If you are living with HIV, you probably know the importance of the treatments prescribed by your doctor to keep your life healthy and normal. By following these treatments exactly, you can control the virus in your body and live a healthy life. Today we are going to talk about one such very important tablet, a combination of three drugs. The names of this one are a bit complicated: Doravirine, Lamivudine, and Tenofovir Disoproxil Fumarate . It is most commonly available in the market under the name DELSTRIGO . Let us talk about this medicine simply, in a way that you can understand.
What really happens with this medicine?
Simply put, this is an antiretroviral drug. This means that it works by stopping the HIV virus from spreading inside your body, that is, by limiting the virus from multiplying. Because it is a combination of three drugs, this drug has a great ability to attack the virus from different sides and control it.
The most important thing: This medicine is not a cure for HIV or AIDS. However, it does control the virus and help your immune system stay strong. So you can live a healthy, active life.
Another thing to remember is that even while you are taking this medicine, there is still a risk of passing the HIV virus to others. Also, this medicine does not protect against other sexually transmitted infections (STIs). Therefore, it is very important to practice safe sex.
What are the things I need to tell the doctor before taking this medicine?
It is very important for your doctor to know everything about you. Only then can he/she give you the most suitable and safest treatment. Before starting this medicine, be sure to inform your doctor if you have any of the following conditions.
| Situation you need to report | Why is that important? |
|---|---|
| Bone problems (e.g. osteoporosis) | There is a possibility of bone weakening when this medication is used long-term. Therefore, it is important for the doctor to be aware of this. |
| Hepatitis B infection | If you stop taking this medicine, your hepatitis B symptoms may suddenly get worse. So it's important for your doctor to be aware of this. |
| Kidney disease | Since the medicine is eliminated from the body through the kidneys, it is important to monitor kidney function. The dosage of the medicine may need to be adjusted. |
| Liver disease | If you have any liver disease, it is important for your doctor to know about it. |
| Allergy to a medicine, food, or dye | It is very important for safety to know if you are allergic to any of the ingredients in this medicine. |
| If you are pregnant or trying to get pregnant | You should talk to your doctor about the pros and cons of using this medication during pregnancy. |
| If the baby is breastfed | Breastfeeding is not recommended for HIV-infected mothers, and you should talk to your doctor about breastfeeding while taking this medication. |
How should I use the medicine?
The method of using this medicine is very simple, but it is essential to follow the instructions exactly.
- Swallow this tablet with a glass of water.
- You can take this with or without food.
- If you feel an upset stomach after taking the medicine, eat some food before taking the medicine.
- The most important thing: Try to take your medicine at the same time every day , exactly as your doctor prescribed.
Is it dangerous to skip a dose of medication?
Yes, it can be very dangerous. Think of these drugs as soldiers fighting the HIV virus in your body. When you take your pills every day, those soldiers keep the virus under control. But if you skip a dose, it's like giving the soldiers a break and giving the virus a chance to get stronger again. Then the virus can get used to the drugs, and later the drugs can stop working. We call this the virus becoming resistant to the drugs. So, do not stop taking the drugs or skip the doses for any reason unless your doctor tells you to.
What do you do if you miss a dose of medicine?
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take a double dose.
What if I take too much medicine?
If you think you have taken too much medicine by mistake, immediately call the National Poisons Information Centre at the Colombo National Hospital , or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
This medicine has been prescribed for you only. Do not share it with others for any reason.
Other medications that should not be taken with this medicine
One medicine we take can 'interact' with another. When that happens, the effectiveness of one medicine may decrease, increase, or cause unwanted side effects. Therefore, you should inform your doctor about every medicine you take, not only those prescribed by your doctor, but also painkillers, vitamins, Ayurvedic medicines, and herbal supplements that you buy from a pharmacy.
The medications below are more likely to interact with this medicine.
| Never take these together. | |
|---|---|
| Type of medicine | Examples |
| Other HIV medications | Efavirenz, Etravirine, Nevirapine |
| Anticancer drugs | Apalutamide, Enzalutamide, Mitotane |
| Some antibiotics | Rifampin, Rifapentine |
| Medicines for epilepsy | Carbamazepine, Oxcarbazepine, Phenobarbital, Phenytoin |
| Herbal products | St. John's wort |
| Be sure to tell your doctor if you are taking these. | |
| Other antivirals | Adefovir, Cidofovir, Acyclovir, Ganciclovir |
| Painkillers (NSAIDS) | Ibuprofen, Naproxen |
| Some other antibiotics | Rifabutin, Aminoglycosides |
*This list is not complete. It is best to tell your doctor about all the things you are taking.*
Things to be careful about while taking the medicine
- Regular check-ups: Your doctor will check you regularly. Don't skip those appointments. He or she will also order blood tests to monitor your progress.
- Pay attention to symptoms: If your symptoms get worse or new symptoms appear, tell your doctor right away.
- Special attention for hepatitis B: If you have hepatitis B, do not even think about stopping your medication without consulting your doctor. Doing so may worsen the disease.
- Bone health:There is a risk of bone loss (bone density loss) when this medicine is taken for a long time. This may increase the risk of fractures. Talk to your doctor about your bone health. Get advice on things like eating a diet rich in calcium and vitamin D.
Possible side effects
Like any medicine, this medicine can cause side effects in some people, but not everyone gets them. Watch out for the symptoms below.
| Side effects that you should report to your doctor immediately | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat, difficulty breathing. |
| Kidney injury | Decreased urine output, swelling of the ankles, hands, or feet. |
| Signs of infection | Fever, chills, cough, sore throat. |
| Serious skin reactions | Redness, blistering, peeling skin (even inside the mouth). |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Diarrhea | Abdominal distension. |
| Dizziness | Dizziness. |
| Headache | Headache. |
| Nausea | Feeling like vomiting. |
| Insomnia or strange dreams | Sleep problems or vivid, unusual dreams. |
How do you keep your medicine safe?
- Keep away from children and pets.
- Store at room temperature (between 20-25 degrees Celsius), in a dry, moisture-free place.
- Keep the medicine in the original bottle it came in. Close the bottle cap tightly.
- Do not remove the small packet (desiccant) inside the bottle. It prevents the medicine from absorbing moisture.
- Dispose of expired medications. Ask your doctor how to properly dispose of unwanted or expired medications.
Take-Home Message
- This medicine helps control the HIV virus, but it does not completely cure it.
- Take your medication at the scheduled times, as directed by your doctor, without skipping any meals. This is essential for the success of your treatment.
- Tell your doctor about all other medications, vitamins, and herbal products you are taking.
- If serious side effects (such as allergies, kidney problems) occur, seek medical advice immediately.
- It is very important to maintain regular contact with your doctor and attend scheduled clinical appointments.
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