Dovato is a complete, single-tablet HIV treatment taken once daily. It combines two antiretroviral medicines: dolutegravir (an integrase strand transfer inhibitor) and lamivudine (a nucleoside reverse transcriptase inhibitor). Together, they form a two-drug regimen that is effective at suppressing HIV while minimising the number of medicines you need to take.

Dovato is used to treat HIV-1 infection in adults who have no known resistance to either dolutegravir or lamivudine, and whose viral load is undetectable or well-controlled.

How it works:

HIV needs two key enzymes to replicate: integrase and reverse transcriptase. Dolutegravir blocks integrase (preventing HIV from inserting its genetic material into your cells), while lamivudine blocks reverse transcriptase (preventing HIV from copying itself). Blocking both enzymes with just two medicines makes Dovato one of the simplest complete HIV regimens available.

Your dose:

One tablet taken once daily. Always take it exactly as prescribed.

How to take it:

• Take Dovato at the same time every day
• It can be taken with or without food
• Swallow the tablet whole
• If you take antacids containing calcium, magnesium, or aluminium, or supplements containing iron or calcium, take Dovato at least 2 hours before or 6 hours after these products

Before you start:

• Tell your doctor about all medicines, vitamins, and supplements you take
• Let your doctor know if you have any kidney or liver problems, including hepatitis B or C
• Tell your doctor if you are pregnant or planning to become pregnant. Dolutegravir-containing medicines have been associated with a small risk of neural tube defects when taken around conception. Your doctor will discuss the risks and benefits with you

Ongoing check-ups:

Regular blood tests to check your viral load, CD4 count, kidney function, and liver health are essential during treatment.

• If you remember within 20 hours of your usual dose: take it as soon as possible, then continue your regular schedule
• If more than 20 hours have passed: skip the missed dose and take your next one at the usual time
• Never take two tablets at once
  

Consistency is critical with HIV treatment. Speak to your doctor or pharmacist if you are struggling to take your medicine regularly.

If you think you have taken more than prescribed, call 000 or go to your nearest emergency department. Bring your medicine packet.

• Store below 30°C
• Keep in the original packaging, away from moisture and light
• Keep out of reach of children and pets

Dovato is generally well tolerated.

Common side effects include:

• Headache and insomnia: Particularly in the early weeks. Usually improve over time
• Nausea: Mild and often resolves after the first few weeks
• Fatigue: Some people feel more tired at the start of treatment
• Dizziness: Usually mild and temporary
• Weight changes: Weight gain can occur with dolutegravir-based regimens. Discuss any concerns with your doctor
• Liver changes: Your liver enzymes may rise, particularly if you have hepatitis B or C. Regular monitoring is important
• Creatinine rise: Dolutegravir can cause a small, harmless rise in blood creatinine without actually affecting kidney function. Your doctor is aware of this

Contact your doctor or pharmacist if any side effect concerns you.

Tell your doctor and pharmacist everything you are taking.

Key interactions include:

• Rifampicin: Significantly reduces dolutegravir levels. An alternative HIV regimen may be needed
• Metformin: Dolutegravir can increase metformin levels in the blood. Your doctor may need to adjust your metformin dose
• Antacids, calcium, iron, and magnesium supplements: Can reduce the absorption of dolutegravir. Separate them from Dovato by at least 2 to 6 hours depending on the product
• St John's Wort: Reduces dolutegravir levels significantly. Avoid it

Never start, stop, or change any medicine without speaking to your doctor first.

Why only two medicines when most HIV regimens use three?

Historically, HIV treatment required at least three antiretroviral medicines to maintain viral suppression and prevent resistance. Dolutegravir has a very high barrier to resistance, meaning HIV is much less likely to develop resistance to it even in a two-drug regimen. Dovato's two-drug approach has been shown in large clinical trials to be as effective as three-drug regimens in the right patients, with potentially fewer long-term side effects from a reduced medicine burden.

Is Dovato safe if I might become pregnant?

This is an important discussion to have with your doctor. Dolutegravir has been associated with a very small increased risk of neural tube defects (such as spina bifida) when taken at the time of conception. The absolute risk is very small, and for many women the benefits of staying on an effective HIV regimen outweigh this risk. Your doctor and specialist will help you make the most informed decision.

Ace provides accurate and independent information medically reviewed on prescription medications. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.