SPEGRA TABLET

🧬💊🛡️ Dolutegravir 50mg + Emtricitabine 200mg + Tenofovir Alafenamide 25mg: A Powerful Once-Daily HIV Regimen

This fixed-dose combination of Dolutegravir 50mg + Emtricitabine 200mg + Tenofovir Alafenamide (TAF) 25mg is a highly effective once-daily antiretroviral therapy (ART) used for the treatment of HIV-1 infection. It combines three powerful agents from different drug classes into a single tablet, offering potent viral suppression, low toxicity, and improved adherence for people living with HIV.

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🔬 Mechanism of Action

Each component plays a unique role in halting HIV replication:

• Dolutegravir (DTG): An integrase strand transfer inhibitor (INSTI), it blocks the action of the integrase enzyme, preventing the integration of viral DNA into the host genome—a key step in HIV replication.

• Emtricitabine (FTC): A nucleoside reverse transcriptase inhibitor (NRTI), it mimics a natural building block of viral DNA. When incorporated, it terminates DNA chain growth.

• Tenofovir Alafenamide (TAF): Also an NRTI and a prodrug of tenofovir, it delivers the active drug directly into lymphocytes, minimizing systemic exposure and reducing kidney and bone side effects.

Together, these agents block multiple stages of HIV’s life cycle, achieving durable viral suppression.

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📌 Indications and Uses

This combination is indicated for:

• Initial treatment of HIV-1 infection in adults and adolescents (weighing ≥35 kg)

• Switch therapy for virologically suppressed individuals (HIV RNA <50 copies/mL) on a stable ART regimen with no history of treatment failure

• Patients who require a once-daily, single-tablet regimen (STR)

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💊 Dosage and Administration

• Standard dose: One tablet once daily, with or without food

• Swallow whole with water

• Must be taken consistently every day to maintain viral suppression

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⚠️ Precautions and Warnings

• Screen for hepatitis B virus (HBV) infection prior to starting; sudden discontinuation may cause HBV flare

• Monitor renal function and liver enzymes

• Use caution in patients with:

  • Pre-existing liver disease

  • Hepatitis co-infection

  • Severe renal impairment

• May cause weight gain in some individuals

• Rare risk of hypersensitivity reactions, particularly to Dolutegravir

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🤒 Side Effects

Common:

• Headache

• Diarrhea

• Nausea

• Fatigue

• Insomnia

Less common but serious:

• Elevated liver enzymes

• Lactic acidosis

• Immune reconstitution inflammatory syndrome (IRIS)

• Kidney or bone toxicity (less with TAF than with older tenofovir forms)

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🔄 Drug Interactions

• Avoid with rifampin, carbamazepine, and St. John’s Wort (reduces Dolutegravir levels)

• Use caution with metformin, antacids, and calcium/magnesium supplements—space out doses

• Safe to use with most other HIV medications if not duplicating components

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🧊 Storage Instructions

• Store at room temperature (20–25°C)

• Keep in original packaging to protect from moisture

• Keep out of reach of children

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📝 Conclusion

The combination of Dolutegravir 50mg + Emtricitabine 200mg + Tenofovir Alafenamide 25mg represents a modern, effective, and safe HIV treatment regimen. With its high barrier to resistance, low pill burden, and improved tolerability, it is especially well-suited for both newly diagnosed patients and those switching from older therapies. Regular monitoring and adherence are key to maximizing long-term outcomes.

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Always follow your doctor’s advice, dosage instructions, and never self-medicate.