Dovato is a single-pill medication that combines two powerful drugs to fight HIV-1, the virus that causes AIDS. It’s prescribed to adults and adolescents who weigh at least 40 kg and can be used for those new to HIV-1 treatment or as a replacement for existing medications if their doctor approves. HIV-1 is a very specific type of human immunodeficiency virus that weakens a person’s immune system by attacking cells called CD4 cells. These cells are crucial in fighting off infections in our body. HIV-1 replicates by hijacking healthy cells and using their machinery to make copies of itself.

This is where the two key ingredients of Dovato come in and disrupt the process: dolutegravir and lamivudine.

Dolutegravir is an integrase inhibitor. HIV-1 is a parasite that needs to integrate its genetic material into a healthy cell’s DNA to replicate. Dolutegravir is the roadblock here and prevents the integration from happening. Essentially, it stops HIV-1 from fitting into the healthy cell and stops new copies from being created.

Lamivudine works differently. It belongs to a class of drugs called nucleoside reverse transcriptase inhibitors. HIV-1 needs an enzyme called reverse transcriptase to copy its genetic material. Lamivudine disrupts this enzyme, bringing a halt to the virus’s replication machinery.

This double attack is what makes Dovato an effective medication for HIV-1. Dolutegravir stops new HIV-1 from being created, while lamivudine prevents existing copies from multiplying. This significantly reduces the amount of HIV-1 in the body, allowing the immune system to recover and fight off illnesses.

You have to remember though that Dovato cannot cure HIV, it can only control the virus and keep it at a certain low level. It controls the damage to the immune system and helps people struggling with HIV-1 live a long and healthy life without the risk of developing any more illnesses related to AIDS.

Precautions and Warnings with Dovato

Dovato has it’s fair share of side effects that you should be aware of. Before consuming the medication, here are some precautionary guidelines you need to keep in mind:

Severe Allergic Reactions

If you experience any of the following symptoms, consult your doctor immediately:

  • Rash (especially when accompanied by other symptoms)
  • Fever
  • Extreme tiredness
  • Muscle or joint aches
  • Blisters or peeling skin
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble breathing or swallowing

Liver Problems

Dovato can cause liver problems, and the risk is higher for certain individuals. People with a history of hepatitis B or C, or those with abnormal liver function tests before starting Dovato, are at an increased risk.

Lactic Acidosis

This is a rare but serious buildup of lactic acid in the blood. Lactic acid is a byproduct produced by your muscles during exercise. While your body usually eliminates it, Dovato can interfere with this process, leading to a dangerous buildup. Symptoms of lactic acidosis include:

  • Feeling drained or lacking energy
  • Achy muscles that seem out of place
  • Struggling to catch your breath or breathing faster than usual
  • Belly pain along with nausea and throwing up
  • Numbness or coldness in your hands and feet, sometimes with a bluish tinge
  • Feeling lightheaded or like the room is spinning
  • Your heart racing or beating irregularly

Precautions for People with Hepatitis B

  • Increased Risk of Resistance: If you have both HIV-1 and Hepatitis B, taking Dovato can cause the Hepatitis B virus to mutate and become resistant to treatment. This means the medication may be less effective in controlling the Hepatitis B infection in the future.
    • Your doctor will likely test you for Hepatitis B before prescribing Dovato. If you have both infections, they will closely monitor your response to treatment and may recommend additional medications to manage Hepatitis B alongside Dovato.
  • Worsening of Hepatitis B Infection (Flare-Up): Stopping Dovato all of a sudden can worsen your existing Hepatitis B infection. This is called a flare-up, where the symptoms become more severe than before. To avoid this complication, never stop taking Dovato without first consulting your doctor.

Dovato Side Effects

Dovato can cause a few serious side effects, so it’s important to be aware of them before taking the medication.

  • Allergic Reactions: While uncommon (less than 1% in studies), Dovato can trigger allergic reactions. Symptoms include rash, blistering skin or mouth, swollen eyes/lips, liver problems, and trouble breathing.
  • Hepatitis B Issues: Dovato comes with a boxed warning for people with Hepatitis B. This is because:
    • Drug Resistance: Dovato’s lamivudine component can make Hepatitis B resistant to treatment, making it harder to control the infection in the future.
    • Worsening Infection: Stopping Dovato suddenly can worsen your Hepatitis B infection.
  • Liver Problems: Dolutegravir, one of the ingredients in Dovato, can cause liver issues. Signs include increased liver enzyme levels, liver failure, and liver toxicity. You might experience symptoms like jaundice, belly pain, and nausea/vomiting. If you notice any of these, talk to your doctor for testing.
  • Immune Reconstitution Syndrome: As your immune system strengthens on Dovato, it might fight off hidden infections, causing symptoms like swollen lymph nodes, fever, or breathing problems.
  • Depression or Suicidal Thoughts: Though rare (less than 2% in studies), Dovato may be linked to depression or suicidal thoughts. Symptoms of depression include loss of interest in activities, sadness, and changes in sleep or weight. If you experience any of these, talk to your doctor right away.

Drug Interactions with Dovato

Dovato can interact with certain medications, potentially affecting their effectiveness or causing side effects.

  • No Mixing with Other HIV Medications: Avoid taking Dovato with other HIV medications. These drugs might interact with each other, leading to unknown side effects.
  • Dofetilide (Tikosyn) – A Big No: Do not take Dovato if you’re using Dofetilide, a medication for irregular heartbeats. Combining them can cause Dofetilide to accumulate in your body, increasing the risk of heart rhythm problems or even a heart attack.
  • Dalfampridine (Ampyra) – Increased Seizure Risk: Dovato can elevate the levels of Dalfampridine, a medication for multiple sclerosis. This can increase your risk of experiencing seizures.
  • Metformin (for Diabetes) – Potential for More Side Effects: Dovato can raise the levels of Metformin, a diabetes medication. This might lead to more frequent side effects like nausea, vomiting, and diarrhea.
  • Rifampin (Antibiotic) – Reduced Dovato Effectiveness: Rifampin, an antibiotic, can decrease the levels of Dolutegravir, one of the active ingredients in Dovato. This can make Dovato less effective in treating HIV.

Cost of Dovato in America

Dovato can be a very expensive medication in the United States. A 30-day supply of Dovato tablets can cost around $3,144, depending on the pharmacy. This is a significant financial burden for many people.

Why is Dovato so Expensive?

Dovato’s high price tag stems from several factors. Developing a new drug like Dovato involves a lot of expensive research and testing. Plus, the company that created it has a temporary exclusive right to sell it (patent), preventing cheaper competition. They aim to recoup their investment and make a profit during this time. Marketing and getting the medication to pharmacies also add to the cost.

Strengths and Dosages of Dovato

There are no dosage adjustments based on whether you eat with it or not. It’s important to take Dovato exactly as prescribed by your doctor for it to be effective.

Dovato comes in only one strength:

  • 50 mg of dolutegravir and 300 mg of lamivudine: This is a single tablet that you take once a day, either with or without food.

Dovato Alternatives

Dovato has alternatives. Here are some:

  • Single-tablet regimens: Biktarvy, Genvoya, Complera and Odefsey
  • Integrase inhibitors: Juluca
  • Other drug classes: abacavir (Ziagen), efavirenz (Sustiva), raltegravir (Isentress), lamivudine (Epivir), Truvada, Descovy (various functions).

FAQ on Dovato

What is Dovato Used For?

Dovato is a prescription medication used to treat HIV infection (Human Immunodeficiency Virus) in adults and children 12 years and older. It helps control the virus by reducing its ability to multiply in your body.

How Does Dovato Work?

Dovato is a two-drug combination tablet containing dolutegravir and lamivudine. These belong to different drug classes that work together to target HIV at various stages in its replication process.

  • Dolutegravir (INSTI): This medication blocks an enzyme called integrase, which HIV needs to insert its genetic material into human cells.
  • Lamivudine (NRTI): Lamivudine interferes with the virus’s ability to make copies of its genetic material.

When Was Dovato Approved?

The FDA (Food and Drug Administration) approved Dovato in April 2019.

Who Makes Dovato?

Dovato is manufactured by ViiV Healthcare, a company focused on developing HIV treatments.

Is There a Generic for Dovato?

No, Dovato is a brand-name medication and currently does not have a generic version available. Generics typically become available after a period of patent exclusivity for the brand-name drug.

How Long Does Dovato Take to Work?

Dovato won’t cure HIV, but it can significantly reduce the amount of virus in your blood (viral load) within weeks. However, it may take several months to reach a maximally suppressed viral load. Your doctor will monitor your viral load through blood tests to assess Dovato’s effectiveness.

Can I Drink Alcohol While Taking Dovato?

While Dovato does not directly interact with alcohol, excessive alcohol consumption can impair your immune system and potentially reduce the effectiveness of your HIV treatment. It’s best to discuss alcohol use with your doctor.

Are There Any Withdrawal Symptoms When I Stop Taking Dovato?

Dovato is not known to cause withdrawal symptoms if you stop taking it. However, stopping HIV medication abruptly is highly discouraged. It can lead to the virus developing resistance to the medications, making it harder to treat in the future. Always consult your doctor before stopping Dovato or any HIV medication.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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