Epivir vs. Triumeq for HIV Treatment: Important Differences and Potential Risks.

Key takeaways

Lamivudine (Epivir) and Triumeq (abacavir/dolutegravir/lamivudine) are both used to treat HIV, but they have some key differences. Lamivudine (Epivir) is a nucleoside reverse transcriptase inhibitor (NRTI) that can also treat hepatitis B (HBV), while Triumeq is a combination of three medications: abacavir, dolutegravir, and lamivudine. Triumeq is only for HIV treatment and includes an integrase inhibitor (dolutegravir) along with two NRTIs. Lamivudine (Epivir) can be taken once or twice daily, whereas Triumeq is taken once daily. Triumeq requires a genetic test before starting to check for a risk of serious allergic reactions, while lamivudine (Epivir) does not. Additionally, Triumeq is not recommended for people with severe liver problems, and it interacts with many other medications, unlike lamivudine (Epivir), which has fewer interactions. Both medications can cause serious side effects, including liver problems and lactic acidosis, but Triumeq also has a risk of severe allergic reactions due to abacavir.

Lamivudine

(Epivir)

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Triumeq

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Summary for Epivir

Prescription only

Lamivudine (Epivir), also known as 3TC, is a nucleoside reverse transcriptase inhibitor (NRTI). It's available as Epivir to treat human immunodeficiency virus (HIV) infections and Epivir HBV to treat hepatitis B virus (HBV). Both brands and their generic formulations can be used in adults and children. But they're not interchangeable so you can't take one brand in place of another. Lamivudine (Epivir) is taken by mouth, typically once or twice daily. Some common side effects of this medication include headache, nausea, and feeling tired.

Indications for Epivir

Treatment of HIV infection for people ages 3 months and older - brand and generic Epivir only
Treatment of chronic (long-term) hepatitis B for people ages 2 years and older - brand and generic Epivir HBV only

Pros and Cons for Epivir

Pros

Epivir HBV is considered a complete HBV treatment
Can take with or without food
Few interactions with other medications or supplements
Available in an oral solution form

Cons

Requires regular blood work and lab tests to make sure your liver and kidneys are healthy
Can worsen hepatitis B if you stop it all of a sudden
Oral solution contains sucrose (a sweetener), which shouldn't be used for people with diabetes
Epivir needs to be used with other ARVs to treat HIV

Common Side Effects for Epivir

Headache (35%)
Nausea (33%)
Feeling tired (27%)
Runny nose and congestion (20%)
Cough (18%)
Diarrhea (18%)
Nausea and vomiting (13%)
Nerve pain (12%)
Muscle pain (12%)
Trouble sleeping (11%)
Fever or chills (10%)
Lack of appetite (10%)
Dizziness (10%)

Warnings for Epivir

Worsening of infection if you have HIV and hepatitis B
Liver problems and lactic acidosis
Pancreas problems
Overactive immune system - Epivir only
Interaction with sorbitol - Epivir oral solution only

Summary for Triumeq

Prescription only

Triumeq is a single-tablet regimen used to treat human immunodeficiency virus (HIV) infections. It contains 3 antiretrovirals (ARVs): abacavir, dolutegravir, and lamivudine. Triumeq is available as either a tablet or a dissolvable tablet for oral suspension (Triumeq PD), but the two are not the same. Before starting treatment, your provider will require you to get a genetic test to see if you're at risk for developing a serious allergic reaction to this medication.

Indications for Triumeq

Treatment of HIV infection (in people who weigh at least 13 pounds)

Pros and Cons for Triumeq

Pros

Only taken once a day for complete HIV treatment
Combines three medications into one pill for convenience
Can be taken with or without food
Available for adults and children at or over 22 lbs

Cons

Dose can't be adjusted so it's not recommended for people with kidney or liver problems
Not safe to use in severe liver problems
Requires a genetic test before starting
Interacts with a lot of medications such as St. John’s wort and oxcarbazepine (Trileptal)

Common Side Effects for Triumeq

Higher lipase levels (suggesting irritated pancreas) (up to 11%)
Higher blood sugar levels (up to 9%)
Higher creatine kinase levels in the blood (suggesting muscle damage) (up to 7%)
Higher fat levels in the blood (up to 6%)
Higher white blood cell count (up to 4%)
Abnormal liver labs (up to 3%)
Trouble sleeping (3%)
Headache (2%)
Feeling tired (2%)

Please note: The side effects listed above are from clinical trials with Tivicay (dolutegravir) and Epzicom (abacavir / lamivudine), which are all active ingredients in Triumeq and Triumeq PD