You are working in an HIV clinic, and a patient comes into the clinic, currently taking dolutegravir, tenofovir alafenamide, and emtricitabine. The patient states that they are interested in potentially being switched to a regimen with fewer drugs if still would be effective.
Which of the following branded products have only two active antiretroviral drugs that could potentially be used to treat HIV? Select all that apply.
Answer with rationale:
The correct answers are B, D, and E.
Brand-generic in this problem: Truvada (tenofovir disoproxil fumarate/emtricitabine), Dovato (dolutegravir/lamivudine), Symtuza (darunavir/cobicistat/tenofovir alafenamide/emtricitabine), Cabenuva (cabotegravir/rilpiverine), Juluca (dolutegravir/rilpiverine), Tivicay (dolutegravir)
Brand-generic with HIV drugs can be tricky, but it is important to remember them because using generic names is sometimes not used in practice. Of the options listed above, Dovato, Cabenuva, and Juluca are the only stand-alone regimens. Truvada is also correct because it contains two active antiretroviral components, but it should not be used by itself to treat HIV. Truvada can, however, be used as pre-exposure prophylaxis for males or females. Dovato is a first-line agent that can be used in patients with a viral load of less than 500k and needs a negative HBV test before starting as only lamivudine would be active against hepatitis B. Symtuza has three agents with antiretroviral activity including darunavir, which is a protease inhibitor that contains a sulfonamide group, and the booster cobicistat which does not have antiretroviral activity. Cabenuva is two drug combination product that is injected once monthly or once every two months as an option for patients who are virologically suppressed. Similarly, Juluca is another two-drug regimen for patients who have been virologically suppressed for at least six months. Lastly, Tivicay is incorrect as it is the brand name for the one drug dolutegravir.
NAPLEX Competencies covered:
2.2 – Commercial availability; prescription or non-prescription status; brand, generic, or biosimilar names; physical descriptions; or how supplied
Have a great week!