Hypersensitivity to any of the components (dolutegravir, lamivudine, tenofovir).
Co-administration with dofetilide (a heart rhythm drug) is contraindicated.
Not recommended in patients with severe renal impairment (creatinine clearance < 50 mL/min) — dose adjustment not possible.
Use caution (or avoid) in severe hepatic impairment (little data available).
Side Effects:
Common / Frequent:
Headache
Diarrhea / GI disturbances
Nausea
Weakness, fatigue
Insomnia / sleep disturbances
Rash, itching
Elevated liver enzymes
Muscle pain / joint pain
Depression, anxiety
Serious / Less Common:
Lactic acidosis (rare)
Kidney / renal toxicity (especially with tenofovir)
Bone mineral density loss (long-term tenofovir use) — need monitoring.
Hypersensitivity reactions (severe)
Precautions:
Adherence is very important: Missing doses can lead to viral resistance.
If stopping treatment (especially in patients co-infected with hepatitis B), monitor for liver flare / hepatitis.
In renal impairment: dose adjustment or alternative regimens may be needed.
In the elderly: use cautiously due to potential decreased kidney/liver function.
Mental health: monitor patients for depression, mood changes.
Bone health: long-term tenofovir may affect bones — periodic monitoring may be needed.
Pregnant women: consult clinician about risks vs benefits.
Do not abruptly stop therapy — could lead to viral rebound / resistance.
Dietary Restrictions:
Take at the same time every day to maintain consistent drug levels.
Avoid antacids, calcium, iron or other divalent cation supplements around the time of taking Viropil — these can reduce uptake of dolutegravir / tenofovir. (General ART advice; consult your doctor about timing.)
Alcohol: Use with caution. Alcohol may worsen liver issues.
Stay well-hydrated, especially because tenofovir can affect kidneys.
Practice safe sex: Viropil does not prevent HIV transmission — virus suppression helps, but other precautions (condoms) still needed.
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