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

Key takeaways

Tenofovir disoproxil fumarate (Viread) and Triumeq (abacavir/dolutegravir/lamivudine) are both medications used to treat human immunodeficiency virus (HIV) infections. However, they belong to different drug classes and have distinct characteristics. Viread is a nucleoside reverse transcriptase inhibitor (NRTI) that is also approved for treating chronic hepatitis B virus (HBV) infections, while Triumeq is a combination of three antiretrovirals: abacavir and lamivudine (both NRTIs) and dolutegravir (an integrase inhibitor). Viread must be taken with other HIV antiretrovirals for the treatment of HIV. Viread is available as a tablet and a powder for oral use, whereas Triumeq comes as a tablet and a dissolvable tablet for oral suspension. Viread is available as a generic, making it a lower-cost option, while Triumeq is brand only. Triumeq requires a genetic test before starting due to the risk of a serious allergic reaction. Common side effects of Viread include rash, diarrhea, and headache, while Triumeq can cause higher lipase levels and trouble sleeping. Both medications require careful monitoring for liver and kidney health, but Triumeq has more drug interactions, including with antacids and certain seizure medications.

Tenofovir disoproxil fumarate

(Viread)

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Triumeq

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Summary for Viread

Prescription only

Tenofovir disoproxil fumarate (Viread), also known as TDF, is a first-choice medication that's used as part of an antiretroviral (ARV) regimen for treating human immunodeficiency virus (HIV) infections. It's also a preferred medication used for treating hepatitis B virus (HBV). Tenofovir disoproxil fumarate, the active ingredient in Viread, is also found in Truvada, a combination medication commonly used for HIV PrEP. Tenofovir disoproxil fumarate (Viread) is available as both an oral tablet and a powder that's mixed with soft food. Common side effects include rash, diarrhea, and headache.

Indications for Viread

Treatment of HIV infection - people ages 2 years and older
Treatment of chronic (long-term) hepatitis B - Brand Viread for people ages 2 years and older; generic for people ages 12 years and older

Pros and Cons for Viread

Pros

Can treat both HIV and HBV infections
Only taken once a day
Available in a powder form that can be mixed with soft foods for people who have difficulty swallowing pills
Tablet form is available as a lower-cost generic medication

Cons

Requires regular blood work and lab tests to make sure your liver and kidneys are healthy
Can worsen hepatitis B if stopped all of a sudden
More likely to cause bone problems compared to similar medications
Interacts with certain medications for hepatitis C and HIV, such as atazanavir (Reyataz) and Harvoni (ledipasvir / sofosbuvir)

Common Side Effects for Viread

Higher cholesterol levels (19-22%)
Rash (5-18%)
Diarrhea (9-16%)
Headache (5-14%)
Pain (3-13%)
Higher creatine kinase (CK) levels, suggesting muscle damage (9-12%)
Feeling depressed (4-11%)
Nausea (8-11%)
Lack of energy (6-11%)

Please note: The side effects above were reported by people taking this medication for HIV infection.

Warnings for Viread

Worsening of hepatitis B infection
Kidney problems
Overactive immune system
Bone problems
Liver problems and lactic acidosis
Interaction with other medications

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