NL/DTGRPV/0023/18a, mei 2018
Juluca
Switching to
Patient information
Introduction You have been given this brochure because you will be using Juluca (dolutegravir/rilpivirine) to inhibit HIV, after your HIV-1 infection has been virally suppressed with your previous treatment. A change of treatment is also called a switch. In this brochure, you will find the most important information you need for such a switch. The decision to use HIV inhibitors is an important one. HIV inhibitors can keep the virus under control for a long time, but do demand something of you: it is very important that you take your medication on time every day. Even if you do not feel ill at all. This is called compliance. If you skip taking your medication or take it too late, your HIV inhibitors may stop working eventually. If you are very compliant, you maximise the chance that the combination of dolutegravir/rilpivirine will continue working for a long time. This brochure is designed to help you with this. Your HIV practitioner and your HIV consultant will assist you with advice and support on all topics in this brochure. If there is something you do not understand, are unsure about what to do, or if you are having difficulties with the treatment, you can ask them for information, advice or support.
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What is Juluca?
Purpose of the treatment
What does Juluca look like?
How often per day?
Dolutegravir/rilpivirine is a combination of two
The purpose of the anti-retroviral therapy is to
Juluca is a pink, round, oval pill.
Always use this medication as prescribed. Are you
drugs that inhibit HIV. One Juluca pill contains
reduce the HIV viral load as much as possible. If
unsure about the correct use? Please contact your
50mg dolutegravir and 25mg rilpivirine. Currently,
the amount of virus in your body is so low that it
doctor or pharmacist. The usual dose is one pill
there are five classes of HIV drugs. Each group sup-
is almost impossible to measure, the treatment is
once daily. Take the pill during a meal.
presses the virus in a different way. Dolutegravir
successful. This will allow your immune system to
is part of the group of integrase inhibitors and
recover, making you less prone to diseases.
The image does not have the actual size.
rilpivirine is a non-nucleoside reverse transcriptase inhibitor. With the combination of these HIV inhibitors, Juluca can control the amount of virus in your body.
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What time?
organisers and the use of an alert. Also discuss
You decide at what time you want to take Juluca,
what you need to do when travelling to a different
but your HIV consultant can advise you about
time zone.
the optimal schedule for you. Choose a schedule that makes it as easy as possible to take your pill at the same time every day. Many people living with HIV use a weekly pill organiser. That way, you only have to sort your pills once a week and you can easily check if you have already taken the pills. Some people use an alert (on a mobile phone, for instance) to help them remember to take their medication on time. Your HIV consultant can advise you on pill
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Forgot to take Juluca?
Should I eat when taking it?
When not to use Juluca?
Ask your doctor or pharmacist for advice if you are
If you do forget a dose, take it as soon as possible
Juluca should be taken with a meal.
Juluca contains lactose and should not be used in
taking one or more of these drugs.
with a meal and return to your usual schedule
case of lactose intolerance.
again. However, if your next dose is scheduled to
Juluca may not be used at the same time as one or
Have you taken too much Juluca?
be taken within 12 hours, skip the missed dose and
more of the following drugs:
If you have taken too many Juluca pills, please
continue your usual schedule. Do not take a double
• dofetilide
contact your doctor or pharmacist for advice.
dose to compensate for the one you missed. If in
• carbamazepine, oxcarbazepine, phenobarbital,
Show them the Juluca packaging if possible.
doubt, contact your doctor or HIV consultant.
phenytoin • rifampicine, rifapentine • proton-pump inhibitors, such as omeprazole, esomeprazole, lansoprazole, pantoprazole, rabeprazole • systemic dexamethasone, except if it is a one-time dose • St John’s wort
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What to do in case of vomiting? In case the medication was taken with food: • vomiting up to 3 hours after taking medication: take medication again; • vomiting more than 3 hours after taking medication: do not take medication again; • if vomiting contains remnants: take medication again. Source: these recommendations have been adopted from chapter 9.1 of the NVHB (Dutch Association of HIV-treating physicians) guidelines, consulted in April 2018
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What are the possible side effects of Juluca?
Usually, this hypersensitivity appears during
Contact your doctor or HIV consultant immediately
in blood pressure within a few hours. If you stopped
the first six weeks of treatment, but it may also
when you develop a skin rash or when you experi-
using Juluca due to hypersensitivity, please return
All drugs can cause side effects, including Juluca.
present later.
ence two or more of the following symptoms.
the remaining Juluca pills to the pharmacy to avoid
It is impossible to predict whether you will expe-
• high body temperature (fever)
ever taking one by accident.
rience side effects and how long they will last if
• lack of energy (fatigue)
you do. This differs for each individual. A complete
• swelling, sometimes of the face or mouth
overview of the possible side effects is listed in the package leaflet. Always inform your doctor,
(angioedema), shortness of breath. • aching muscles or joints
Very common side effects– occurring in more than one in ten users are: headache, dizziness, diarrhoea, nausea, trouble with sleeping.
HIV consultant or pharmacist about all side
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effects that you experience. Some people are
Stop using Juluca immediately in case of symptoms
hypersensitive to dolutegravir, one of the com-
and signs of hypersensitivity reactions. If you have
ponents in Juluca. This hypersensitivity can be
ever stopped taking Juluca due to hypersensitivity,
very serious and can lead to skin reactions and
you may NEVER use drugs that contain dolute-
serious effects on the liver. Less than 1% of the
gravir again, such as Juluca, Triumeq and Tivicay.
users are actually hypersensitive to dolutegravir.
If you do, you may develop a life-threatening drop 13
Never stop without consultation
Never restart without consultation
Do not stop using Juluca without consulting your
If you stopped taking Juluca – especially if it was
doctor! Taking your HIV medication every day, on
due to hypersensitivity – never restart Juluca or
time, increases the chance of successful long-term
another drug that contains dolutegravir (such as
treatment against HIV. If you stop without consul-
Triumeq or Tivicay) without consulting your doctor
tation or supervision, you run the risk of reducing
or HIV consultant.
your chances of successful treatment in the future, because certain drugs will no longer work (as well).
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Can I use other medicines in combination with Juluca?
medication that you are using. This also applies to
How should I store Juluca?
medicines available at pharmacists or drugstores
Keep Juluca out of sight and reach of children.
You may be using other medicines in addition
without a prescription (over-the counter) and for
Also keep Juluca out of reach of pets. There are
to Juluca. Some medicines can affect how well
alternative medicines. For example, simultaneous
no specific storage conditions for Juluca. Do not
Juluca works or increase the chance that you will
use with St John’s wort is strongly discouraged.
use Juluca after its expiration date, which can be
experience side effects.
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• Ask for a prescription that extends longer than the exact day of your next appointment • Hand in your prescription to the pharmacy on time.
found on the box and on the bottle after the let-
Juluca can also affect the way other medicines
It is recommended to take H2 antagonists 12 hours
ters EXP. Never flush medication down the sink or
work. The package leaflet contains a list of me-
before or 4 hours after Juluca. The recommendation
the toilet, and do not throw them in the bin, either.
dicines that you – provided you are using one of
for taking antacids is 6 hours before or 4 hours after
Return medicines you are no longer using to the
these drugs – need to tell your doctor about. If the
taking Juluca. Calcium, iron supplements or multi-
pharmacy or ask the pharmacist what to do with
dose of one of Juluca’s active ingredients needs to
vitamins may be taken at the same time as Juluca
them.
be adjusted, Juluca can no longer be prescribed
with a meal. If calcium or iron supplements or multi-
as a combination pill; the active ingredients will
vitamins cannot be taken at the same time as Juluca,
The pharmacy
have to be administered in separate pills with a
it is recommended that you take these supplements
Tips to avoid running out of HIV medication:
different dose. Inform your doctor about all other
6 hours before or 4 hours after taking Juluca.
• Ask your doctor for a new prescription on time 17
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Address details
utmost care. No rights may be reserved based on
ViiV Healthcare B.V.
errors that may have been made despite these
Huis ter Heideweg 62
efforts. We recommend reading the package leaflet,
3705 LZ Zeist, The Netherlands
before using Juluca. contact-nl@viivhealthcare.com Production: Volle Maan, Amsterdam Design and illustrations: Richard Kleist
Telephone number +31 (0) 30 - 698 60 60
Copyright: May 2018, ViiV Healthcare B.V., Zeist, the Netherlands. Doctors, HIV consultants and pharmacist can request additional brochures at ViiV Healthcare B.V.
www.viivhealthcare.com