Used For:

• HIV treatment

Contraindications:

• Hypersensitivity to any of the components (dolutegravir, lamivudine, tenofovir). Co-administration with dofetilide (a heart rhythm drug) is contraindicated. Not recommended in patients with severe renal impairment (creatinine clearance < 50 mL/min) — dose adjustment not possible. Use caution (or avoid) in severe hepatic impairment (little data available).

Side Effects:

• Common / Frequent:Headache Diarrhea / GI disturbances Nausea Weakness, fatigue Insomnia / sleep disturbances Rash, itching Elevated liver enzymes Muscle pain / joint pain Depression, anxiety Serious / Less Common:Lactic acidosis (rare) Kidney / renal toxicity (especially with tenofovir) Bone mineral density loss (long-term tenofovir use) — need monitoring. Hypersensitivity reactions (severe)

Precautions:

• Adherence is very important: Missing doses can lead to viral resistance. If stopping treatment (especially in patients co-infected with hepatitis B), monitor for liver flare / hepatitis. In renal impairment: dose adjustment or alternative regimens may be needed. In the elderly: use cautiously due to potential decreased kidney/liver function. Mental health: monitor patients for depression, mood changes.Bone health: long-term tenofovir may affect bones — periodic monitoring may be needed.Pregnant women: consult clinician about risks vs benefits. Do not abruptly stop therapy — could lead to viral rebound / resistance.

Dietary Restrictions:

• Take at the same time every day to maintain consistent drug levels. Avoid antacids, calcium, iron or other divalent cation supplements around the time of taking Viropil — these can reduce uptake of dolutegravir / tenofovir. (General ART advice; consult your doctor about timing.)Alcohol: Use with caution. Alcohol may worsen liver issues. Stay well-hydrated, especially because tenofovir can affect kidneys.Practice safe sex: Viropil does not prevent HIV transmission — virus suppression helps, but other precautions (condoms) still needed.