Indications: Instgra (Dolutegravir) is used for the treatment of Human Immunodeficiency Virus (HIV) infection in adults and pediatric patients weighing at least 30 kilograms (kg) (approximately 66 pounds). It is typically prescribed as part of combination antiretroviral therapy (ART) for the management of HIV-1 infection.

Mechanism of Action: Dolutegravir, the active ingredient in Instgra, belongs to a class of medications known as integrase strand transfer inhibitors (INSTIs). It works by inhibiting the activity of the HIV enzyme integrase, which is responsible for integrating the viral DNA into the DNA of the host immune cells. By blocking this process, dolutegravir prevents the replication of the HIV virus and reduces the viral load in the body.

Administration: Instgra tablets are administered orally. The recommended dosage regimen for adults and pediatric patients weighing at least 30 kg is typically one 50 mg tablet once daily.

Dosage: The dosage of Instgra (dolutegravir) may vary depending on factors such as the patient’s age, weight, renal function, and concomitant medications. It is important to follow the dosage instructions provided by the healthcare provider.

Efficacy: Dolutegravir has demonstrated high efficacy in the treatment of HIV-1 infection, both in treatment-naive patients and those who have previously received antiretroviral therapy. Clinical studies have shown that dolutegravir-based regimens are effective in achieving and maintaining viral suppression, improving immune function, and reducing the risk of HIV-related complications.

Common Side Effects:

1. Headache
2. Nausea
3. Diarrhea
4. Insomnia
5. Fatigue
6. Dizziness
7. Abnormal dreams

Most side effects associated with dolutegravir are mild to moderate in severity and tend to improve over time with continued treatment.

Precautions:

1. Hypersensitivity Reactions: Patients should be monitored for signs of hypersensitivity reactions, including rash, fever, and liver enzyme elevations, and dolutegravir should be discontinued if a hypersensitivity reaction occurs.
2. Neuropsychiatric Effects: Patients may experience neuropsychiatric side effects such as depression, anxiety, and suicidal ideation while taking dolutegravir. Close monitoring is recommended, particularly in patients with a history of psychiatric disorders.
3. Pregnancy and Breastfeeding: Dolutegravir may be used in pregnant individuals with HIV, but caution is advised, and healthcare providers should consider the potential risks and benefits when prescribing dolutegravir during pregnancy or breastfeeding.

Important Considerations:

1. Drug Interactions: Dolutegravir may interact with other medications, including certain antacids, anticonvulsants, and rifampin. Patients should inform their healthcare provider about all medications they are taking to avoid potential interactions.
2. Adherence to Treatment: It is essential for patients to adhere to the prescribed dosage regimen and continue treatment as directed by their healthcare provider to maximize the effectiveness of dolutegravir-based therapy and minimize the risk of viral resistance.
3. Regular Monitoring: Patients receiving dolutegravir should undergo regular monitoring of HIV viral load, CD4 cell count, renal function, and liver function to assess treatment response and detect any potential adverse effects.

Instgra (dolutegravir) is an important component of combination antiretroviral therapy for the treatment of HIV infection. Patients considering or undergoing treatment with Instgra should consult their healthcare provider for personalized guidance and monitoring. This description is for informational purposes only and does not replace professional medical advice.