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

Key takeaways

Epzicom (abacavir/lamivudine) and Triumeq (abacavir/dolutegravir/lamivudine) are both used to treat HIV, but they have some key differences. Epzicom combines two antiretrovirals (abacavir and lamivudine), while Triumeq includes an additional third antiretroviral, dolutegravir. This makes Triumeq a complete single-tablet regimen for HIV treatment, whereas Epzicom needs to be taken with other HIV medications. Triumeq is available in both tablet form and as a dissolvable tablet for children, while Epzicom is only available as a tablet for adults. Both medications require a genetic test before starting to check for a risk of severe allergic reactions. Epzicom is available as a generic, which can be more affordable, while Triumeq does not have a generic form. Additionally, Triumeq has more interactions with other medications and may be less prefered during pregnancy.

Epzicom

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Triumeq

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Summary for Epzicom

Prescription only

Epzicom is a combination medication containing two HIV antiretrovirals (ARVs), abacavir (Ziagen) and lamivudine (Epivir). It's used with other HIV ARVs for the treatment of HIV.

Indications for Epzicom

HIV treatment

Pros and Cons for Epzicom

Pros

Contains 2 first choice HIV ARV options
Convenient dosing (1 tablet, once a day, with or without food)
Same dose for everyone weighing more than 55 lbs (25 kg)
Contains lamivudine, which also works against hepatitis B
Available as a generic, which can be more affordable

Cons

Dose can't be adjusted so it's not recommended for people with kidney or liver problems
Requires a genetic test called HLA-B 5701 because the allergic reaction can be fatal
Not a good option for people with heart problems
People taking methadone might need a higher dose of methadone after starting Epzicom
People with hepatitis B can have worsened hepatitis B if they suddenly stop taking Epzicom

Common Side Effects for Epzicom

Headache (7%)
Tiredness and fatigue (6%)
Dizziness (6%)
Nausea (5%)
Diarrhea (5%)
Rash (5%)
Fever (5%)

Warnings for Epzicom

SEVERE ALLERGIC REACTION
WORSENING OF HEPATITIS B
LIVER PROBLEMS
IMMUNE RECONSTITUTION SYNDROME
HEART ATTACK

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