5 Dolutegravir Side Effects You Should Know About

The treatment of HIV goes back to the 1980s. Before current medications were available, people often had to take many large, hard-to-swallow tablets multiple times per day. What’s more, these medications often led to many different side effects. 

Much has evolved in the decades since these treatments initially became available. Today, most HIV treatments are combination medications that are taken only once per day. They have fewer side effects, and they’re highly effective when taken as directed. 

However, like with all medications, newer HIV medications still have some side effects to consider. Dolutegravir — an oral medication used in many HIV treatment regimens — is no exception. If you have a new prescription for dolutegravir, you may be curious about what side effects you should be aware of.

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Which medications contain dolutegravir?

Dolutegravir is a medication that’s FDA approved to treat HIV. HIV medications of this type are referred to as antiretroviral therapy (ART). 

In most cases, dolutegravir is used in combination with other medications. This can be done by combining individual pills or taking one combination medication. When you take dolutegravir by itself, name-brand Tivicay is what’s filled at the pharmacy. But dolutegravir also comes in three combination tablets: 

• Dovato (dolutegravir/lamivudine)

• Juluca (dolutegravir/rilpivirine)

• Triumeq (dolutegravir/abacavir/lamivudine)

Each of these three medications are taken once a day. One of these combination medications may be the only tablet you need for your ART regimen. And because these medications all contain dolutegravir, they often share similar side effects. 

Below, we’ll detail five of the most notable dolutegravir side effects and how you might manage them.

1. Insomnia

Insomnia (trouble sleeping) is never ideal when you’re trying to unwind at night. And when it happens, it can lead to drowsiness and fatigue the following day. It doesn’t help when one of your daily medications is likely the cause of your insomnia, either. 

Dolutegravir is reported to cause insomnia and sleep disturbances in some people. If you’re taking dolutegravir and are having trouble falling or staying asleep, small changes can make a difference. For instance, one study found that when taken in the morning, about 75% of people taking dolutegravir experienced fewer sleep issues. 

Make sure to ask your pharmacist about the best time of day to take dolutegravir. They can also offer other tips for better sleep, if needed.

2. Elevated blood glucose

Dolutegravir can occasionally elevate your blood glucose (sugar) readings. This is especially problematic if you’re living with diabetes.

In dolutegravir’s initial clinical trials, up to 9% of people experienced a jump in their blood glucose levels after taking the medication. Another study also found that people who previously did not have Type 2 diabetes had a higher risk of developing diabetes after taking dolutegravir. 

Because of risks like these, your healthcare provider may want you to monitor your blood glucose more often to ensure that it stays in a safe range. It’s important to keep an eye out for possible symptoms of high blood glucose as well. Signs that your glucose is too high may include dry mouth, feeling thirsty, and frequent urination. 

3. Headache

Headaches are another possible side effect of dolutegravir. Thankfully, they’re not too common.

In clinical trials, only about 2% of people taking dolutegravir reported a headache. Most reported their headache cases as mild. Another study also found that older adults and women were more likely to develop brain-related side effects, like headaches, after taking dolutegravir compared to other people.

If you experience a headache while taking dolutegravir, certain lifestyle changes may make a difference. Ask your healthcare provider about possible stress-reduction techniques, hydration tips, and exercise changes. There are also several over-the-counter medications that you can take to relieve your symptoms. Ask your pharmacist about these products:

• Acetaminophen (Tylenol)

• Naproxen (Aleve, Naprosyn)

• Ibuprofen (Advil, Motrin)

• Aspirin

4. Liver problems

A possible side effect of ART medications, like dolutegravir, is elevated liver protein (transaminase) levels. While you can’t typically feel these changes, high transaminase levels can be a sign of possible liver problems. This risk is higher in people living with underlying hepatitis B or hepatitis C. While rare, there have also been limited reports of dolutegravir causing drug-induced liver injury.

Because your liver is an essential organ, it’s important to realize when it may be injured. Signs of acute liver problems may include: 

• Jaundice (yellowing of the skin or eyes)

• Swelling 

• Bloating 

• Confusion

For these reasons, your healthcare provider may want to monitor your liver health periodically while you’re taking dolutegravir. And if you develop symptoms like these while taking dolutegravir, contact your healthcare provider right away to discuss next steps.

5. Immune reconstitution inflammatory syndrome

Immune reconstitution inflammatory syndrome (IRIS) is when your immune system goes into overdrive and starts attacking parts of your body. In rare and specific situations, dolutegravir has been linked to IRIS.

If it happens, IRIS usually occurs while you’re recovering from an infection like tuberculosis, Mycobacterium avium complex, or Pneumocystis pneumonia. These infections are often called opportunistic infections because they’re more likely to happen in people with weakened immune systems. Some of the signs and symptoms of IRIS include confusion, difficulty breathing, and swollen lymph nodes.

Thankfully, most people who develop IRIS have only mild symptoms. But in some cases, severe or potentially life-threatening symptoms can appear. Out of caution, it’s important to talk with your healthcare provider about the best time to resume or start taking dolutegravir after you recover from an illness.

When should I contact my healthcare provider about side effects from dolutegravir?

Dolutegravir is well-tolerated. When side effects do occur, they’re typically mild in nature. But if you experience any bothersome or worrisome side effects at any point, contact your healthcare provider as soon as you can. But if your side effects feel severe, it’s better to seek emergency medical care.

As with any medication, there’s also a chance of being allergic to dolutegravir. If you develop a serious allergic reaction, including trouble breathing or swelling of the face or throat, call 911 or go to the closest emergency room. 

Why trust our experts?

Written by:

Cole D. Luty, PharmD, BCPS

Cole D. Luty, PharmD, BCPS, is a licensed pharmacist. He earned his Doctor of Pharmacy degree from Butler University, and he’s board-certified in pharmacotherapy.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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