What is Triumeq?

Triumeq is a medication used to treat HIV. It is a combination of three separate antiretroviral drugs in one pill, taken once a day.

It combines 50mg dolutegravir, 600mg abacavir and 300mg lamivudine in an oval, film-coated purple tablet. The tablet has ‘572 Tri’ on one side.

How does Triumeq work?

Triumeq combines three drugs in one pill. Two of the drugs (abacavir and lamivudine) are from a class of drugs known as nucleoside reverse transcriptase inhibitors (NRTIs) and one drug (dolutegravir) is an integrase inhibitor. Each drug class works against HIV in a different way.

The aim of HIV treatment is to reduce the level of HIV (the ‘viral load’) in your body until it is undetectable – usually less than 50 copies of virus per ml of blood. Taking HIV treatment and having an undetectable viral load protects your immune system and stops HIV being passed on to someone else during sex.

How do I take Triumeq?

You should take Triumeq once a day. It can be taken with or without food.

HIV treatment works best if you take it every day, ideally at the same time each day. It may help to set an alarm, e.g. on your mobile phone, to remind you. If you forget to take a dose of Triumeq and realise within 20 hours of the time you usually take it, take it as soon as possible then take your next dose at your usual time.  If you realise with less than four hours left until your next dose, don’t take a double dose, just skip the dose you’ve forgotten and then carry on with your normal routine.

What are the possible side effects of Triumeq?

All medicines have possible side effects. It’s a good idea to talk to your doctor, nurse or pharmacist about what to expect before you start taking any medication, and how to manage any side effects which occur.

A full list of side effects, including less common side effects, can be found in the patient information leaflet that comes with Triumeq.

Side effects can be described as:

Common – a side effect that occurs in at least one in a hundred people (more than 1%) who take this drug.

Rare – a side effect that occurs in fewer than one in a hundred people (less than 1%) who take this drug.

Common side effects of Triumeq include (most common in bold):

• difficulty sleeping, headache, fatigue, dizziness.
• nausea (feeling sick), diarrhoea, loss of appetite, indigestion, flatulence, feeling bloated
• muscle pain and discomfort, rash.

Important warning: Abacavir and dolutegravir, two of the active ingredients in Triumeq, can cause a serious hypersensitivity (allergic) reaction. It is important that you discuss this with your doctor or pharmacist before taking Triumeq, and read the alert card and manufacturer’s patient information leaflet that comes with your Triumeq tablets.

A hypersensitivity reaction to abacavir is associated with a particular gene. Before starting treatment with Triumeq (or any other treatment that contains abacavir), you will have a genetic test called ‘HLA-B*5701’. If the test is positive, you should not take Triumeq or any other treatment that contains abacavir. If the test is negative, it is very unlikely you would have a reaction to the drug, but it makes good sense to look out for symptoms, particularly during the first six weeks of taking the drug.

The most common symptoms of a hypersensitivity reaction are rash and fever, plus other symptoms including:

• shortness of breath, sore throat or cough
• nausea or vomiting, or diarrhoea or abdominal pain
• tiredness or achiness, or generally feeling ill.

You should see a doctor immediately (or go to A&E if out of hours) if you think you are having a hypersensitivity reaction.

People with HIV may gain weight after starting antiretroviral treatment. Clinical trials of new HIV drugs introduced since 2003 show that people taking dolutegravir (one of the components of Triumeq) are at higher risk of substantial weight gain than people taking other antiretroviral drugs.

Does Triumeq interact with other drugs?

You should always tell your doctor and pharmacist about any other drugs or medication you are taking. That includes anything prescribed by another doctor, medicines you have bought from a high-street chemist, herbal and alternative treatments, and recreational or party drugs (‘chems’).

Some medicines or drugs are not safe if taken together – the interaction could cause increased, dangerous levels, or it could stop one or both of the drugs from working. Other drug interactions are less dangerous but still need to be taken seriously. If levels of one drug are affected, you may need to change the dose you take. This must only be done on the advice of your HIV doctor.

If you are taking Triumeq it’s important to check with your HIV doctor or pharmacist before taking any medicines from the following groups:

• antibiotics
• antiepileptic medicines
• herbal medicines – in particular St John’s Wort should be avoided
• metformin (a tablet to treat diabetes) – levels of this drug can be increased by Triumeq; your doctor may need to decrease the dose

Taking calcium, iron, magnesium or aluminium can stop you from absorbing Triumeq properly – all multivitamin and mineral supplements and antacids must be taken at least six hours before or two hours after Triumeq.

The patient information leaflet which comes with your Triumeq has a full list of medicines which should be avoided.

Can I take Triumeq in pregnancy?

If you are considering having a baby, or think you might be pregnant, talk to your doctor as soon as possible about which combination of anti-HIV medications would be right for you. It is important to take antiretroviral treatment during pregnancy to prevent passing HIV from mother to baby.

It is not recommended you take Triumeq at the time of becoming pregnant or during the first 12 weeks of pregnancy unless you are taking folic acid supplements.

If you become pregnant while taking Triumeq, see your doctor as soon as possible to review your treatment.

The British HIV Association lists Triumeq as an option that may be considered for women who begin HIV treatment later on in pregnancy, depending on their individual circumstances.

Women living with HIV are advised not to breastfeed, as HIV can be passed on in breast milk. However, some women do choose to breastfeed. Triumeq should not be used during breastfeeding as at least one of the drugs it contains passes into breast milk.

Can children take Triumeq?

In the European Union, Triumeq tablets can be taken by children aged 12 years and over, weighing 25kg or more. There is also a dispersible tablet that can be prescribed for children weighing between 14kg and 25kg. In the United Kingdom, at the time of writing, Triumeq tablets can be taken by children aged 12 years and over, weighing 40kg or more.

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