Delstrigo (Doravirine/Lamivudine/Tenofovir disoproxil fumarate) for HIV

Delstrigo (doravirine/lamivudine/tenofovir disoproxil fumarate) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat human immunodeficiency virus type 1 (HIV-1) infection in adults and children weighing at least 35 kilograms.

How Delstrigo Works and How It’s Taken

Delstrigo is a combination of three HIV medicines: doravirine, lamivudine, and tenofovir disoproxil fumarate.

These medicines block reverse transcriptase. This is an enzyme that HIV-1 needs to make more copies of itself.

Doctors prescribe Delstrigo to adults and children who weigh at least 35 kilograms and have not taken HIV medicines before.

Delstrigo may also replace a person’s current HIV treatment. The person must have an HIV-1 viral load below 50 copies per milliliter while taking a stable treatment. They must also have no history of treatment failure and no known resistance to the medicines in Delstrigo.

HIV-1 is the virus that causes acquired immune deficiency syndrome (AIDS).

Delstrigo is taken as one tablet once daily. It may be taken with or without food.

Typical Dosing for HIV

The recommended dose is one Delstrigo tablet once daily.

Each tablet contains:

100 milligrams of doravirine
300 milligrams of lamivudine
300 milligrams of tenofovir disoproxil fumarate

When Delstrigo is taken with rifabutin, a person should also take one doravirine 100-milligram tablet about 12 hours after the Delstrigo dose.

Delstrigo is not recommended for people with an estimated creatinine clearance below 50 milliliters per minute.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Delstrigo Side Effects

In clinical studies of Delstrigo, the most common side effects occurred in about 5 percent to 7 percent of people. These include:

Dizziness
Nausea
Abnormal dreams

Serious Side Effects and Warnings

Delstrigo can cause serious side effects that may require immediate medical attention. These include:

Severe skin reactions and allergic-type reactions — These reactions can include Stevens-Johnson syndrome/toxic epidermal necrolysis and DRESS, which can cause a painful or worsening rash, mouth sores, fever, swollen lymph nodes, or other organ problems.
Hepatitis B flare after stopping Delstrigo — A serious worsening of hepatitis B can lead to liver failure in people who have both HIV-1 and hepatitis B.
New or worsening kidney problems — These problems can include kidney failure and Fanconi syndrome, a kidney tubule problem that can cause low phosphorus and other serious imbalances.
Bone loss and bone softening — Lower bone mineral density and osteomalacia, which can cause bone pain and may contribute to fractures, can occur.
Immune reconstitution syndrome — As the immune system gets stronger, an inflammatory reaction can occur, which can unmask hidden infections or trigger autoimmune problems.

Get medical help right away if you think you are having a serious reaction.

How To Save on Delstrigo

Merck & Co., Inc, the manufacturer of Delstrigo, offers a savings coupon. Eligible people with private insurance may pay as little as $0 in out-of-pocket costs, up to a maximum program benefit of $6,800. The program is not available to people who are uninsured or enrolled in Medicare or other government insurance programs.

The savings coupon program also offers a free trial for eligible people, providing up to a 30-tablet supply of Delstrigo.

To learn more, visit the special offers for Delstrigo website.

What To Know Before Taking Delstrigo

Before starting Delstrigo, your healthcare provider will test you for hepatitis B virus infection.

Your healthcare provider will also check your kidney function before or when you start Delstrigo and during treatment. Tests include serum creatinine, estimated creatinine clearance, urine glucose, and urine protein. If you have chronic kidney disease, your serum phosphorus should also be checked.

Before taking Delstrigo, tell your doctor if you:

Have liver problems, including hepatitis B
Have kidney problems
Have bone problems, including a history of bone fractures
Are pregnant or plan to become pregnant
Are breastfeeding or plan to breastfeed

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Tell your doctor if you have taken rifabutin during the past four weeks.

Do not take Delstrigo if you have allergies to doravirine/lamivudine/tenofovir disoproxil fumarate or any ingredients in Delstrigo.

Do not take Delstrigo with:

Carbamazepine
Oxcarbazepine
Phenobarbital
Phenytoin
Enzalutamide
Rifampin
Rifapentine
Mitotane
St. John’s wort

Refill Delstrigo before you run out. Do not stop taking it without first speaking with your healthcare provider. Stopping treatment, even for a short time, may increase the amount of HIV-1 in your blood. The virus may also become harder to treat.

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose. Take your next dose at the regular time. Do not take two doses at the same time.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Delstrigo, talk with your doctor about the risks and benefits.

There is a pregnancy registry for people who take Delstrigo during pregnancy. Healthcare providers can register pregnancies by visiting the Antiretroviral Pregnancy Registry or calling 800-258-4263.

Talk with your healthcare provider about breastfeeding during treatment. Possible risks include passing HIV-1 to a baby who does not have the virus, making HIV-1 harder to treat in a baby who has the virus, and causing side effects from Delstrigo. Lamivudine, Doravirine and tenofovir can pass into breast milk.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Delstrigo for HIV?

In a 96-week study of adults starting HIV treatment for the first time, 77 percent of people taking Delstrigo had an HIV-1 viral load below 50 copies per milliliter at week 96.

In a 48-week study of adults whose HIV-1 was already under control, 91 percent had a viral load below 50 copies per milliliter at week 48 after switching to Delstrigo.

In a study of children ages 12 to younger than 18 whose HIV-1 was already under control, 95 percent remained below 50 copies per milliliter at week 24 after switching to Delstrigo.

How long does Delstrigo take to work for HIV?

The studies measured HIV-1 viral load at weeks 24, 48, and 96. It does not state exactly how many days or weeks it takes for Delstrigo to start working. It does show that many people had an HIV-1 viral load below 50 copies per milliliter at those study time points.

Can Delstrigo cause liver or kidney problems in people with HIV?

Delstrigo has warnings for both liver and kidney problems.

In people who have both HIV-1 and hepatitis B, stopping Delstrigo can cause a serious hepatitis B flare. This means hepatitis B can suddenly get worse. Liver function should be checked closely for at least several months after stopping treatment.

Kidney problems have also been reported with tenofovir disoproxil fumarate, one of the medicines in Delstrigo. These problems can include sudden kidney failure and Fanconi syndrome, which affects the kidney tubes.

Delstrigo should be stopped if there is a clinically important decline in kidney function, signs of Fanconi syndrome, or an estimated creatinine clearance below 50 milliliters per minute.