doctor will likely recommend a different medication to treat your HIV. This is because there haven’t been enough studies to determine if an increase in dolutegravir dosing is needed and if the medication will still be effective.

Be sure to talk with your doctor about any seizure medications you take before you start using Triumeq.

Triumeq and certain stomach medications

Some stomach medications may interact with Triumeq. These drugs may cause the level of dolutegravir in your body to decrease. Dolutegravir is one of the active drugs in Triumeq.

With a reduced level of dolutegravir, the drug may not work as well as it should to treat your HIV.

Examples of stomach medications that may decrease the level of dolutegravir in your body include:

  • calcium carbonate (Tums)
  • aluminum hydroxide/magnesium hydroxide/simethicone (Maalox, Mylanta)
  • sucralfate (Carafate)

Doses of these drugs should be separated from your Triumeq dose so that they don’t interact with each other. Be sure to take your Triumeq at least 2 hours before or 6 hours after taking these medications.

If you’re taking any stomach medications, talk with your doctor or pharmacist before starting Triumeq treatment. They can tell you if the drug doses need to be separated.

Triumeq and metformin

If you’re taking metformin (Glumetza, Fortamet), talk with your doctor before starting Triumeq treatment. Triumeq may cause an increased level of metformin in your body. This can lead to an increased risk of side effects, such as diarrhea, nausea, or vomiting.

Your doctor may decrease your dose of metformin and monitor you for side effects if you take it along with Triumeq. They may also recommend a different medication to treat your condition.

Triumeq and methadone

Taking Triumeq with methadone may cause you to have a lower level of methadone in your body. Most people won’t need a dose increase. But some people may need an increased dose of methadone while they’re taking Triumeq.

If you’re taking methadone, talk with your doctor before starting Triumeq treatment. They may monitor you more often than usual to see if the methadone dose is still working for you.

Triumeq and drugs that contain sorbitol

Triumeq may interact with a sugar alcohol called sorbitol. Other medications, usually liquids, may contain sorbitol to sweeten the taste. Sorbitol may decrease the level of lamivudine in your body. Lamivudine is one of the active drugs in Triumeq. If the level of lamivudine is decreased, Triumeq might not work as well as usual to treat your HIV.

Examples of medications that contain sorbitol include:

  • loratadine solution (Claritin)
  • acetaminophen solution (Tylenol)

If you’re taking other medications, talk with your doctor before you start taking Triumeq. They can tell you if any of them contain sorbitol and if they may interact with lamivudine. If they do, your doctor may recommend a different medication to treat your condition.

Triumeq and herbs and supplements

Certain supplements have been specifically reported to interact with Triumeq, including the following.

Triumeq and multivitamins

Taking Triumeq with multivitamins that contain iron or calcium may decrease the level of dolutegravir in your body. Dolutegravir is one of the active drugs in Triumeq.

With a low level of dolutegravir, Triumeq may not work as well as it should to treat your HIV.

If you’re using a multivitamin that has iron or calcium in it, you can take it at the same time as Triumeq. However, you should take the multivitamin and Triumeq with food.

If you take Triumeq on an empty stomach, take it at least 2 hours before or 6 hours after your multivitamin.

Talk with your doctor about the best time to take Triumeq and if you need to separate the doses from multivitamin doses.

Triumeq and calcium

Calcium may lower the level of dolutegravir in your body. Dolutegravir is one of the active drugs in Triumeq.

With a low level of dolutegravir, Triumeq may not work as well as it should to treat your HIV.

If you’re using a calcium supplement, you can take it at the same time as Triumeq. However, you should take the calcium supplement and Triumeq with food.

If you take Triumeq on an empty stomach, take it at least 2 hours before or 6 hours after your calcium supplement.

If you have any questions about when to take Triumeq or a calcium supplement, talk with your doctor.

Triumeq and St. John’s wort

You should not take Triumeq if you’re using St. John’s wort. St. John’s wort is an herbal supplement that may be used to treat many conditions, such as depression or menopause.

St. John’s wort may decrease the level of an active drug in Triumeq called dolutegravir. With a low level of dolutegravir, Triumeq may not work as well as it should to treat your HIV.

It’s not known how much St. John’s wort may decrease your dolutegravir level. It’s also not known if you need to take additional dolutegravir while you use St. John’s wort. Because more research is needed, you should avoid using both Triumeq and St. John’s wort.

Talk with your doctor about other ways to manage depression, menopause, or other conditions you’re taking St. John’s wort for.

Triumeq and foods

There aren’t any foods that have been specifically reported to interact with Triumeq. Some other medications that are used to treat HIV, such as efavirenz (Sustiva), may interact with grapefruit and grapefruit juice. However, Triumeq doesn’t have any known interactions with grapefruit or grapefruit juice.

If you have any questions about eating certain foods with Triumeq, talk with your doctor.

Alcohol may increase the level of abacavir in your body. Abacavir is one of the active drugs in Triumeq. A high level of abacavir may increase your risk for developing side effects from the drug.

Alcohol may also worsen Triumeq side effects, such as dizziness, nausea, and headache. (To learn more, see the “Triumeq side effects” section above.)

If you drink alcohol, talk with your doctor about what amount of alcohol is safe for you to drink while you’re taking Triumeq.

You should take Triumeq or give your child this drug or Triumeq PD according to a doctor’s or healthcare professional’s instructions.

How to take

Triumeq comes as an oral tablet that you swallow whole.

Triumeq PD comes as a tablet that you mix with water to form an oral suspension before giving it to your child. For full details on how to prepare and give your child Triumeq PD, see the manufacturer’s instructions.

When to take

Triumeq and Triumeq PD are taken once daily. The drug’s manufacturer doesn’t recommend a best time to take these drugs, but it’s best to take a dose at about the same time each day. This is important for helping maintain a consistent level of medication in the body.

To help make sure that either you or your child 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 Triumeq with food

Triumeq and Triumeq PD can be taken with or without food.

However, if you take Triumeq with multivitamins or drugs that have iron or calcium in them, you should take Triumeq with food. (If your child takes Triumeq or Triumeq PD with such multivitamins or drugs, they’ll also need to take it with food.) Otherwise, you’ll need to take Triumeq at least 2 hours before or 6 hours after taking that vitamin or drug. (To learn more, see “Triumeq and herbs and supplements” in the “Triumeq interactions” section above.)

Can Triumeq be crushed, split, or chewed?

It’s not recommended that you crush, split, or chew Triumeq oral tablets. This is because it’s not known if the drug will still be safe or effective when it’s broken up.

Triumeq PD tablets should only be dissolved in water and then taken according to the manufacturer’s instructions.

If you have trouble swallowing your Triumeq tablets, talk with your doctor. They may recommend ways to make it easier to take your medication. They may also be able to recommend a different treatment for your HIV.

It’s not recommended that you take Triumeq* if you’re in the first trimester of pregnancy or planning to become pregnant. The first trimester is 0 to 13 weeks. This time frame is months 1 to 3.

One of the active drugs in Triumeq, dolutegravir, may cause serious brain and spinal abnormalities in the fetus. The abnormalities may occur throughout the first trimester when dolutegravir is taken at the time of conception (when the egg is fertilized by the sperm) and in early pregnancy.

The other active drugs in Triumeq (abacavir and lamivudine†) are not believed to cause an increased risk of congenital anomalies (also called birth defects).

If you’re able to become pregnant, your doctor may have you take a pregnancy test before you start taking Triumeq.

If you’re pregnant or planning to become pregnant, talk with your doctor. They’ll help you decide whether Triumeq may be right for you after your first trimester of pregnancy.

* Triumeq PD is prescribed only to children with a certain body weight. However, because it is similar to Triumeq, the information in this section also applies to Triumeq PD.
† Abacavir/lamivudine is available as a brand-name drug called Epzicom.

Pregnancy registry

Pregnancy registries collect information on drugs taken during pregnancy. The registries help determine what side effects, if any, the drug causes while you’re pregnant. There’s a pregnancy registry called Antiretroviral Pregnancy Registry (APR) for Triumeq and other antiretroviral drugs. (These drugs help treat HIV.)

If you take Triumeq while you’re pregnant, it’s recommended that your doctor enroll you in the pregnancy registry. For more information, talk with your doctor or visit the APR website.

It’s not recommended that you take Triumeq* if you’re in the first trimester of a pregnancy or planning to become pregnant. 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 Triumeq.

For more information about taking Triumeq during pregnancy, see the “Triumeq and pregnancy” section above.

* Triumeq PD is prescribed only to children with a certain body weight. However, because it is similar to Triumeq, the information in this section also applies to Triumeq PD.

For females using Triumeq

The manufacturers of Triumeq recommend that females who can become pregnant* use an effective form of birth control while taking the drug. Examples of birth control include birth control pills, patches, injections, and condoms.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

For males using Triumeq

To help prevent pregnancy, effective birth control, such as condoms, is recommended for males* taking Triumeq.

* Sex and gender exist on spectrums. Use of the term “male” in this article refers to sex assigned at birth.

It’s not recommended that you breastfeed if you have HIV. This is because your child may contract the virus through breast milk.

Both abacavir and lamivudine,* two of the active drugs in Triumeq,† can pass into human breast milk. The third active drug in Triumeq, dolutegravir,* was found in the milk of pregnant animals given the drug. It’s not known if Triumeq would affect a breastfed child or whether the drug may affect breast milk production.

Your doctor can recommend other healthy ways to feed your child while taking Triumeq.

* Abacavir/lamivudine is available as a brand-name drug called Epzicom. Dolutegravir is available as a brand-name drug called Tivicay.
† Triumeq PD is prescribed only to children with a certain body weight. However, because it is similar to Triumeq, the information in this section also applies to Triumeq PD.

Triumeq is used to treat HIV, which is a virus that attacks your immune system (your body’s defense against infection). HIV enters the body through blood or other bodily fluids, such as semen or breast milk.

With HIV, the body may not be able to fight off infection or diseases such as cancer as it usually would. If left untreated, HIV can progress to AIDS. This is the most severe stage of HIV. With AIDS, the immune system has been greatly damaged by HIV. As a result, it’s even harder for the body to fight off illness.

Triumeq PD, which is also used to treat HIV, works in the same way as discussed below for Triumeq.

What Triumeq does

Triumeq is made up of three different drugs: abacavir, dolutegravir, and lamivudine.* Abacavir and lamivudine are both in a class of medications called nucleoside reverse transcriptase inhibitors (NRTIs). Dolutegravir is in a class of medications called integrase inhibitors.

All three drugs work by preventing HIV from reproducing in your blood. The goal is to reduce the level of HIV in your blood until it’s so small that lab tests can’t detect it. The level of HIV in your blood is known as the viral load.

With a decreased level of HIV, you should have fewer and less severe effects from the virus. You should also have a lower risk for HIV becoming AIDS.

* Abacavir/lamivudine is available as a brand-name drug called Epzicom. Dolutegravir is available as a brand-name drug called Tivicay.

How long does it take to work?

Triumeq will start to work as soon as you start using it. How long it takes for the viral load (level of HIV in your blood) to decrease depends on several factors. These include:

  • what your viral load was before you started taking Triumeq
  • whether you take Triumeq as your doctor prescribes

To learn more about how soon Triumeq may start to work for you, talk with your doctor.

If you’re interested in learning about the half-life of Triumeq, you can ask your doctor about that, too. A drug’s half-life is the amount of time it takes for your body to remove half a dose of medication from your system.

Here are answers to some frequently asked questions about Triumeq and Triumeq PD.

Can I use Triumeq as PrEP to help prevent HIV?

At this time, Triumeq and Triumeq PD are not approved to be used as preexposure prophylaxis (PrEP). With PrEP, people who may have known risk factors for contracting HIV take a medication to help prevent it. Known risk factors for contracting HIV include injecting drugs and practicing sex without condoms or other barrier methods.

There are currently only two drugs approved to be used as PrEP:

  • emtricitabine/tenofovir disoproxil (Truvada)
  • emtricitabine/tenofovir alafenamide (Descovy)

If you’re interested in taking a medication as PrEP to help prevent HIV, talk with your doctor. They can discuss your medication options with you.

Will I have to take any tests before starting Triumeq treatment?

Yes. You will need to take a blood test before starting Triumeq treatment to check for a gene called HLA-B*5701. If you have this gene, you’re more likely to have an allergic reaction* to Triumeq. If you test positive for HLA-B*5701, your doctor will likely recommend a different medication to treat your HIV.

If you’re able to become pregnant, your doctor may also have you take a pregnancy test before you start taking Triumeq. This is because one of the active drugs in Triumeq, dolutegravir, may harm the fetus. To learn more, see the “Triumeq and pregnancy” section above.

In addition, your doctor may test your kidneys and liver to make sure they’re healthy. If you have certain kidney or liver problems, Triumeq may not be the best choice to treat your HIV.

In such cases, your doctor may recommend a different medication instead. To learn more, see “Kidney conditions” in the “Triumeq precautions” section below. You can also refer to “Can I take Triumeq if I have liver problems?” right below.

Before you start taking Triumeq, talk with your doctor about any tests you may need to have.

If your child is taking Triumeq or Triumeq PD, they’ll also need to have a blood test for HLA-B*5701 before starting treatment. They may also need some of the tests mentioned just above to see if they can take the drug safely.

* Triumeq and Triumeq PD have a boxed warning for allergic reaction. A boxed warning is the most serious warning from the FDA. The warning alerts doctors and patients about drug effects that may be dangerous. To learn more, see “Allergic reaction” in the “Triumeq side effects” section above.

Can I take Triumeq if I have liver problems?

It depends on how severe the liver problem is. People who have a moderate to severe liver condition, such as liver failure or severe cirrhosis, should not use Triumeq or Triumeq PD. This is because it’s not known if the drug is safe or effective for people with such conditions.

Triumeq and Triumeq PD also have a boxed warning for the worsening of a liver infection called hepatitis B. A boxed warning is the most serious warning from the FDA. (The boxed warning also mentions risk of developing hepatitis B virus that is resistant to lamivudine, one of the active drugs in these medications.) To learn more, see “Risk of lamivudine-resistant hepatitis B virus and worsening of hepatitis B” in the “Triumeq side effects” section above.

However, people with a mild liver condition, such as small changes in liver function tests, may be able to take the active drugs in Triumeq or Triumeq PD separately.

This is because one of the drugs, abacavir, needs to be given in a decreased dose in people with mild liver conditions. Triumeq and Triumeq PD contain three active drugs, including abacavir, in fixed amounts. So to decrease the dose of abacavir, the active drugs in these medications need to be taken separately.

Before you use Triumeq (or your child uses Triumeq or Triumeq PD), talk with your doctor about any liver problems you have. They can determine whether Triumeq or Triumeq PD is right for you or your child and adjust your medication plan if needed.

What kind of drug is Triumeq?

Triumeq and Triumeq PD are combination medications that are made up of three different drugs: abacavir, dolutegravir, and lamivudine.*

Abacavir and lamivudine are both in a class of drugs called nucleoside reverse transcriptase inhibitors (NRTIs). Dolutegravir is in a class of medications called integrase inhibitors. Together, these three drugs work to decrease the level of HIV in your body. This should reduce the effects of HIV.

For more information on how Triumeq and Triumeq PD works to treat HIV, see the “How Triumeq works” section above.

* Abacavir/lamivudine is available as a brand-name drug called Epzicom. Dolutegravir is available as a brand-name drug called Tivicay.

Will Triumeq cure HIV?

No, Triumeq and Triumeq PD can’t cure HIV. In fact, there’s currently no cure for HIV.

However, these medications can decrease the level of HIV in your blood, which should reduce the effects of HIV on your body.

Why do I need to make sure I don’t run out of Triumeq?

If you run out of Triumeq and miss doses, the level of HIV in your blood may increase. As a result, the virus can become resistant to the medication and harder to treat.

Also, if you stop taking Triumeq, even for a few days, you may have a reaction when restarting treatment. Although rare, in some cases, these reactions have been life threatening. They may occur within a few hours after taking Triumeq or medications containing abacavir (one of the active drugs in Triumeq).

If you run out of Triumeq and miss some doses, talk with your doctor before you start taking the drug again. They may want to monitor you so they can treat you quickly if you have a reaction to the drug.

In addition, if you have both HIV and hepatitis B, stopping Triumeq treatment may cause your hepatitis B to get worse.* This is another reason why it’s important to make sure you have enough Triumeq.

You should not stop taking Triumeq without talking with your doctor first. If you have more questions about making sure you have enough of the drug, reach out to your doctor.

The above also applies to Triumeq PD. If your child is taking this drug, try to ensure that you do not run out of it.

* Triumeq and Triumeq PD have a boxed warning for worsening hepatitis B. A boxed warning is the most serious warning from the FDA. The warning alerts doctors and patients about drug effects that may be dangerous. To learn more, see “Worsening hepatitis B” in the “Triumeq side effects” section above.

Do not take more Triumeq than your doctor recommends. Or if your child takes Triumeq or Triumeq PD, do not give them more than what their doctor prescribes. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Triumeq

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

Some medications may decrease the level of dolutegravir in your body. Dolutegravir is one of the active drugs in Triumeq.

If you’re taking a medication that decreases the level of dolutegravir in your body, your doctor may recommend that you take a separate dolutegravir tablet. (This would be in addition to Triumeq.) You would take the tablet to increase your dolutegravir dose to the correct level. (If your child takes Triumeq PD and a medication that decreases dolutegravir, this would apply to them as well.)

Examples of drugs that may reduce the level of dolutegravir include:

  • efavirenz (Sustiva)
  • fosamprenavir (Lexiva) and ritonavir (Norvir)
  • tipranavir (Aptivus) and ritonavir (Norvir)
  • carbamazepine (Tegretol)
  • rifampin (Rifadin, Rimactane)

Before you take Triumeq, talk with your doctor about any other medications that you take. They can determine if the drugs can lower the level of dolutegravir. Then your doctor can adjust your medications as needed.

Triumeq comes with several precautions.

Unless otherwise noted, the precautions for Triumeq below also apply to Triumeq PD.

FDA warnings

This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Allergic reaction. People taking Triumeq or one of its active drugs, abacavir, have experienced allergic reactions. In some cases, these allergic reactions were serious or even fatal. The reactions may affect how well your organs work in your body.

You’re more likely to have an allergic reaction if you have a specific gene called HLA-B*5701. In fact, if you have this gene or have had an allergic reaction to Triumeq or abacavir, you should not use Triumeq.

If you or your doctor think you’re having an allergic reaction to Triumeq, they’ll likely have you stop taking the drug. For more information about the risk of allergic reaction, see “Allergic reaction” in the “Triumeq side effects” section above.

Risk of lamivudine-resistant hepatitis B virus and worsening of hepatitis B. It’s possible to have both HIV and hepatitis B, which is an infection caused by the hepatitis B virus (HBV). People with both conditions who take drugs containing lamivudine, such as Triumeq, may develop HBV that is resistant to lamivudine. Lamivudine treats hepatitis B as well as HIV. So having lamivudine-resistant HBV can make hepatitis B more difficult to treat.

Before starting Triumeq treatment, your doctor will likely give you an HBV test. If you have HIV and hepatitis B, your doctor may recommend treating the hepatitis B while taking Triumeq. Or they may recommend a treatment other than Triumeq for your HIV.

If you have both HIV and hepatitis B and you stop taking Triumeq, your hepatitis B may get worse. To monitor for worsening hepatitis B, your doctor will measure your blood levels for a few months. They may also have you start taking medication to keep the hepatitis B from worsening.

To learn more, see “Risk of lamivudine-resistant hepatitis B virus and worsening of hepatitis B” in the “Triumeq side effects” section above.

Other precautions

Before taking Triumeq, talk with your doctor about your health history. Triumeq may not be right for you if you have certain medical conditions or other factors affecting your health. These include the ones mentioned below.

Note: For more information about the potential negative effects of Triumeq, see the “Triumeq side effects” section above.

Liver conditions. You should not use Triumeq if you have a liver condition, such as hepatitis. If you have a mild liver condition, such as small changes in liver function tests, your doctor may recommend that you take the active drugs in Triumeq separately.

This is because one of the drugs, abacavir, needs to be given in a decreased dose in people with mild liver conditions. Triumeq comes as a tablet containing one strength, so for a lower dose, the active drugs must be used separately.

If you have a moderate to severe liver condition, such as liver failure or severe cirrhosis, you should not use Triumeq. (This is known as a contraindication, which is a condition or factor that would prevent you from taking the drug.) It’s not known if the drug is safe or effective for people with such conditions. Before you use Triumeq, talk with your doctor about any liver problems you have.

Kidney conditions. Certain kidney conditions, such as chronic kidney disease, can cause your kidney function to be reduced. If you have such a condition, Triumeq may not be the best drug to treat your HIV.

This is because one of the active drugs in Triumeq, lamivudine, needs to be given in a decreased dose in people with reduced kidney function. Triumeq comes as a tablet containing one strength, so for a lower dose, the active drugs must be used separately.

Before you use Triumeq, talk with your doctor about any kidney conditions that you have.

Heart disease. Triumeq may increase your risk for having a heart attack. If you already have heart disease, such as coronary heart disease, taking Triumeq may increase this risk further. If you have HIV and heart disease, talk with your doctor about the best medication for you.

Pregnancy. It’s not recommended to take Triumeq if you’re pregnant or planning to become pregnant. For more information, see the “Triumeq and pregnancy” section above.

Breastfeeding. It’s not recommended that you breastfeed if you have HIV. For more information, see the “Triumeq and breastfeeding” section above.

Depression and other mental health conditions. If you have a history of a mental health condition, such as depression, talk with your doctor before using Triumeq. You may have an increased risk for suicidal thoughts and behaviors while taking the medication. They can advise you on whether Triumeq or a different drug is right for you.

When you get Triumeq or Triumeq PD 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 current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, ask your pharmacist how to properly dispose of it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

You should store Triumeq or Triumeq PD at a room temperature of 68°F to 77°F (20°C to 25°C). If needed, you can keep the medication from 59°F to 86°F (15°C to 30°C) for a short period of time.

Triumeq and Triumeq PD should be stored in their original bottles. Each bottle has a desiccant (a drying agent) inside it to help protect the drug from moisture. It’s important not to remove the desiccant from the bottle.

If you don’t keep Triumeq or Triumeq PD in the original bottle or remove the desiccant, the drug may break down. As a result, Triumeq or Triumeq PD may not work as well as usual to treat HIV.

Be sure to keep your bottle of Triumeq tightly sealed. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Triumeq, or your child no longer needs to take Triumeq PD, and you 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.

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