Other options if you are starting treatment for the first time

Your doctor may suggest you start treatment on a different drug combination to the ones described above.

There may be reasons why one of the combinations recommended for starting HIV treatment is not suitable for you. This could be because of possible interactions with other drugs you are taking, or because the type of HIV you have is resistant to one or more drugs. Or it could be because you want to avoid certain side-effects. 

In some cases, if your doctor thinks it will work as well for you, they may suggest you start on a combination that costs less for the NHS to buy. Your doctor will only do this if they also think this combination will work for you.

The recommendations suggest some alternative combinations for people starting HIV treatment in certain circumstances. 

Kivexa (a drug combining lamivudine [3TC] and abacavir) is an acceptable alternative to Truvada if your viral load is below 100,000 copies. You need to have a special test before starting treatment with Kivexa to see if you have a gene associated with allergy to abacavir. You must not take Kivexa if the result is positive.

Alternative choices for a third drug in the combination are: 

  • Kaletra, the protease inhibitor lopinavir, boosted with ritonavir, taken in two pills containing the combined drugs

or 

  • nevirapine (Viramune, Viramune prolonged-release or a generic version), a drug in the NNRTI class

or 

  • rilpivirine (Edurant). This is the latest drug in the NNRTI class

or 

  • fosamprenavir (Telzir), also a protease inhibitor that needs to be boosted with ritonavir.

Tenofovir, emtricitabineand rilpivirine are also available in a fixed-dose combination tablet called Eviplera

You can find out more about these drugs in the NAM booklet, Anti-HIV drugs, or by using My drugs chart, an online tool to create a personalised drug chart.

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.