What is Juluca?
Juluca is a medication used to treat HIV. It is a combination of two separate antiretroviral drugs in one pill, taken once a day.
How does Juluca work?
Juluca combines two antiretroviral drugs in one pill. Dolutegravir is an HIV integrase inhibitor. Rilpivirine is a non-nucleoside reverse transcriptase inhibitor. Each drug class works against HIV in a different way.
The aim of HIV treatment is to reduce the level of HIV (the ‘viral load’) in your body until it is undetectable – usually less than 50 copies of virus per ml of blood. Taking HIV treatment and having an undetectable viral load protects your immune system and stops HIV being passed on to someone else during sex.
You can take Juluca if your viral load has been undetectable for at least six months. Juluca does not need to be combined with other anti-HIV drugs.
How do I take Juluca?
You should take Juluca once a day. Juluca should be taken with a meal.
HIV treatment works best if you take it every day, ideally at the same time each day. It may help to set an alarm, e.g. on your mobile phone, to remind you. If you forget to take a dose of Juluca and realise within 12 hours of the time you usually take it, take it as soon as possible with food, then take your next dose at your usual time. If you realise more than 12 hours late, don’t take a double dose, just skip the dose you’ve forgotten and then carry on with your normal routine.
If you vomit less than four hours after taking Juluca, take another dose. If you vomit more than four hours after taking Juluca there is no need to repeat the dose.
What are the possible side effects of Juluca?
All medicines have possible side effects. It’s a good idea to talk to a doctor, nurse or pharmacist about what to expect before you start taking any medication, and how to manage any side effects which occur.
A full list of side effects, including less common side effects, can be found in the patient information leaflet that comes with Juluca.
Side effects can be described as:
- Common – a side effect that occurs in at least one in a hundred people (more than 1%) who take this drug.
- Rare – a side effect that occurs in fewer than one in a hundred people (less than 1%) who take this drug.
Common side effects of Juluca include:
- difficulty in sleeping, abnormal dreams, depression, depressed mood, anxiety, headache, dizziness, drowsiness, fatigue
- nausea, diarrhoea, abdominal pain, vomiting, flatulence, dry mouth, decreased appetite
- increased liver enzymes or bilirubin or creatinine phosphokinase or lipase or pancreatic amylase
- decreased white blood cell count, haemoglobin or platelet count, increased total or LDL cholesterol, increased triglycerides
- rash, itching.
People with HIV may gain weight after starting antiretroviral treatment. Clinical trials of new HIV drugs introduced since 2003 show that people taking dolutegravir (one of the components of Juluca) are at higher risk of substantial weight gain than people taking other antiretroviral drugs.
Does Juluca interact with other drugs?
You should always tell your doctor and pharmacist about any other drugs or medication you are taking. That includes anything prescribed by another doctor, medicines you have bought from a high-street chemist, herbal and alternative treatments, and recreational or party drugs.
Some medicines or drugs are not safe if taken together – the interaction could cause increased, dangerous levels, or it could stop one or both of the drugs from working. Other drug interactions are less dangerous but still need to be taken seriously. If levels of one drug are affected, you may need to change the dose you take. This must only be done on the advice of your HIV doctor.
You should not take Juluca if you are currently taking medicines from the following groups:
- products that contain St John’s wort (a herbal remedy used for depression and anxiety)
- rifampicin and rifapentine (used to treat some bacterial infections such as tuberculosis)
- carbamazepine, oxcarbazepine, phenobarbital and phenytoin (used to treat epilepsy and prevent seizures)
- proton pump inhibitors, such as omeprazole, esomeprazole, lansoprazole, pantoprazole, rabeprazole (used to treat acid reflux)
- systemic dexamethasone (anti-inflammatory steroid, many uses for treatment of serious conditions)
- dofetilide (treatment for irregular heartbeat).
H2-recepter antagonists such as famotidine, used to reduce the amount of stomach acid, should be taken at least 4 hours after or 12 hours before Juluca.
Antacids containing magnesium should be taken at least 6 hours before or 4 hours after Juluca.
Calcium supplements, iron supplements or multivitamins should be taken at the same time as Juluca, with a meal.
Can I take Juluca in pregnancy?
Juluca is not recommended for women who are pregnant or who might become pregnant. Juluca should be used with effective contraception.
If you are considering having a baby, or think you might be pregnant, talk to your doctor as soon as possible about which combination of anti-HIV medications would be right for you. It is important to take antiretroviral treatment during pregnancy to prevent passing HIV from mother to baby.
Can children take Juluca?
Juluca is not licensed for use in children.
Talking to your doctor
If you have any concerns about your treatment or other aspects of your health, it’s important to talk about these. For example, if you have any symptom or side effect which may be from your treatment, or if you are finding it difficult to take your medication every day, one of your healthcare team will be able to help.
Building a relationship with a doctor may take time. You may feel very comfortable talking to your doctor, but some people find it more difficult, particularly when talking about sex, mental health, or symptoms they find embarrassing. It’s also easy to forget things you wanted to talk about.
Preparing for an appointment can be very helpful. Take some time to think about what you are going to say. You might find it helpful to talk to someone else first, or to make some notes and bring them to your appointment.
For detailed information on this drug, visit the Juluca page in the A-Z of antiretroviral medications.