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Juluca

dolutegravir / rilpivirine
Used for HIV Treatment
Used for HIV Treatment

Juluca (dolutegravir / rilpivirine) is an HIV antiretroviral (ARV) tablet that contains two medications. It's not meant for people who have never taken HIV ARVs. Still, it's a good option for people who are well controlled on their current HIV regimen and want to switch to different regimen.

Reviewed by:
reviewer
Hope Chang, PharmD, AAHIVP
reviewer
Allison Gourley, PharmD
Last reviewed on April 26, 2022
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageCostContraindicationsAlternativesLatest newsPricesMedicare
basics-icon

What is Juluca (dolutegravir / rilpivirine)?

What is Juluca (dolutegravir / rilpivirine) used for?

  • HIV treatment for people who are well controlled on an HIV ARV regimen already and want to switch regimens

How Juluca (dolutegravir / rilpivirine) works

Juluca (dolutegravir / rilpivirine) is an HIV ARV combination medication. It contains two medications that prevent HIV from infecting your cells and making copies of itself.

  • Dolutegravir is an integrase inhibitor and prevents HIV from inserting itself in your DNA (genetic material).

  • Rilpivirine is a non-nucleoside reverse transcriptase inhibitor (NNRTI). It stops an important enzyme (reverse transcriptase) and blocks the HIV DNA-making process.

Drug Facts

Common BrandsJuluca
Drug ClassHIV ARV combo
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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$4274.62(save 16.79%)
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$3557.12
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What are the side effects of Juluca (dolutegravir / rilpivirine)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Diarrhea (2%)
  • Headache (2%)

Other Side Effects

  • Nausea
  • Stomach pain and discomfort
  • Low appetite
  • Fatigue or tiredness
  • Dizziness
  • Mood changes

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Allergic reaction: rash, fever, fatigue, muscle or joint aches, shortness of breath, skin blisters and peeling

Source: FDA

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
  • Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
  • Rash, fever, and swollen lymph nodes
  • Thoughts of suicide or self-harm, worsening mood, feelings of depression

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

pros-and-cons

Pros and cons of Juluca (dolutegravir / rilpivirine)

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Pros

Convenient; one tablet once a day

Two medications is a full HIV regimen; less risk for side effects

No dose adjustments needed for people with mild kidney or liver problems

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Cons

Must be taken with food

Not meant for people first starting HIV ARVs

Can interact with a lot of medications, including over-the-counter (OTC) heartburn products

pharmacist-tips

Pharmacist tips for Juluca (dolutegravir / rilpivirine)

pharmacist

  • Take Juluca (dolutegravir / rilpivirine) with a meal. You won't absorb enough medication if you take it on an empty stomach. A protein shake doesn't count as a meal.

    • Make sure your provider has a full list of your medications so they can check for interactions. This is especially important if you take antiseizure medications, steroids, or certain stomach acid treatments.

      • You can take Juluca (dolutegravir / rilpivirine) with certain stomach acid treatments like famotidine (Pepcid AC) and cimetidine (Tagamet HB). However, you need to separate them. Take Juluca (dolutegravir / rilpivirine) at least 4 hours before or 12 hours after these medications.

        • Iron and calcium supplements also interact with Juluca (dolutegravir / rilpivirine). You can take them at the same time with Juluca (dolutegravir / rilpivirine). If you'd rather separate them, take Juluca (dolutegravir / rilpivirine) 4 hours before or 6 hours after these supplements.

          • Make sure you contact your pharmacy to order a refill when you're running low on tablets. Sometimes, it can take a little extra time to process refills for high-cost medications like HIV ARVs and you don't want to run out of medication.

            • If you have to go to the hospital or emergency room, bring your Juluca (dolutegravir / rilpivirine) tablets. Not every hospital will have this medication in their pharmacy and you don't want to miss doses.

              faqs

              Frequently asked questions about Juluca (dolutegravir / rilpivirine)

              Is Juluca (dolutegravir / rilpivirine) a complete regimen for HIV?
              Yes, Juluca (dolutegravir / rilpivirine) is a complete HIV regimen. For many years, HIV regimens contained at least three HIV ARVs. To lower the risk of long-term side effects, scientists have studied regimens that contain two HIV ARVs. The FDA has approved two, 2-drug regimens at this time, Juluca (dolutegravir / rilpivirine) and Dovato (dolutegravir / lamivudine). In clinical trials, 95% of people continued to have an undetectable viral load after switching to Juluca (dolutegravir / rilpivirine) from a 3-drug regimen.
              Can I take omeprazole (Prilosec) with Juluca (dolutegravir / rilpivirine)?
              No, you can't take omeprazole (Prilosec) or other proton pump inhibitors (PPIs) if you're taking Juluca (dolutegravir / rilpivirine). PPIs decrease (lessen) how much Juluca (dolutegravir / rilpivirine) gets absorbed into your body, so they can't be taken together. There are other acid-lowering medications that you can take with Juluca (dolutegravir / rilpivirine), such as famotidine (Pepcid AC) and calcium carbonate (Tums). Juluca (dolutegravir / rilpivirine) might not be a good option if you take PPIs daily.
              When is the best time to take Juluca (dolutegravir / rilpivirine)?
              You can take Juluca (dolutegravir / rilpivirine) at any time of the day. It needs to be taken with a meal, so pick a mealtime when you usually eat at a consistent time. You'll want to try to take the medication at the same time every day so the medication levels stay consistent (steady) in your body.
              Is it okay to take Juluca (dolutegravir / rilpivirine) when you're breastfeeding?
              In general, it's not recommended for people living with HIV to breastfeed, due to the risk of passing HIV to the breastfed infant.
              What if I can't afford Juluca (dolutegravir / rilpivirine)?
              There are many different programs that can help you pay for your HIV ARV medications. If you have commercial insurance (like through your employer) and have a high copay, you might qualify for a copay card. If you don't have insurance, you might be able to get the medication straight from the manufacturer. Find out more through the Juluca (dolutegravir / rilpivirine) patient assistance program. If your insurance doesn't cover the medication, they might prefer you to use a different HIV ARV first. Ask your provider, pharmacist, insurance provider, and care team about resources if you ever have difficulty affording your medication.
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              What are the risks and warnings for Juluca (dolutegravir / rilpivirine)?

              Juluca (dolutegravir / rilpivirine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

              risk-warning

              Severe rash and allergic reactions

              In some rare cases, Juluca (dolutegravir / rilpivirine) can cause severe allergic reactions that can affect your organs and be life-threatening. If you suddenly get a high fever, blistering rash all over your body, swelling in the face, or trouble breathing, stop taking Juluca (dolutegravir / rilpivirine) and contact your provider or get medical help right away.

              risk-warning

              Liver toxicity

              • Risk factors: History of liver disease | Hepatitis B or C infection

                Some people have changes in their liver tests after starting Juluca (dolutegravir / rilpivirine). It can happen to anyone, but it's more common in people who have some type of liver disease. Your provider will check your liver before you start Juluca (dolutegravir / rilpivirine) and will see if you also have a hepatitis B or hepatitis C infection. After you start the medication, your provider will do regular blood tests to monitor your liver.

                risk-warning

                Birth defects

                • Risk factors: Taking Juluca (dolutegravir / rilpivirine) during the first trimester of pregnancy

                  Taking dolutegravir, an ARV found in Juluca (dolutegravir / rilpivirine), during your first trimester of pregnancy might raise the risk of neural tube defects for your unborn baby. Your provider might check if you're pregnant before you start Juluca (dolutegravir / rilpivirine). If you're pregnant or trying to become pregnant, talk to your healthcare provider about the safest medication options. If you're currently taking Juluca (dolutegravir / rilpivirine) and don't want to become pregnant, talk to your provider about your options for birth control.

                  risk-warning

                  Depression and changes in mood

                  • Risk factors: History of mental health conditions

                    Rilpivirine, one of the HIV ARVs in Juluca (dolutegravir / rilpivirine), has been linked to negative thoughts, depression, and thoughts of suicide. If you or a loved one notices that your mood starts to change while taking Juluca (dolutegravir / rilpivirine), let your provider know. If you start thinking about wanting to harm yourself, get medical attention right away.

                    risk-warning

                    Serious interactions with other medications

                    • Risk factors: Taking a lot medications

                      Always make sure your healthcare team has a full list of the medications you're taking, including over-the-counter (OTC) medications and supplements. Don't start taking any new medications without talking to your provider or pharmacist first. Many medications can interact with Juluca (dolutegravir / rilpivirine). Some interactions can cause unpleasant side effects, while others can affect how well Juluca (dolutegravir / rilpivirine) works (its antiretroviral activity) and lead to resistance (which can make HIV harder to treat). Your provider might adjust your medications to make sure they're all safe for you to take.

                      dosage

                      Juluca (dolutegravir / rilpivirine) dosage forms

                      The average cost for 30 tablets of 50mg/25mg of Juluca (dolutegravir / rilpivirine) is $3557.12 with a free GoodRx coupon. This is 16.79% off the average retail price of $4274.62.
                      tablet
                      Tablet
                      DosageQuantityPrice as low asPrice per unit
                      50mg/25mg30 tablets$3557.12$118.57

                      Typical dosing for Juluca (dolutegravir / rilpivirine)

                      The recommended dose is 1 tablet by mouth once a day with a meal. Each tablet contains 50 mg of dolutegravir and 25 mg of rilpivirine.

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                      How much does Juluca (dolutegravir / rilpivirine) cost?

                      To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
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                      contraindications-icon

                      Juluca (dolutegravir / rilpivirine) contraindications

                      Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Juluca (dolutegravir / rilpivirine) will not be safe for you to take.
                      alternatives

                      What are alternatives to Juluca (dolutegravir / rilpivirine)?

                      There are a number of medications that your doctor can prescribe in place of Juluca (dolutegravir / rilpivirine). Compare a few possible alternatives below.
                      Juluca (dolutegravir / rilpivirine)
                      Used for:

                      • HIV treatment for people who are well controlled on an HIV ARV regimen already and want to switch regimens

                      $3557.12 Lowest GoodRx priceView Prices
                      Dovato (dolutegravir / lamivudine)
                      Used for:

                      • Treatment of HIV infection in adults

                      $3009.70 Lowest GoodRx priceView Prices
                      Biktarvy
                      Used for:

                      • Starting HIV treatment for the first time, or

                      • Have a HIV viral load of less than 50 copies/mL from a previous ART

                      $4120.28 Lowest GoodRx priceView Prices

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