Dolutegravir: What You Need to Know Right Now

Dolutegravir is a powerful HIV drug from the integrase inhibitor class. Doctors use it as part of combination therapy to stop the virus from copying itself. It works fast, often helps patients reach undetectable viral loads, and is taken once daily in most people. This page gives clear, practical info—how to take it, what to watch for, and when to talk to your provider.

How dolutegravir works and dosing

Dolutegravir blocks the HIV integrase enzyme, which keeps the virus from inserting its genetic material into your cells. That’s why it’s so effective when used with other antiretrovirals. Typical adult dosing is 50 mg once daily with or without food. If you take certain medicines—like rifampin for tuberculosis—your doctor may prescribe 50 mg twice daily instead.

Dolutegravir is never used alone as a long-term treatment. It’s always part of a combination pill or a multi-drug regimen. Before starting, expect baseline tests: viral load, CD4 count, kidney function, hepatitis B screening, and for people who can get pregnant, a pregnancy test and counseling.

Side effects, interactions and safety

Common side effects include headache, trouble sleeping, nausea, and diarrhea. Some people experience weight gain. Dolutegravir can also slightly raise serum creatinine without harming kidney filtration—this is a known effect and often not dangerous. Rare but serious reactions like severe rash or liver problems can happen; stop the drug and contact your doctor if you get unexplained fever, rash, jaundice, or severe tiredness.

Watch for drug interactions. Don’t take antacids or mineral supplements containing calcium, magnesium, aluminum or iron at the same time. Aim to separate them (for many products this means taking dolutegravir at least 2 hours before or 6 hours after, but follow your provider’s exact plan). Certain enzyme inducers (rifampin, carbamazepine, phenytoin) lower dolutegravir levels—dose adjustments may be needed. Dolutegravir can raise metformin levels; if you use metformin, your doctor will monitor and may change the metformin dose.

If you’re pregnant or planning pregnancy, talk to your provider. Early reports once suggested a small risk of neural tube defects when dolutegravir was taken at conception. Later data changed how clinicians weigh risks and benefits, so treatment decisions are individualized.

Missed dose advice: if you forget a dose, take it as soon as you remember unless it’s almost time for your next dose—don’t double up. Keep pills in original packaging and store at room temperature away from moisture.

Dolutegravir is prescription-only. Buy it only from reputable pharmacies and never skip follow-up labs. Good viral control reduces transmission risk and improves health—if you have questions about side effects, interactions, or where to get your meds safely, reach out to your clinic or pharmacist.