INSTGRA TABLET

🧬💊🌈 Dolutegravir 50mg Tablet: A Powerful Anchor in HIV Treatment

Dolutegravir 50mg is a highly effective integrase strand transfer inhibitor (INSTI) used in the treatment of HIV-1 infection. It plays a central role in antiretroviral therapy (ART), either as monotherapy in fixed-dose combinations or as part of a combination regimen. Its once-daily dosing, high barrier to resistance, and potent viral suppression make it a preferred choice globally, including in first-line and second-line HIV treatment protocols.

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🔬 Mechanism of Action

Dolutegravir works by inhibiting the HIV integrase enzyme, which is essential for integrating viral DNA into the host’s genome — a crucial step in the HIV replication cycle. By blocking this step, Dolutegravir:

• Prevents replication of HIV

• Reduces viral load in the bloodstream

• Helps restore immune function

• Slows progression to AIDS

This action provides strong and sustained viral suppression when used in combination with other antiretroviral medications.

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📌 Indications and Uses

Dolutegravir 50mg is indicated for the treatment of HIV-1 infection in:

• Adults and adolescents aged ≥12 years and weighing ≥40 kg

• Treatment-naïve patients (first-time therapy)

• Treatment-experienced patients (with or without integrase resistance)

• Prevention of mother-to-child transmission (under medical supervision)

It is used either as a single agent (alongside other antiretrovirals) or more commonly in fixed-dose combinations like:

• Dolutegravir + Lamivudine + Tenofovir (TLD)

• Dolutegravir + Lamivudine (2-drug regimen)

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💊 Dosage and Administration

• Standard dose: 50mg once daily, with or without food

• In case of known integrase resistance, dose may be increased to 50mg twice daily

• Adherence is crucial for effectiveness and to avoid resistance

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⚠️ Precautions and Warnings

• Pregnancy: Generally safe, but some studies suggest a small risk of neural tube defects in early pregnancy. Always consult a physician.

• Renal impairment: No dose adjustment required unless co-administered with other renally excreted drugs

• Liver disease: Use cautiously in patients with severe hepatic impairment

• May cause increased liver enzymes, particularly in co-infected HIV/HBV or HIV/HCV patients

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🤒 Side Effects

Common:

• Headache

• Insomnia

• Nausea

• Diarrhea

• Dizziness

Serious/Rare:

• Hypersensitivity reactions: rash, fever, organ dysfunction

• Immune reconstitution inflammatory syndrome (IRIS)

• Elevated liver enzymes

• Weight gain (observed in some long-term studies)

Seek immediate medical help for signs of allergic reactions or severe mood changes.

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🔄 Drug Interactions

• Cation-containing antacids or supplements (calcium, magnesium): Can reduce Dolutegravir absorption. Take 2 hours before or 6 hours after.

• Rifampicin: Lowers Dolutegravir levels—requires twice-daily dosing

• Metformin: Increased levels when co-administered—dose adjustment may be needed

Always inform your healthcare provider of all medications being taken.

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🧊 Storage Instructions

• Store at room temperature (15–30°C)

• Keep dry and away from direct light

• Out of reach of children

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📝 Conclusion

💡 Dolutegravir 50mg represents a modern, potent, and well-tolerated option in the fight against HIV. With strong viral suppression, a high resistance barrier, and once-daily convenience, it is now the backbone of HIV treatment regimens worldwide. For those living with HIV, Dolutegravir offers hope, health, and long-term viral control when used as part of a consistent treatment plan.

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