Tivicay, made simple.
Tivicay is an HIV medicine, but here is the most important thing to know up front: Tivicay is one part of a treatment, not the whole thing. It is taken together with other HIV medicines. This guide explains how it works, how to take it, and how to get help with cost. A Mississippi pharmacist wrote it for you, with care.
This guide is here to teach you. It is not medical advice, and it does not replace your doctor or pharmacist. Always do what your doctor tells you, and ask a pharmacist before you change how you take any medicine.
Print this guide for your fridgeWhat Tivicay is and why your doctor gave it to you
Tivicay is a medicine for HIV. Its other name is dolutegravir.
This is the single most important thing to understand about Tivicay: it is one component of a treatment, not a complete treatment by itself. Most HIV treatments are a team of medicines working together. Tivicay is one player on that team. Your doctor will have you take it alongside one or more other HIV medicines.
If you are not certain whether you have your whole HIV treatment, ask your pharmacist this exact question: am I taking all the HIV medicines I am supposed to. At Fairview we will check it against what your doctor prescribed. It is a question worth asking out loud.
Here is the part worth holding onto. When HIV is kept undetectable by taking your full treatment every day, it is not passed to others through sex. Doctors call this U equals U, undetectable equals untransmittable. Treatment protects your health, and the people you care about.
How Tivicay works
To make more of itself, HIV has to insert its own genetic material into your cells. It uses a tool, an enzyme called integrase, to do that.
Tivicay blocks that tool.
When the virus cannot insert itself into your cells, it cannot copy itself. The other HIV medicines on your team block different steps. Together, the team pushes the amount of HIV in your blood down, usually until a test can no longer find it. This works only while you take your full treatment every day.
Your dose
Tivicay is a tablet. Most people take it once a day, though some take it twice a day, and your doctor decides which is right for you. You can take it with or without food. If it upsets your stomach, a little food can help.
Your doctor picks your dose and your pharmacist checks it. This page will not tell you what dose to take. The most important things with Tivicay are taking it every day on schedule, and taking it together with the rest of your HIV treatment, exactly as your doctor set it up.
Timing, and what to do if you miss a dose
Take Tivicay at about the same time each day. Tie it to a daily habit so it is easy to remember.
HIV medicine works best taken every day without gaps. Missed doses give the virus a chance to copy itself and become harder to treat.
If you miss a dose:
- If you miss a dose, take it as soon as you remember on the same day.
- If it is close to the time of your next dose, skip the missed one and take the next on schedule.
- Never take two doses at once to catch up.
- If you take Tivicay twice a day, the timing rule can be a little different, so call your pharmacist if you are unsure.
Side effects, what is normal and what is not
Common, and usually mild.
- Trouble sleeping.
- A headache, or feeling tired.
- Nausea or loose stools.
- Some weight gain, which can happen with this kind of HIV medicine.
Call your doctor if you see:
- New or worsening low mood, sadness, or anxiety.
- Unusual tiredness, loss of appetite, yellow skin or eyes, or dark urine.
- A new rash, especially with a fever or feeling unwell.
- Weight gain that is large or quick.
Go to the emergency room right away if:
- You have a rash along with a fever, blistering, facial swelling, red eyes, or feeling very unwell. This can be a serious allergic reaction. Stop the medicine and get care, and do not take it again.
- You have signs of liver trouble: severe belly pain, yellow skin or eyes, and confusion.
- You have thoughts of harming yourself. Call or text 988, or go to the emergency room.
What to be careful with
One heart rhythm medicine, called dofetilide, must never be taken with Tivicay. A medicine for walking in multiple sclerosis, called dalfampridine, also must not be combined with it. The herbal supplement St. John's Wort should be avoided, because it can make Tivicay weaker and let the virus rebound.
Here is the everyday one that is most often missed. Calcium, iron, magnesium, zinc, antacids, laxatives, and many multivitamins that contain minerals can grab onto Tivicay in your stomach and stop it from being absorbed. Patients take these all the time without thinking to mention them.
The timing fix is simple. Take Tivicay at least 2 hours before, or at least 6 hours after, any of those supplements or antacids. If you take a mineral supplement with food, you may take it together with Tivicay.
If you take the diabetes medicine metformin, Tivicay can raise its level, so your doctor may watch that. The simple rule: before you start or stop anything, including vitamins and antacids you buy yourself, tell your pharmacist you take Tivicay. Every single time.
What it costs
The cost is different for every person, because every insurance plan is different.
Here is the honest way to find your price. If you pay cash, call Fairview and we will give you a price for your situation. If you have private insurance, there may be a coupon or a savings program from the maker of the drug that helps lower your cost, and we will check if one is available for you. The best step is to let a pharmacist look at your plan. We do this for every patient.
Do not let cost make you skip doses. Call us first. There is almost always something we can do.
There is also a generic version of many medicines. The generic is the same medicine. Ask your pharmacist if a generic is a good fit for you.
What should be checked
Before you start Tivicay, and while you take it, your care team checks a few things to keep you safe and confirm your treatment is working.
Your doctor should check:
- Your HIV viral load, to confirm it stays undetectable.
- How well your liver is working, especially if you have hepatitis.
- Your mood, especially if you have a history of depression or anxiety.
- A lab value called creatinine. Tivicay can nudge this number up a little, which is expected and is not kidney damage.
Your pharmacist should:
- Confirm you are taking your full HIV treatment, not just Tivicay alone.
- Check every new medicine and supplement against Tivicay, including vitamins and antacids.
- Make sure you have your refills on time, with no gaps.
- Keep your information private, always.
At Fairview, the first thing we check for a Tivicay patient is that you have your whole regimen, every medicine your doctor intended. If a refill is running late, we call you. Your care is handled discreetly and with respect.
Special situations
Tivicay is part of a team.
Because Tivicay is one component and not a whole treatment, the most important special situation is simply this: make sure you always have all of your HIV medicines, and take them all. If one of your other HIV medicines runs out, that is just as serious as Tivicay running out. Call Fairview if any part of your treatment is getting low.
Vitamins and antacids.
This is the everyday trap with Tivicay. A multivitamin, a calcium pill, an iron supplement, or a heartburn antacid can quietly block the medicine. Keep Tivicay 2 hours before or 6 hours after them, or take a mineral supplement together with food. When in doubt, ask.
Never stop on your own.
If you ever want to change or stop your HIV treatment, plan it with your doctor. Stopping suddenly lets the virus rebound. A safe change is always possible with a plan.
Pregnancy.
Older worry about dolutegravir and birth defects has been largely eased by newer, larger studies, and current HIV guidelines support its use in pregnancy. Still, if you are pregnant or planning to be, talk it through with your HIV doctor.
Cost should never be the reason you stop.
A generic version of dolutegravir is available, which can lower the cost. There are also manufacturer and assistance programs. If cost is a worry, call Fairview before you ever skip a dose, and we will help you find the lowest price.
How Fairview helps Tivicay patients
When you fill Tivicay at Fairview, here is what you get. This is normal care for us, and it is always private.
At your first fill:
- We confirm you have your whole HIV treatment, not just Tivicay.
- We check all your medicines and supplements, including vitamins.
- We explain the timing rule for minerals and antacids.
- We talk through cost, including whether a generic lowers your price.
At every refill:
- We check that all parts of your regimen are on track.
- We check your file for any new medicines.
- We make sure there is no gap before your next refill.
On our own, without being asked:
- If a refill is running late, we call you.
- If we see a medicine that does not mix with Tivicay, we call your doctor.
- We check your cost at every fill to keep it as low as possible.
- We keep your care discreet and respectful, always.
Questions people ask about Tivicay
No. Tivicay is one HIV medicine that is taken together with other HIV medicines. Think of it as one part of a team. Make sure you are taking all the HIV medicines your doctor prescribed, not just Tivicay.
Related guides
Have a question about your Tivicay? Ask a pharmacist you can trust.
The key with Tivicay is remembering it is one part of a team, and keeping the whole team going every day. Fairview is here to help you do exactly that, privately and without judgment. Moving your prescription to us takes one phone call.