Has your doctor prescribed you a medicine to control your HIV status? The name of the medicine may be a combination of Dolutegravir and Rilpivirine. It usually comes under the brand name JULUCA. Don't be confused by the names, which are a bit complicated. In this article, we will talk about this medicine, what it does to your body, and the precautions you need to take while using it, in a very simple way that you can understand.
What is this medicine called Dolutegravir; Rilpivirine?
Simply put, this is a combination of two antiretroviral drugs that work against the HIV virus. The main purpose of this is to control the activity of the HIV virus in your body and reduce its strength.
Think of it like a shield that reduces the power of the virus. This largely controls the spread and further growth of the virus within the body.
But here you need to remember something very important . This medicine does not completely cure HIV. That is, it is not a cure, but a treatment . Also, even if you take this medicine, the risk of transmitting the HIV virus to another person will not be completely eliminated. That risk is only significantly reduced. Therefore, you should continue to follow safe methods.
Things you need to tell your doctor before starting medication
It is very important for your doctor to know your complete health history before prescribing this medicine. Therefore, if you have any of the following conditions, be sure to tell your doctor about them without hiding anything .
- Liver disease: If you have any pre-existing liver disease, please tell us about it.
- Mental health issues: It is important to let your doctor know if you have had suicidal thoughts, plans, or attempts in the past, or if someone in your family has a history of this.
- Allergies: Tell your doctor if you have any allergies to Dolutegravir, Rilpivirine, or any other medicines, foods, or dyes contained in this medicine.
- Pregnancy: This is very important if you are pregnant, trying to get pregnant, or planning to get pregnant soon . This medicine may affect the unborn baby.
- Breastfeeding: If you are a breastfeeding mother, you should also tell your doctor about it.
How exactly do I use this medicine?
To get the most out of this medicine, it is very important to know how to use it correctly.
- Take with food: This medication should be taken with a glass of water and a meal . Do not take on an empty stomach.
- Take it on time: Try to take your medicine at about the same time every day, exactly as your doctor prescribed. Make this a habit.
- Don't miss doses: No matter how well you feel, don't skip doses or stop taking your medication without your doctor's advice. Skipping doses can cause the HIV virus to develop resistance to this medication. If you do, this medication, as well as other HIV medications, may not work for you in the future.
- What if you take too much?: If you think you have taken too much medicine, immediately call the National Poisons Information Centre at the Colombo National Hospital , or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
- What if I miss a dose?: Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take the next dose at the scheduled time. Never take a double dose.
This medicine is for you only. Do not share your medicine with others, even if they have the same symptoms as you.
Other drugs that may interact with this medicine (Drug Interactions)
This is a very important part. Some medications can cause problems when taken with this medicine. So tell your doctor about all the medications you are taking (including vitamins, herbal remedies, and supplements) .
The table below lists some medications that may cause problems with this medicine.
| Dolutegravir; Potential interactions with Rilpivirine | |
|---|---|
| Medicines that should never be taken together | |
| Phoenix/Some medications for epilepsy | Carbamazepine, Oxcarbazepine, Phenobarbital, Phenytoin |
| Some medications used for gastritis (Proton Pump Inhibitors) | Esomeprazole, Pantoprazole, Omeprazole, Lansoprazole, Rabeprazole |
| Some medications for fungal infections | Fluconazole, Itraconazole, Ketoconazole, Posaconazole, Voriconazole |
| Some medicines for tuberculosis | Rifampin, Rifapentine |
| Other medications | Dexamethasone, Dofetilide, St. John's wort, Cisapride, Pimozide, Thioridazine, Ziprasidone |
| Medications that may cause interactions and should be taken under medical advice | |
| Some antibiotics | Clarithromycin, Erythromycin, Rifabutin |
| Other medicines for gastritis (Antacids) | Aluminum hydroxide, Magnesium hydroxide, Calcium carbonate, Cimetidine, Famotidine |
| Supplements | Calcium supplements, Iron supplements |
| Other medications | Metformin, Methadone, Sucralfate, drugs that affect heart rhythm (QT interval prolonging drugs) |
This list is not complete, so it's safest to tell your doctor about everything you take.
Things to be careful about while taking the medicine
- Regular check-ups: See your doctor at regular intervals. He or she can do the necessary blood work to see how the medication is affecting your body.
- Serious skin reactions: This is very important. If you develop a skin rash with symptoms such as fever or chills, a few weeks or months after starting the medicine, tell your doctor right away . This rash may turn red or purple, then blister and peel. Or it may be a red rash with swollen lymph nodes on the face, lips, or neck/armpits. This could be a sign of a serious condition called DRESS syndrome, which requires immediate treatment.
- Liver damage: Dark yellow/brown urine, yellowing of the eyes or skin, pain in the upper right side of the stomach, and extreme fatigue may be signs of liver problems. Tell your doctor right away.
- Mood changes: If you experience mood changes, depression, or suicidal thoughts, tell your doctor or a loved one immediately.
Side effects of the medicine
| Type of side effect | Characteristics |
|---|---|
| Things to report to the doctor immediately |
|
| Things that are usually not serious, but should be reported to the doctor if they persist |
If you experience any other unusual symptoms not mentioned in this list, talk to your doctor about them as well.
Take-Home Message
- Always take this medicine with food , at the prescribed time, as prescribed by your doctor. Do not skip doses.
- Tell your doctor about all other medications, vitamins, and supplements you are taking. Some medications, especially those for gastritis, should not be taken with this one.
- If you experience a severe skin rash, mood changes, or symptoms of liver damage along with fever, seek medical advice immediately.
- Remember that this is a treatment, not a cure, for HIV. Continue to practice safe sex .
- Avoid becoming pregnant while taking this medicine. If you are planning to become pregnant, talk to your doctor first.
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