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DOVATO (dolutegravir/lamivudine) | HIV-1 Treatment
Dovato (Dolutegravir/Lamivudine)

Starting from $1249

Dovato
Dolutegravir Sodium, Lamivudine
Select product strength & quantity:

Order up to a 3-month supply (6 pens)

Prescription Required.

Product of Canada.

Shipped from Canada.

Prescription Required.Product of Canada.Shipped from Canada.

What is Dovato?

Dovato, a distinguished brand in the realm of combination antiretroviral medications, is used in the treatment of HIV-1 infection. It is a blend of two potent drugs: dolutegravir and lamivudine. This brand’s medication is specifically designed for the initiation of therapy in HIV-1 infected individuals and is notable for its dual-action mechanism in inhibiting viral replication.

Composition and Mechanism:

Dovato’s effectiveness stems from its two active components:

  1. Dolutegravir: This component is an HIV integrase inhibitor, playing a pivotal role in preventing the integration of viral DNA into the DNA of healthy host cells. By blocking the HIV integrase enzyme, dolutegravir disrupts a critical stage in the HIV replication cycle, thereby impeding the virus’s ability to proliferate within the host.
  2. Lamivudine: As a nucleoside reverse transcriptase inhibitor (NRTI), lamivudine impedes the HIV replication process by inhibiting the reverse transcriptase enzyme. This enzyme is responsible for converting the virus’s RNA into DNA, a crucial step in the replication process. Lamivudine’s structure mimics the natural nucleosides of DNA, leading to premature termination of the viral DNA chain during replication.

Dual Mechanism of Action:

The combination of dolutegravir and lamivudine in Dovato offers a robust approach to managing HIV infection. By targeting two distinct and crucial steps in the HIV life cycle, Dovato provides an effective means to reduce the virus’s ability to multiply and spread. This dual mechanism of action is instrumental in maintaining control over the viral load in patients, contributing significantly to the management of HIV.

Clinical Efficacy:

Dovato has demonstrated high efficacy in clinical trials, with a significant percentage of patients achieving undetectable viral loads. This outcome is crucial in the long-term management of HIV, as maintaining a low viral load is key to preventing the progression of the disease and reducing the risk of transmission.

How does Dovato work?

The medications in Dovato work to reduce viral replication, but they accomplish this through two distinct mechanisms. Dolutegravir is an HIV integrase inhibitor. This drug prevents the virus from incorporating its DNA into healthy host cells. Lamivudine is a nucleoside reverse transcriptase inhibitor (NRTI) that inhibits the virus from making copies of itself. Viral replication is a multi-step process, and Dovato targets two distinct points within that replication cycle.

  1. Dolutegravir as an Integrase Strand Transfer Inhibitor (INSTI): Dolutegravir, classified as an INSTI, plays a critical role in inhibiting the HIV integrase enzyme. This enzyme is essential for the viral replication process, as it integrates the viral DNA into the host cell’s DNA. By blocking this enzyme, dolutegravir prevents the integration of HIV DNA into the chromosomes of the human immune cells, thereby interrupting the HIV replication cycle at a crucial stage.
  2. Lamivudine as a Nucleoside Reverse Transcriptase Inhibitor (NRTI): Lamivudine, an NRTI, works by inhibiting the activity of reverse transcriptase, another vital enzyme in the HIV replication process. Reverse transcriptase converts the virus’s RNA into DNA, a key step in viral replication. Lamivudine mimics the natural building blocks of DNA, thus interfering with the reverse transcriptase enzyme. When incorporated into the newly forming viral DNA chain, it results in premature termination of the DNA chain, thereby halting further replication of the virus.

Together, these two drugs target different steps in the HIV life cycle, making Dovato a potent combination for treating HIV infection by reducing the virus’s ability to multiply and spread. This dual mechanism of action helps in managing the viral load effectively in patients with HIV.

Dosage

Dovato is available in the following strength:

50 mg/300 mg

The dose of Dovato is started and maintained at 50 mg/300 mg once daily. Special instructions for Dovato intake recommend taking dolutegravir, a component of Dovato, 2 hours before or 6 hours after consuming cation-containing antacids, laxatives, sucralfate, oral iron supplements, oral calcium supplements, or buffered medications. This timing is crucial to prevent drug interactions and maintain the drug’s effectiveness.

For patients taking carbamazepine or rifampin, an additional 50 mg dose of dolutegravir is advised 12 hours after the regular Dovato dose. This adjustment is necessary due to the interaction of these medications with dolutegravir, affecting its plasma concentration.

The goal of all HIV therapies, including Dovato, is to reduce a patient’s viral load to an undetectable level. In clinical trials, Dovato has been shown to be effective in achieving this goal, with 91% of patients reaching undetectable levels of less than 50 copies per mL after 48 weeks of treatment.

The maximum daily dose of Dovato should not exceed 100 mg of dolutegravir and 300 mg of lamivudine. Adhering to this dosage limit is important to avoid potential overdose and associated complications.

Overdose

Signs or symptoms indicating an overdose of Dovato have not been extensively documented. However, in the event of an overdose, specific measures such as continuous hemodialysis may be employed to remove lamivudine, one of the components of Dovato, from the body. This process can be critical in managing the overdose, as hemodialysis aids in the excretion of the drug.

It’s also important to understand the metabolism and elimination processes for Dovato. Dovato’s components, dolutegravir and lamivudine, are metabolized in the liver and kidneys. Dolutegravir is primarily metabolized by the liver enzymes UGT1A1 and CYP3A. The role of these enzymes is crucial as they help in breaking down the medication for elimination from the body. Drugs that induce these enzymes may decrease plasma concentrations of dolutegravir, while those that inhibit these enzymes may increase its concentrations. Therefore, in the event of an overdose, the impact on these metabolic pathways needs to be considered for appropriate management.

If you suspect an overdose of Dovato, it is imperative to seek immediate emergency medical care or call the Poison Help line at 800-222-1222. Quick and appropriate medical intervention is key in managing an overdose situation effectively.

Dovato Side Effects

The most common side effects of Dovato include the following:

  • Diarrhea
  • Nausea
  • Headache
  • Anxiety
  • Tiredness
  • Trouble sleeping

In addition to these common side effects, Dovato may also cause more significant toxicities, which include:

  • Insomnia: Difficulty in falling or staying asleep.
  • Weight gain and increased body mass index (BMI): Noted in adults in clinical trials and some pediatric cohorts.
  • Neuropsychiatric symptoms: These can be particularly pronounced in patients with a history of psychiatric illness and may include mood changes, depression, or anxiety.

Furthermore, patients should be aware of and report:

  • Symptoms of an allergic reaction, including skin rashes, swelling of the face or mouth, and difficulty breathing.
  • Liver dysfunction signs, such as jaundice (yellowing of the skin and eyes), dark urine, and abdominal pain.
  • Lactic acidosis indicators, like severe muscle pain, breathing difficulties, and feeling unusually cold, especially in the extremities.

Immediate medical attention is crucial if you experience symptoms of liver dysfunction, lactic acidosis, or a severe allergic reaction. These symptoms can indicate serious health issues that require prompt treatment.

Moreover, patients initiating treatment with Dovato, especially those with advanced HIV disease, may experience immune reconstitution inflammatory syndrome (IRIS). This condition is marked by a rapid decline in HIV RNA levels and can cause dormant infections to resurface.

Contact your healthcare provider if you experience any of the above symptoms or have concerns about potential side effects of Dovato.

Warnings & Precautions

Children

Dovato has not been studied or approved in children under 12 years old.

Pregnancy and Breastfeeding

Taking Dovato while pregnant can increase the risk of neural tube defects and mitochondrial dysfunction, especially in the first trimester. Starting this medication while you are pregnant or trying to become pregnant is not recommended.

HIV-1 and HBV Coinfection

All patients should be screened for both HIV and hepatitis B virus (HBV). It is common for patients to have both viral infections. There are special treatment considerations for these patients due to the risk of developing severe side effects. Lamivudine resistance may develop, and you may experience worsening HBV when discontin

HIV-1 and HBV Coinfection

All patients should be screened for both HIV and hepatitis B virus (HBV) prior to starting Dovato treatment. Coinfection with HIV and HBV is not uncommon, and managing these patients requires special considerations due to the complexity of the diseases and the potential for severe side effects. Lamivudine, a component of Dovato, plays a role in treating HBV as well. However, there is a risk of developing lamivudine resistance. Furthermore, discontinuing Dovato in coinfected patients can lead to a flare-up or exacerbation of HBV, making it crucial to closely monitor and manage HBV in these patients. Treatment for chronic HBV may be required in addition to HIV treatment, underscoring the need for a comprehensive approach to managing coinfection.

Hypersensitivity

Hypersensitivity reactions are more commonly associated with dolutegravir, one of the components of Dovato. These reactions can manifest as muscle and joint pain, difficulty breathing, severe rash, blisters or ulcers in the skin or mouth, and swelling of the face or tongue. Patients who have previously experienced hypersensitivity reactions to dolutegravir or lamivudine are advised against taking Dovato.

Immune Reconstitution Syndrome

This syndrome is an inflammatory response that can occur upon initiating Dovato treatment, particularly in patients with advanced HIV disease. It results from the immune system recovering and can cause previously dormant infections to become active. Monitoring for symptoms of immune reconstitution syndrome is important when starting Dovato.

Serum Lipids and Blood Glucose

Patients on Dovato may experience changes in serum lipid and blood glucose levels. Regular monitoring of these parameters is recommended, especially for patients with existing conditions that could be exacerbated by such changes.

Kidney Problems

Dovato is not recommended for patients with a creatinine clearance below 30 mL/min, as the dosage cannot be safely adjusted for this group. For patients with a creatinine clearance between 30 and 49 mL/min, careful monitoring is advised due to the potential for higher exposure to lamivudine.

Liver Problems

Patients with severe liver disease, particularly those with Child-Pugh C classification, should use Dovato with caution. The medication may also pose risks for patients with a history of heavy alcohol use or early liver disease (Child-Pugh B). Liver function monitoring is often recommended for patients on Dovato due to the potential for liver dysfunction.

Lactic Acidosis and Severe Hepatomegaly with Steatosis

Lactic acidosis, a severe and potentially fatal condition, can occur with Dovato use and is often associated with liver problems. Severe hepatomegaly with steatosis, also known as fatty liver disease, is another serious condition that may develop. Discontinuation of Dovato is advised if either of these conditions is suspected.

Hematological

Dovato can cause a rare condition called red cell aplasia, where the bone marrow fails to produce adequate red blood cells. Monitoring of blood cell counts is important, and typically, counts return to normal once the medication is discontinued.

Dietary Considerations

Dovato can be taken with or without food, providing flexibility in dosing.

Drug Interactions

This is not a complete list of drug interactions. Notify your doctor of all your medications, including vitamins and over-the-counter supplements.

Dofetilide

Dofetilide is an antiarrhythmic used for certain heart conditions. Dovato causes an increased amount of dofetilide in the blood, which can be life-threatening. The use of these two medications together is contraindicated.

Cladribine

Cladribine is a chemotherapeutic agent which can be used in leukemias and multiple sclerosis. Taking cladribine with Dovato is contraindicated because of the decreased efficacy of cladribine.

Organic Cation Transporters (OCT-1 and OCT-2) Substrates and Inhibitors

Caution should be used when taking Dovato in combination with drugs that are either substrates or inhibitors of OCT-1 and OCT-2. E.g., clofarabine, erdafitinib, fexinidazole, gilteritinib, pacritinib, and tafenoquine. These combinations increase the risk of developing side effects or decreasing treatment efficacy.

Dalfampridine

Dalfampridine is a potassium channel blocker used for patients with multiple sclerosis. Taking Dovato in combination with dalfampridine may increase the risk of seizures. Caution should be exercised when taking both medications.

Anticonvulsants

Anticonvulsants such as oxcarbazepine, phenytoin, and phenobarbital can impact the efficacy of Dovato. Carbamazepine may also reduce the effectiveness but taking an additional 50 mg dose of dolutegravir can offset this. The additional dose of dolutegravir should be separated by 12 hours from your Dovato dose.

Metformin

Metformin is an antidiabetic medication. The amount of metformin in the blood may increase when taking Dovato. Monitoring for complications while taking both drugs is recommended because the metformin dose may need adjustment.

Rifampin

Rifampin is used to treat certain infections. This combination decreases the amount of dolutegravir in the blood, which could impact the efficacy of Dovato. Data shows that an additional 50 mg dose of dolutegravir should be taken. This dose should be separated by 12 hours from your Dovato dose.

St. John’s Wort (Hypericum perforatum)

St. John’s Wort is a common herbal product that decreases the amount of dolutegravir in the blood; it is not recommended to be taken with Dovato.

Polyvalent Cationic Drugs

Drugs containing polyvalent cations, including antacids, laxatives, and sucralfate, decrease the efficacy of Dovato. Your dose should be taken 2 hours before or 6 hours after taking these polyvalent cationic drugs.

Oral calcium and iron supplements

The amount of dolutegravir in the blood decreases when taking oral calcium, oral iron, or multivitamins that contain calcium or iron. Dovato should be taken 2 hours before or 6 hours after taking calcium or iron-containing medications. However, if these drugs are taken with food, they can all be taken simultaneously.

Sorbitol

Sorbitol may lead to a decreased amount of lamivudine in the blood. Taking sorbitol-containing drugs while on Dovato is not recommended and may require monitoring.

Alternative Medications

Notify your doctor of all prescriptions and supplements you are currently taking. There are individual treatments not listed that you may want to discuss with your doctor.

Complete Regimen

These medications have fixed doses of various drugs that manage HIV through different mechanisms. This often decreases the total number of pills patients must take.

  • Atripla (efavirenz + tenofovir disoproxil fumarate + emtricitabine)
  • Biktarvy (bictegravir + tenofovir alafenamide + emtricitabine)
  • Cabenuva (cabotegravir + rilpivirine)
  • Complera (rilpivirine + tenofovir disoproxil fumarate + emtricitabine)
  • Delstrigo (doravirine + tenofovir disoproxil fumarate + lamivudine)
  • Genvoya (elvitegravir + cobicistat + tenofovir alafenamide + emtricitabine)
  • Juluca (dolutegravir + rilpivirine)
  • Odefsey (rilpivirine + tenofovir alafenamide + emtricitabine)
  • Stribild (elvitegravir + cobicistat + tenofovir disoproxil fumarate + emtricitabine)
  • Symfi And Symfi Lo (efavirenz + tenofovir disoproxil fumarate + lamivudine)
  • Symtuza (darunavir + cobicistat + tenofovir alafenamide + emtricitabine)
  • Triumeq (dolutegravir + abacavir + lamivudine)

Medication Price & Coupons

Buy Dovato from Canada

For those in the US looking to purchase Dovato, a significant cost-saving option is available through Pharma Giant, a Canadian source. Dovato, a combination antiretroviral medication used for HIV-1 treatment, can be notably expensive in the United States. The cost for a 30-tablet supply can exceed $3,600, posing a financial challenge for many.

However, Pharma Giant offers a more affordable alternative. Through their service, Dovato is available for $1,248.95 for a 30-tablet supply. This price represents a substantial saving compared to US prices.

Dovato Coupon

Special Offer with Coupon Code: To make this deal even more appealing, Pharma Giant provides an additional discount. By using the coupon code DOVATOTEN, customers can save 10% off their purchase of Dovato. This offer further reduces the financial burden and makes this essential medication more accessible.

Frequently Asked Questions

Dovato is a prescription medicine approved by the FDA for the treatment of HIV infection in adults. It’s a complete regimen and should not be used with other HIV medicines. Dovato contains dolutegravir and lamivudine.

The price of Dovato in Canada for 50mg/300mg strength varies based on the quantity purchased. Here is the price breakdown for different quantities:

  • 30 Tablets: $1,248.95.
  • 60 Tablets: $2,397.56.
  • 90 Tablets: $3,521.94.

These prices offer a cost-effective option for those requiring Dovato for HIV-1 treatment, especially when compared to the price of this drug from a US pharmacy.

Key considerations include being aware of potential severe skin rashes, allergic reactions, liver problems, lactic acidosis, and possible drug interactions. It’s crucial to contact your doctor immediately if you develop a rash or symptoms indicating liver problems.

Dolutegravir, a component of Dovato, can be taken with or without food. It’s important to follow specific guidelines if you’re taking antacids, iron supplements, or other medications that might interact with Dovato.

If you miss a dose of Dovato, take it as soon as you remember. However, if it’s close to the time for your next dose, skip the missed dose and continue with your regular schedule.

Common side effects include insomnia, headache, and weight gain. Less common but more severe side effects include hypersensitivity reactions, neuropsychiatric symptoms, immune reconstitution inflammatory syndrome (IRIS), hepatotoxicity, and rare cases of drug reaction with eosinophilia and systemic symptoms (DRESS).

Store Dovato in a cool, dry place away from direct sunlight and moisture. Keep it out of reach of children.

While early concerns were raised about Dovato’s use during pregnancy, recent data indicate that the prevalence of neural tube defects is similar between women taking Dovato and those on other ARVs at conception.

For patients with difficulty swallowing tablets, Dovato tablets can be split or crushed and mixed with a small amount of semisolid food or liquid to be consumed immediately.

Inform your healthcare provider about any allergies, liver or kidney problems, other medical conditions, and all medications you’re currently taking, including prescription, over-the-counter medicines, vitamins, and herbal supplements.

The efficacy of Dovato can be reduced in patients with certain combinations of integrase strand transfer inhibitor (INSTI)-resistance mutations. Patients should be screened for hepatitis B virus infection before using Dovato.

Dovato is unique as it’s a two-drug regimen combining dolutegravir and lamivudine, offering an effective treatment for HIV with potentially fewer side effects compared to traditional three-drug regimens.

Dovato is a complete treatment regimen for HIV and is not typically combined with other HIV medicines. It’s important to discuss whether you are taking any other medications with your doctor.

Dovato is suitable for adults with HIV who meet certain medical criteria, as determined by a healthcare provider. It’s important for patients to have a discussion with their healthcare provider to understand if Dovato is right for them.

There are no specific dietary restrictions while taking Dovato, but general healthy eating habits can support overall well-being and treatment efficacy.

Long-term effects of Dovato are generally favorable, but like all HIV treatments, it requires ongoing monitoring by a healthcare professional for any potential side effects or complications.

Dovato can interact with certain medications, including antacids, iron supplements, and others. It’s important to inform your healthcare provider of all medications you’re taking to avoid potential interactions.

Some patients taking Dovato may experience neuropsychiatric symptoms, especially those with a history of psychiatric illness. It’s important to monitor mental health and report any concerns to your healthcare provider.

Moderate alcohol consumption is generally considered safe with Dovato, but excessive alcohol use should be avoided. Discuss alcohol use with your healthcare provider.

Switching to Dovato from another HIV medication should be done under the guidance of a healthcare provider, who will consider your treatment history and current health status.

If you experience side effects, contact your healthcare provider immediately. They can advise on the best course of action, which may include adjusting the treatment plan.