Viropil (Dolutegravir 50mg, Lamivudine 300mg, Tenofovir 300mg)

• Delivery from India up to 20 days.
• The minimum order is 4 packs.
• Pack of 30 tablets.

Viropil buy at a profitable price in India (Dolutegravir 50mg, Lamivudine 300mg, Tenofovir 300mg)

Viropil is prescribed for adult patients weighing more than 40 kg with the disease HIV infection.

Pharmacodynamics

Dolutegravir belongs to the class of antiviral drugs of HIV-1 inegrase inhibitors. The action of the drug prevents the integration of HIV with the active part and stops the stage of transfer of the DNA synthesis chain, which is specific for the HIV replication cycle.

Tenofovir D.F.: Tenofovir D.F. disrupts the development of transcriptase, destroys the usual substrate deoxyadenosine-5'-triphosphate and after adding to the DNA using a viral DNA chain eliminator. Tenofovir is used to stop the synthesis of viral DNA, which is necessary for the chain removal process.

Lamivudine belongs to the class of nucleoside synthetic analogues. Lamivudine is phosphorylated intracellularly into the active 5'-triphosphate metabolite (lamivudine triphosphate 3TC-TP). This active metabolite is involved in the prevention of reverse transcriptase via chain termination following infusion of a nucleotide analogue.

Pharmacokinetics

Suction
The maximum concentration of Dolutegravir in plasma is from 2 to 3 hours.

Tenofovir DF: 1 hour ± 0.4 hours and bioavailability is 25%

Lamivudine: 1.5 ± 0.5 μg / ml. The bioavailability of lamivudine is 80-87%

Distribution
Protein binding for dolutegravir, tenofovir, lamivudine is 98.9%, <0.7-7.2% and 36%.

Metabolism
Dolutegravir is mainly metabolized through UGT1A1 with some contribution from CYP3A

Tenofovir occurs metabolized to the cytochrome P450 enzyme where trans-sulfoxide occurs during lamivudine metabolism, and the biotransformation is catalyzed by sulfotransferases.

Breeding
Dolutegravir is excreted unchanged with feces by 53%, and urine by 31%, lamivudine with urine by 5.2% ± 1.4% through a trans-sulfoxide metabolite

The final half-life of Dolutegravir is 14 hours, tenofovir DF is 17 hours, and lamivudine is 5-7 hours.

Dosage and administration

Piror, to begin treatment with Viropil, the patient must be tested for HIV infection.

The usual dose of Viropil is one tablet: 50 mg of dolutegravir, 300 mg of tenofovir DF, 300 mg of lamivudine - 1 time per day.

The drug is taken before meals.

To reduce the risk of side effects in the form of neurological problems, this drug should be taken before bedtime.

The prescribed dose of viropil is one tablet of dolutegravir 50 mg + lamivudine 300 mg + tenofovir DF 300 mg taken once a day.

Renal failure:

Dosage adjustment is necessary for patients with an initial creatinine clearance of <50 ml / min.

Liver failure:

In patients with mild to moderate liver failure, dose adjustment is not required.

Geriatric Use:

For elderly patients, use with caution.

Side effects

Lactic acidosis
HBV exacerbation
Kidney damage
Psychiatric problems
Nervous problems
Skin problems
Liver toxicity
Decompensated Cirrhosis
pancreatitis
Bone defects
Immune Recovery Syndrome
Fat redistribution
Most common side effects
Headache, pain, fever, abdominal pain, back pain, asthenia, diarrhea, nausea, dyspepsia, vomiting, lipodystrophy, arthralgia, insomnia

Laboratory abnormalities

Increased cholesterol, increased creatine kinase, increased AST and ALT, hematuria, neutropenia, increased serum amylase

Interaction

Viropil with inducers of CYP3A causes an increase in clearance of Viropil and leads to a decrease in plasma concentration.
Viropil with warfarin causes prothrombin time and INR values ​​to fluctuate.
Viropil with anticonvulsants causes a decrease in the concentration effect of these drugs.
Viropyl with antifungal, antidepressant or anti-infective agents reduces the effect of the concentration of these drugs.
Viropyl with antimalarial, antimycobacterial, calcium channel blockers or lipid-lowering drugs causes a decrease in the concentration of these drugs.
When interaction with metformin or dofetilide leads to an increase in the concentration of these drugs in the plasma.

Food Interactions

The use of Dolutegravir with mineral or vitamin substances, this can lead to an increase in the content of ions, and this
alteration interferes with the absorption of dolutegravir and reduces effectiveness.

There is a slight nutritional interaction with drugs.

Diet should only be maintained after consultation with a medical consultant.

Ordinary food
Grapes and grape juice;
Oranges
Products containing vitamins E, C;
Garlic;
Calcium supplements.
Contraindications
Hypersensitivity reaction occurs in patients with concomitant use with dofetilide

Contraindications

Hypersensitivity reaction occurs in patients with concomitant use with dofetilide

Precautionary measures

Severe hepatomegaly with stethosis / lactic acidosis: while the use of nucleoside analogues involves the use of lamivudine alone or a combination of it, it is harmful to the fetus. Lamivudine should be used with caution in patients with liver disease with a known factor.

Neoplasm or worsening renal failure: Cases such as acute renal failure and Fanconi syndrome have been reported with tenofovir DF. When using tenofovir, there is no data on safety and effectiveness in patients. Routine monitoring of calculated creatinine and serum phosphorus clearance should be performed.

Patients with HIV-1 and HBV co-infection: post-therapeutic exacerbation of hepatitis can occur in patients infected with both HIV-1 and HBV when the treatment regimen for Lamivudine containing the HIV-1 regimen changes to a regimen containing Lamivudine.

Pregnancy and lactation

Pregnancy Category Lamivudine: C

Pregnancy category tenofovir and dolutegravir: B

The drug Viropil penetrates the placenta well, no birth defects were observed in the first trimester

This medicine should be used with the likely benefits, which justifies the likely risk.

Breastfeeding should not be allowed.

Storage and handling

Store at temperatures below 30oC

Protect the drug from heat, moisture and light.

Missed dose

If skipping occurs, take the drug as soon as possible, while remembering, otherwise leave the missed dose. Maintain a regular dosing schedule

Avoid the missed dose if possible. Please consult your doctor.

Do not self-medicate with Viropil tablets.

Overdose

An overdose of the drug does not have a specific antidote. If this happens to patients, they should be monitored and provide standard supportive care, but a higher dose of tenofovir is removed by hemodialysis with an extraction rate of about 54%