HIV is a human immunodeficiency virus that weakens your body’s defense system by multiplying inside your cells. To create copies of itself, HIV relies on a specific cellular machinery. Tivicay is an antiviral medication that disrupts this critical process and helps to control HIV infection.

Tivicay belongs to a drug class called integrase inhibitors. Integrase is a crucial enzyme that HIV needs to insert its genetic material (RNA) into the DNA of your cells. This integration step is important for the virus to replicate and spread. Tivicay acts like a roadblock, specifically targeting and inhibiting integrase. By preventing integrase from functioning, Tivicay throws a wrench into HIV’s replication machinery. Without a functional integrase, the virus cannot copy its genetic material and spread throughout your body.

It’s important to remember that Tivicay doesn’t eliminate HIV entirely, but only reduces the amount of virus present in the body. This measure is referred to as viral load. This decrease in viral load offers several benefits. A weakened viral army allows your immune system to recover and function more effectively. Once your immune system is less overwhelmed, it can better fight off infections and illnesses. With a consistently low viral load, the risk of developing complications associated with HIV, such as opportunistic infections and AIDS, also gets significantly reduced.

Precautions and Warnings with Tivicay

Tivicay comes with some crucial precautions and warnings to be aware of before starting or while taking this medication:

  • Drug Interactions: If you’re currently taking dofetilide (Tikosyn), Tivicay is not safe for you. There’s a potential for serious side effects when these medications are combined.
  • Allergic Reactions: People with a known allergy to dolutegravir, the active ingredient in Tivicay, should not take this medication.
  • Liver Disease: If you have a history of liver problems, especially hepatitis B or C, inform your doctor before starting Tivicay. They may need to monitor your liver function more closely during treatment.
  • Pregnancy Testing: A negative pregnancy test might be required before starting Tivicay to minimize potential risks to the developing baby.

Additional Considerations for Women

  • Pregnancy: Tivicay can harm an unborn baby, especially during the first trimester. Discuss effective birth control methods with your doctor and inform them immediately if you become pregnant while taking Tivicay.
  • Breastfeeding: If you have HIV, breastfeeding is not recommended to avoid transmitting the virus to your baby through breast milk.

Tivicay Side Effects

Tivicay, like most medications, can cause side effects in some users. Here’s a breakdown of the potential side effects to be aware of:

  • Allergic Reactions: A rash is a potential sign of an allergic reaction to Tivicay. If you experience a rash, especially with any of the following symptoms, seek immediate medical attention:
    • Fever
    • General feeling of illness
    • Fatigue
    • Muscle or joint aches
    • Mouth blisters or sores
    • Blistering or peeling skin
    • Eye redness or swelling
    • Facial, lip, or tongue swelling
    • Breathing problems
  • Liver Problems: People with a history of hepatitis B or C may be more susceptible to liver function changes while on Tivicay. This risk also applies to those without preexisting liver conditions. Symptoms to watch out for include:
    • Yellowing of the skin or whites of the eyes (jaundice)
    • Dark or tea-colored urine
    • Light-colored stools
    • Nausea or vomiting
    • Loss of appetite
    • Right upper abdominal pain, tenderness, or aching
  • Immune Reconstitution Syndrome: As your immune system strengthens on Tivicay, it may fight off dormant infections in your body, causing temporary symptoms. Inform your doctor immediately if you experience any new health issues after starting Tivicay.

Drug Interactions with Tivicay

Be sure to mention any and all medications you are currently taking to your prescriber. This includes, prescription, non-prescription drugs, herbal supplements and vitamins.

Medications to Avoid with Tivicay

  • Dofetilide (Tikosyn): This medication used for heart conditions can cause serious side effects when combined with Tivicay.
  • Pilsicainide: Another heart medication that poses risks when taken with Tivicay.

Medications Requiring Caution with Tivicay

  • Metformin: Tivicay may affect how your body absorbs metformin.
  • Antacids: These medications can hinder Tivicay’s absorption. It’s recommended to avoid taking antacids within 6 hours before or 2 hours after taking Tivicay. Discuss alternative heartburn medications with your doctor that can be taken safely with Tivicay.
  • Calcium and Iron Supplements: Similar to antacids, these supplements can interfere with Tivicay’s absorption. Avoid taking them within 6 hours before or 2 hours after Tivicay. If you take Tivicay with food, you can take calcium or iron supplements at the same time.
  • Certain HIV Medications: Medications like etravirine, efavirenz, fosamprenavir/ritonavir, nevirapine, or tipranavir/ritonavir may interact with Tivicay. Your doctor will determine appropriate dosages or alternative medications to ensure optimal effectiveness.
  • Rifampicin: This medication can reduce Tivicay’s effectiveness.
  • Anti-Seizure Medications (phenytoin, phenobarbital, carbamazepine): Tivicay may affect the levels of these medications in your body.

Cost of Tivicay in America

The average cash price is around $2,150 per month, which translates to roughly $2,458 for 30 tablets (50 mg each).

Why is Tivicay so Expensive?

Tivicay is a relatively new drug, and the pharmaceutical companies that developed it still hold the patent. This monopoly allows them to set the price without competition from lower-cost generic alternatives. Developing new medications like Tivicay involves significant investments in research, clinical trials, and manufacturing. Pharmaceutical companies recoup these costs by factoring them into the drug’s price.

Strengths and Dosages of Tivicay

It is essential to always follow the instructions of your prescriber when dosing for any medication.

Strengths

Tivicay comes in tablets of two strengths:

  • 25 mg
  • 50 mg
Adult Dosages (HIV Infection)
  • Standard Dosage: 50 mg once daily
  • Dosage Adjustments:
    • For coadministration with certain medications: If you’re taking specific medications that affect how your body processes Tivicay, you might need a twice-daily dose of 50 mg.
    • INSTI-experienced patients: In some cases of prior treatment with Integrase Strand Transfer Inhibitor (INSTI) medications or suspected INSTI resistance, a twice-daily dose of 50 mg might be prescribed.
Adult Dosage (Nonoccupational Exposure)
  • US CDC Recommendation: 50 mg once daily for 28 days
  • Important Considerations:
    • Tivicay is part of the preferred regimen for nonoccupational HIV exposure prophylaxis (PEP) when combined with emtricitabine-tenofovir disoproxil fumarate (DF) or lamivudine/zidovudine.
    • Tivicay is not recommended for non-pregnant women of childbearing potential who are sexually active or have been sexually assaulted and are not using effective contraception due to potential birth defect risks.
    • Tivicay should not be used in early pregnancy due to potential neural tube defect risks in the unborn baby.
    • PEP should ideally be started within 72 hours of exposure.
Pediatric Dosage (Nonoccupational Exposure)
  • US CDC Recommendation: For children 13 years or older and weighing at least 40 kg, the dosage is 50 mg once daily for 28 days.
  • Important Considerations: Similar to adults, Tivicay is part of the preferred PEP regimen when combined with emtricitabine-tenofovir DF or lamivudine/zidovudine. The same restrictions regarding pregnancy and early PEP initiation apply to children as well.

Tivicay Alternatives

  • NNRTIs (efavirenz, rilpivirine, etravirine): Block HIV from converting its RNA into DNA.
  • INSTIs (raltegravir, elvitegravir): Similar to Tivicay, prevent HIV from integrating its genetic material into human cells.
  • Protease inhibitors (atazanavir, darunavir, lopinavir/ritonavir): Block an enzyme HIV needs to mature and multiply.

FAQs on Tivicay

What is Tivicay?

Tivicay (dolutegravir) is a prescription medication used in combination with other antiretroviral drugs to treat HIV-1 infection in adults and children.

Does Tivicay Make You Gain Weight?

Weight gain associated with HIV treatment can occur, but it’s not a confirmed side effect of Tivicay specifically. There are various factors that can contribute to weight changes during HIV treatment, so it’s important to discuss this with your doctor.

How Long Does Tivicay Stay in Your System?

The exact duration Tivicay stays in your system depends on various factors like your metabolism and liver function. Generally, it takes several days for the medication to be eliminated from your body after you stop taking it.

How Long Do Tivicay Side Effects Last?

Most common side effects of Tivicay, like trouble sleeping, fatigue, or headache, are usually mild and temporary. They may improve within a few days or weeks of starting the medication. However, if you experience any side effects, especially severe ones, consult your doctor.

Who Makes Tivicay?

ViiV Healthcare manufactures Tivicay.

What Can Be Taken in Place of Tivicay?

Several alternative medication classes can be used in place of Tivicay for HIV treatment. These include:

  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs): Efavirenz (Sustiva), rilpivirine (Edurant), etravirine (Intelence).
  • Integrase strand transfer inhibitors (INSTIs) besides Tivicay: Raltegravir (Isentress), elvitegravir (Viractavir).
  • Protease inhibitors (PIs): Atazanavir (Reyataz), darunavir (Prezista), lopinavir/ritonavir (Kaletra).

What Over-the-Counter Medicine Should I Not Take with Tivicay?

Certain over-the-counter medications can interact with Tivicay, reducing its effectiveness. It’s crucial to talk to your doctor or pharmacist before taking any over-the-counter medications while on Tivicay. Here are some examples to avoid:

  • Antacids (for indigestion and heartburn)
  • Calcium and iron supplements (if taken within 6 hours before or 2 hours after Tivicay)
  • John’s Wort (herbal supplement)

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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