Dolutegravir

Dolutegravir: Uses, Dosage, Benefits, and Safety Profile

Dolutegravir is a widely used antiretroviral medication designed to treat HIV-1 infection. It belongs to a class of drugs called integrase strand transfer inhibitors (INSTIs), which block a key step in the HIV replication cycle. Because of its strong antiviral activity, once-daily dosing, and high resistance barrier, Dolutegravir has become a preferred component of modern HIV treatment regimens worldwide.

Indications

Dolutegravir is approved for:

• First-line treatment of HIV-1 in adults and adolescents, usually combined with other antiretroviral drugs.

• Treatment of HIV-infected patients with prior therapy experience, including some resistant strains.

• Use in fixed-dose combinations such as dolutegravir/lamivudine (dual therapy) or dolutegravir/abacavir/lamivudine (triple therapy), depending on clinical needs.

It is favored for its rapid viral suppression and strong efficacy across a wide range of patient populations.

Mechanism of Action

Dolutegravir works by inhibiting the HIV integrase enzyme, which is responsible for inserting viral DNA into the human genome. By blocking this process, the drug prevents the virus from establishing infection in new cells, thereby reducing viral load and improving immune recovery.

Dosage Overview

Dolutegravir is typically taken once daily.
Common dosing includes:

• 50 mg once daily for treatment-naïve individuals.

• 50 mg twice daily for patients with certain forms of integrase-resistant HIV or when used with specific interacting medications.

Dolutegravir can be taken with or without food, though timing may need adjustment if used alongside supplements containing magnesium, calcium, or iron due to absorption interactions.

Side Effects and Precautions

Most people tolerate Dolutegravir well. Common side effects include headache, insomnia, fatigue, and mild digestive discomfort. Rarely, some individuals experience mood changes or weight gain. Drug interactions should be evaluated carefully, especially with anticonvulsants and certain antibiotics. Pregnant individuals should consult a specialist regarding use during early pregnancy.

Conclusion

Dolutegravir remains one of the most reliable and effective antiretroviral agents available today. Its potent antiviral activity, simple dosing, and high resistance barrier make it a central component of modern HIV management.