Juluca contains two active ingredients, dolutegravir and rilpivirine. The drug belongs to the integrase strand transfer inhibitors (INSTIs) class, which prevents HIV from replicating and spreading.

This drug inhibits the integrase enzyme, preventing viral DNA from being integrated into the host cell’s DNA. This effectively prevents the virus from replicating and perpetuating the infection. On the other hand, rilpivirine is an NNRTI, which obstructs the reverse transcriptase enzyme, an essential part of HIV replication. Combining these two mechanisms delivers a decisive blow to the virus, reducing its presence and impact within the body.

As a first-line therapy, Juluca is not recommended for people newly diagnosed with HIV. Instead, it is a strategy for people who have successfully managed the virus and wish to simplify their treatment regimen.

It is essential that you continue to take all HIV medications per your doctor’s instructions to decrease your risk of spreading HIV disease to others. Your doctor may recommend using an effective barrier method (latex or polyurethane condoms/dental dams) during sexual activity. Keep your items (such as needles/syringes, toothbrushes, and razors) away from others with contact blood or other body fluids. Further information can be obtained from one of our pharmacists or doctors.

Warnings and Precautions 

Juluca is a medication designed to keep HIV in check, but like any medical treatment, it comes with its set of warnings and precautions. Here’s what you need to know:

Potential Drug Interactions

Taking Juluca alongside certain medications can lead to adverse interactions. It’s vital to inform your healthcare provider about all the drugs, supplements, or herbal remedies you’re taking. This ensures your safety and helps your doctor make informed decisions about your treatment plan. A more detailed list of common drug interactions can be found below.

Liver Function Monitoring

Regular monitoring of your liver function is essential when on Juluca. The medication might affect liver enzymes, potentially leading to complications. By keeping a close eye on your liver health, your healthcare team can take prompt action if any issues arise.

Allergic Reactions

While rare, allergic reactions to Juluca can occur. If you experience symptoms like rash, itching, swelling, severe dizziness, or trouble breathing, seek medical attention immediately. This highlights the significance of taking the medication under medical supervision.

Adherence to Dosage Schedule

Consistency is key with Juluca. Skipping doses or altering the prescribed schedule can compromise the effectiveness of the treatment and even contribute to drug resistance. Maintain open communication with your healthcare provider to address any challenges you face in adhering to the schedule.

Pregnancy Considerations

If you’re pregnant, planning to conceive, or breastfeeding, consult your healthcare provider before taking Juluca. The effects of the medication on unborn babies or infants are not fully understood, and your doctor can guide you on the best course of action for your situation.

Bone Health Monitoring

Some HIV medications, including Juluca, have been associated with bone density loss. Periodic bone health assessments can help detect any issues early, enabling interventions to maintain your bone health.

Kidney Function Monitoring

Juluca can impact kidney function in some cases. Regular kidney function tests are crucial to ensure your kidneys are functioning optimally while on the medication.

Mental Health Considerations

HIV treatment can take a toll on mental health. Juluca, while crucial for physical well-being, might have emotional and psychological effects. Reach out to your healthcare provider if you experience mood changes, depression, or anxiety.

Regular Follow-ups

Stay connected with your healthcare provider through regular follow-up appointments. These appointments allow your doctor to monitor your progress, address any concerns, and make adjustments to your treatment plan as needed.

Side Effects

Juluca can lead to a range of side effects that vary in their frequency and severity. Here, we’ll discuss the most common, rare, and severe reactions that individuals might experience when taking Juluca. Please note, the list below is not a complete list. If you have any questions about side effects, or believe you are having one, please contact your healthcare professional right away.

Common Side Effects

Side effects that are commonly associated with Juluca are generally mild and transient. These effects often subside as the body adjusts to the medication. It’s important to note that not everyone will experience these side effects, and some individuals may experience different reactions. Common side effects of Juluca include:

  • Headache: A mild headache might occur initially but tends to diminish over time.
  • Nausea: Some individuals might experience mild nausea, which can often be alleviated by taking the medication with food.
  • Fatigue: A temporary feeling of tiredness could manifest as the body adapts to the medication.
  • Dizziness: In some cases, dizziness might be observed, especially during the first few doses.
  • Insomnia: Sleep disturbances might affect a minority of users, although adopting good sleep hygiene practices can mitigate this.

Rare Side Effects

While less common, some individuals may experience rarer side effects when taking Juluca. It’s essential to monitor for these reactions and consult a healthcare provider if they occur persistently. Rare side effects of Juluca include:

  • Skin Rash: In some cases, Juluca can lead to skin reactions, including rashes or itching. While these reactions are less common, they should not be ignored, as they may indicate an individual’s sensitivity to the medication.
  • Digestive Issues: Some individuals might experience gastrointestinal disturbances, such as diarrhea or stomach discomfort.
  • Mood Changes: Mood swings or changes in mental well-being have been observed in a minority of Juluca users. It’s essential to monitor one’s emotional health and seek medical guidance if noticeable shifts occur.
  • Elevated Liver Enzymes: In rare cases, Juluca might cause a temporary increase in liver enzyme levels.

Severe Side Effects

Severe side effects associated with Juluca are extremely rare but require immediate medical attention if they occur. These reactions could indicate a serious adverse response to the medication. Severe side effects of Juluca include:

  • Allergic Reactions: Although rare, severe allergic reactions to Juluca can occur. Symptoms such as swelling of the face, lips, tongue, or throat, along with difficulty breathing, necessitate immediate medical attention.
  • Liver Problems: Juluca could potentially impact liver function, leading to symptoms like yellowing of the skin or eyes, dark urine, and abdominal pain. Regular monitoring is recommended to detect any potential liver abnormalities.
  • Pancreatitis: An inflammation of the pancreas is an exceedingly rare but severe side effect that may cause severe abdominal pain.
  • Lactic Acidosis: In rare cases, Juluca can lead to a buildup of lactic acid in the bloodstream, resulting in fatigue, muscle weakness, trouble breathing, and an irregular heartbeat. Swift medical attention is necessary if these symptoms arise.
  • Immune Reconstitution Syndrome: Juluca can cause the immune system to recover rapidly, leading to inflammation in response to previously acquired infections. This might necessitate medical intervention.

Interactions

Understanding interactions with Juluca is paramount to ensure your health and treatment effectiveness. Always communicate openly with your healthcare provider about the medications, herbal remedies, and foods you’re consuming. By staying informed and proactive, you can optimize your treatment plan and achieve the best possible outcomes in your journey toward health and well-being.

Drug Interactions

Certain medications and products may interact with Juluca, potentially affecting its performance. These include:

  • Dofetilide
  • Orlistat
  • Proton pump inhibitors (PPIs) like esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole
  • Other HIV Meds: It’s crucial not to combine Juluca with other HIV treatments. Additionally, avoid taking Juluca with products containing rilpivirine, unless you are also using rifabutin.

Medications That Impact Juluca

Several medications can influence the removal of rilpivirine from your body, potentially affecting how Juluca works. Examples of such medications are:

  • Dexamethasone
  • Certain macrolide antibiotics like clarithromycin (such as, Biaxin), erythromycin
  • Rifamycins including rifampin and rifapentine
  • Drugs used to treat seizures, such as carbamazepine (ie: Tegretol), oxcarbazepine, phenobarbital, phenytoin (such as Dilantin), primidone
  • Combination products for treating chronic hepatitis C like ombitasvir/paritaprevir/ritonavir/dasabuvir.

Herbal Interactions

The realm of herbal remedies is vast, and while some can complement traditional medications, interactions can occur. Here’s what you need to know about Juluca’s interactions with herbal remedies:

St. John’s Wort

St. John’s Wort, commonly used for mood disorders, can lower the concentration of Juluca in the bloodstream. This can lead to a decrease in the medication’s efficacy, making it crucial to avoid this herbal remedy.

Echinacea

Echinacea, often used to boost the immune system, might interact with Juluca and other antiretroviral drugs. Consult your healthcare provider before combining these substances to ensure your treatment plan remains uncompromised.

Food Interactions

Food can sometimes influence how medications are absorbed and utilized by the body. While Juluca can generally be taken with or without food, there are certain considerations to keep in mind:

Grapefruit

Grapefruit and its juice can affect the metabolism of Juluca, potentially altering its concentration in the bloodstream. It’s advisable to avoid consuming grapefruit products while on this medication.

High-Fat Meals

Consuming high-fat meals alongside Juluca might delay its absorption, leading to variations in blood levels. To maintain consistent results, try to take the medication with a light meal or snack.

Strengths and Dosages

Juluca, a breakthrough medication, comes in different strengths to accommodate varying needs. These strengths and dosages are carefully determined by healthcare professionals based on your medical history, current health status, and specific treatment goals. It’s crucial to follow your doctor’s recommendations precisely to ensure the best outcomes. The typical dosages include:

  • Juluca 50 mg/25 mg: This strength contains 50 mg of dolutegravir and 25 mg of rilpivirine. It’s often prescribed for adults who have achieved viral suppression and want to switch to a simpler regimen.
  • Juluca 100 mg/25 mg: With 100 mg of dolutegravir and 25 mg of rilpivirine, this dosage is suitable for individuals who are initiating antiretroviral treatment for the first time.

Overdose

While Juluca is a well-tolerated medication, accidental overdose can still occur. If you suspect an overdose, it’s vital to take immediate action. Common signs of overdose might include severe dizziness, fainting, or unusual heartbeat. If you or someone else may have taken more than the prescribed dose, follow these steps:

  1. Seek Medical Attention: Contact emergency medical services or your healthcare provider immediately. They can provide guidance on the necessary steps to take.
  2. Avoid Self-Treatment: Refrain from attempting to “counteract” the overdose on your own. Only healthcare professionals can provide appropriate interventions.

Missed Dose

Missing a dose of Juluca can disrupt your treatment plan, potentially impacting its effectiveness. If you accidentally miss a dose, follow these guidelines:

  1. Take It ASAP: As soon as you remember, take your missed dose. However, if it’s close to the time for your next scheduled dose, skip the missed one and resume your regular dosing schedule.
  2. Don’t Double Up: Never take a double dose to compensate for a missed one. Doubling up can lead to an overdose and unwanted side effects.
  3. Consult Your Doctor: If you find that you frequently miss doses, or if you’re unsure about the best course of action, consult your healthcare provider. They can provide personalized advice to help you stay on track with your medication.

Storage

Storing medication correctly is essential to maintain its effectiveness and safety. Juluca is a crucial medication used to treat HIV. To ensure its optimal performance, proper storage is vital.

Keeping Juluca in its original packaging helps protect it from light, moisture, and other external factors that could compromise its quality. The packaging is designed to provide a controlled environment that maintains the medication’s potency.

Find a cool, dry spot to store your Juluca. Extreme temperatures, both hot and cold, can affect the medication’s stability. Avoid storing it near sources of heat, such as radiators, stoves, or direct sunlight. A room temperature of around 68 to 77 degrees Fahrenheit (20 to 25 degrees Celsius) is ideal.

Moisture can degrade the effectiveness of Juluca. Store it in a place where humidity levels are low. Avoid storing it in the bathroom or near sinks.

Freezing temperatures can damage Juluca’s chemical structure, rendering it ineffective. Ensure that the medication doesn’t come into contact with freezing conditions.

Always seal the packaging tightly after use. This prevents air and moisture from getting inside and compromising the medication’s quality.

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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