DolutegravirDolutegravir Sodium

About Dolutegravir

Dolutegravir blocks integrase, an enzyme HIV needs to copy itself. The label approves Tivicay and Tivicay PD, with other antiretrovirals, for HIV-1 in adults (whether or not previously treated) and in children weighing at least 2 kg who have not taken an integrase inhibitor before; Tivicay is also approved with rilpivirine as a complete regimen for certain adults whose virus is already suppressed. The usual adult dose is 50 mg once a day for people new to treatment or new to integrase inhibitors. The dose becomes 50 mg twice a day for those taking certain UGT1A or CYP3A inducers (efavirenz, carbamazepine, rifampin, fosamprenavir or tipranavir boosted with ritonavir), and for people with integrase resistance or suspected resistance. Children are dosed by age and weight, and with those inducers the total daily dose is doubled and split into two doses.

There is no boxed warning. It must not be taken by anyone who has had an allergic reaction to dolutegravir, or with dofetilide. Allergic reactions with rash, fever or organ problems have occurred; the label says to stop it and other suspect drugs right away. Liver injury has been reported, and people with hepatitis B or C are more prone to rising liver enzymes, so liver tests are monitored. Immune reconstitution syndrome can occur as the immune system recovers. Common side effects include trouble sleeping, tiredness and headache.

What is distinctive is the two forms. Tivicay PD 5 mg tablets and Tivicay 10, 25 and 50 mg tablets are not bioequivalent, so the dose must be recalculated when a child switches between them. On pregnancy, the current label (revised August 2026) has no warning section on neural tube defects; it says two large ongoing studies in Botswana and Eswatini show a similar rate of neural tube defects in infants born to people taking dolutegravir at conception, that human data are insufficient to definitively assess a risk of birth defects or miscarriage, and that pregnancy registry data do not indicate an increased risk of birth defects. Dolutegravir passes into breast milk. It is not a controlled substance.

Taking Dolutegravir

How to take it

Take it once or twice a day as prescribed, with or without food, at about the same times each day. Tivicay PD tablets can be swallowed whole one at a time or dispersed in drinking water only (5 mL for 1 or 3 tablets, 10 mL for 4 to 6 tablets) in the supplied cup and given within 30 minutes; never chew, cut or crush them.

If you miss a dose

Take the missed dose as soon as you remember. Do not take a double dose, and do not stop it without talking to the prescriber.

Storage

Keep it tightly closed in the original container with the desiccant left in, at room temperature, away from heat and moisture. Throw away a PD mixture not given within 30 minutes.

Interactions to know about

Take dolutegravir 2 hours before or 6 hours after antacids or laxatives with aluminum or magnesium, sucralfate and buffered medicines. Calcium or iron supplements, including multivitamins with them, can be taken at the same time if dolutegravir is taken with food; otherwise use the same spacing. Dofetilide is never combined with it, it raises metformin levels, and nevirapine, oxcarbazepine, phenytoin, phenobarbital and St. John’s wort are avoided.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Dolutegravir differs from pharmacy to pharmacy

Dolutegravir is sold only as the Tivicay and Tivicay PD brands from one maker, so every quote is priced as a brand and differences come from how each pharmacy buys and prices it.

Tivicay, Tivicay PD and each tablet strength are separate products, so compare quotes only for the same form, strength and quantity. The dispensing fee is a small part of a brand quote.

Ways to pay less for Dolutegravir without insurance

• Ask ViiV Healthcare whether its savings or patient assistance program applies to someone paying cash; many copay programs require commercial insurance.
• Compare quotes from more than one pharmacy for the exact form and strength prescribed.
• Once the regimen is stable, ask the prescriber whether a ninety-day supply is appropriate.
• If the dose is 50 mg, check that the prescription is written for the 50 mg tablet rather than a combination of smaller tablets.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Dolutegravir

1. 1.Is my dose of dolutegravir once a day or twice a day, given my other medicines?
2. 2.How far apart should I take my antacid, iron, calcium or multivitamin from my Tivicay?
3. 3.My child is switching between Tivicay PD and Tivicay tablets; has my child’s dose been recalculated?
4. 4.Which signs of an allergic reaction or liver problem mean I should stop and call my doctor?

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