NRTI + INSTI dual regimen

Lamivudine with dolutegravir

Brand names: Dovato

Adult dose

Dose: 1 tab (300mg lamivudine + 50mg dolutegravir) PO OD

Route: PO

Frequency: OD

Clinical pearls

First-line dual regimen in treatment-naive HIV-1 (HIV-1 RNA <500,000, no HBV co-infection)
Test for HBV before initiation

Contraindications

Concurrent dofetilide
Concurrent strong UGT1A1/CYP3A4 inducers (rifampicin, carbamazepine)
HBV co-infection (insufficient HBV cover)

Side effects

Headache
Insomnia
Hypersensitivity reactions
Hepatotoxicity
Weight gain
Neural tube defect signal at conception (early data later attenuated)

Interactions

Polyvalent cations (Mg/Ca/iron antacids) — separate by 6h before or 2h after
Rifampicin
Metformin (raised levels)
Sorbitol-containing meds

Monitoring

Viral load
CD4
LFTs

Reference: BNF; BHIVA HIV guidelines; https://bnf.nice.org.uk/drugs/lamivudine-with-dolutegravir/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways