Sustiva and Triumeq shouldn’t be coadministered. When combined, adverse interactions may be experienced [1].
Sustiva is a drug used with other medications to treat and manage HIV. Its active ingredient is called efavirenz. This med belongs to the non-nucleoside reverse transcriptase inhibitor (NNRTI) class of drugs that prevents the replication of HIV. Efavirenz blocks the activity of reverse transcriptase enzymes and the formation of DNA, without which HIV cells cannot divide and multiply. This drug does not cure HIV or AIDS, but it helps stop the infection of healthy cells in the body. Efavirenz is indicated for antiretroviral combination therapy for adults, adolescents, and children who are over 3 months old who are infected with HIV-1 [2].
The main active ingredients of the drug are lamivudine, dolutegravir, and abacavir. It is available in the form of tablets, where 1 pill contains 50 mg of dolutegravir as well as abacavir (600 mg) in the form of abacavir sulfate, and lamivudine (300 mg). This drug is intended for treating HIV infection in both adults and children (over the age of 12 years). It is used in complex antiretroviral therapy.
All three active substances inhibit the development and action of viral agents in the body. After oral administration, dolutegravir interacts with integrase enzymes [3]. As a result, retroviral DNA insertion is blocked and inhibition of HIV replication occurs. The remaining two drug components of the med act as potent selective reverse transcriptase inhibitors.
Sustiva and Triumeq are both HIV inhibitors, though they have different active ingredients, which may interfere with each other.
Coadministration of Triumeq with potent inducers of UGT1A and CYP450 3A4 isoenzymes such as efavirenz may significantly reduce plasma concentrations of dolutegravir. Dolutegravir is a substrate of UGT1A9, UGT1A3, and P-glycoprotein in vitro. In 12 subjects, the administration of dolutegravir with efavirenz decreased dolutegravir peak plasma concentration (Cmax), trough plasma concentration (Ctrough), and systemic exposure (AUC) of dolutegravir by 39%, 75%, and 57% respectively, compared to administration without efavirenz. Using cross-study assessments of historical pharmacokinetic data collected over a long period of time, dolutegravir does not affect the pharmacokinetics of efavirenz [4].
As the interaction between Sustiva and Triumeq is not well-studied, it’s necessary to consult a healthcare professional, who can recommend a dosage adjustment or an alternative treatment.