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Dovato vs Odefsey
Introduction
For patients diagnosed with HIV-1, certain antiretroviral drugs that inhibit the replication of the virus can help in managing disease progression and enhancing quality of life. Dovato and Odefsey are two such drugs that are prescribed for this purpose. They each contain different active ingredients but both have demonstrated effectiveness in suppressing viral load among patients with HIV-1. Dovato is a combination medication containing dolutegravir, an integrase strand transfer inhibitor (INSTI), and lamivudine, a nucleoside reverse transcriptase inhibitor (NRTI). This dual therapy approach targets two stages in the HIV lifecycle to prevent further replication of the virus. On the other hand, Odefsey is composed of emtricitabine/tenofovir alafenamide (two NRTIs) along with rilpivirine which is a non-nucleoside reverse transcriptase inhibitor (NNRTI). This triple-drug regimen has been designed to optimize efficacy while minimizing potential side effects.
Dovato vs Odefsey Side By Side
| Attribute | Dovato | Odefsey |
|---|---|---|
| Brand Name | Dovato | Odefsey |
| Contraindications | Should not be taken with certain antacids, laxatives, anti-seizure drugs, and St. John's wort. Could worsen hepatitis B infection when stopped suddenly. | Should not be taken with certain antacids, laxatives, anti-seizure drugs, and St. John's wort. Could worsen hepatitis B infection when stopped suddenly. |
| Cost | $2,500 for 30 tablets | $3,000 for 30 tablets |
| Generic Name | Dolutegravir/Lamivudine | Emtricitabine/Rilpivirine/Tenofovir alafenamide |
| Most Serious Side Effect | Severe allergic reactions, liver problems, lactic acidosis, changes in body fat distribution | Liver problems, kidney issues, bone problems, immune system changes |
| Severe Drug Interactions | Medicines that can interfere with its components, including certain antacids, laxatives, anti-seizure drugs, and St. John's wort. | Medicines that can interfere with its components, including certain antacids, laxatives, anti-seizure drugs, and St. John's wort. |
| Typical Dose | One tablet once daily containing 50 mg of dolutegravir and 300 mg of lamivudine | One tablet per day with food, containing 200 mg emtricitabine, 25 mg rilpivirine, and 25 mg tenofovir alafenamide |
What is Dovato?
Dolutegravir/lamivudine (the generic name for Dovato) is a two-drug combination of antiretroviral medications used in the treatment of HIV infection. This regimen represents an advance in antiretroviral therapy as it involves fewer drugs, potentially reducing side effects and drug interactions. Dovato works by preventing the virus from multiplying, thereby reducing viral load within the body. It was first approved by the FDA in 2019.
Emtricitabine/rilpivirine/tenofovir (Odefsey) is another option for treating HIV infection, combining three different antiretroviral drugs into one pill taken once daily. Odefsey has been available since 2016 and acts on various stages of the virus's life cycle to prevent its proliferation.
Both treatments are effective at suppressing HIV; however, they have different side effect profiles due to their distinct compositions. While both can cause issues like headache or diarrhea, Odefsey may also cause depressive disorders and insomnia more frequently than Dovato.
What conditions is Dovato approved to treat?
Dovato is approved for the treatment of various aspects of HIV-1 infection:
- First-line therapy for adults with no previous antiretroviral treatment history
- Substitution for a stable antiretroviral regimen in adults who are virologically suppressed (HIV-1 RNA less than 50 copies/mL) on a stable antiretroviral regimen with no history of treatment failure and no known substitutions associated with resistance to the individual components of Dovato.
How does Dovato help with these illnesses?
Dovato aids in managing HIV by maintaining a lower amount of virus available within the body. It accomplishes this by blocking two key enzymes - reverse transcriptase and integrase, which are responsible for allowing the HIV virus to reproduce itself inside human cells. By inhibiting these enzymes, Dovato effectively prevents the replication of the virus, thus helping control its spread throughout the body.
HIV is a type of retrovirus that affects immune system cells, hindering their function and leading to progressive deterioration if left untreated. Consequently, individuals with HIV have an increased risk of developing serious infections or diseases due to compromised immunity.
Odefsey works similarly but with one additional component known as tenofovir alafenamide (TAF), which has been shown to be less harmful on kidneys and bones compared to older versions of tenofovir like TDF found in other antiretroviral regimens.
Therefore, by reducing viral proliferation through enzyme inhibition, both Dovato and Odefsey can limit negative effects associated with HIV infection and help patients manage their condition more effectively.
What is Odefsey?
Odefsey is a brand name for a combination of three drugs- emtricitabine, rilpivirine, and tenofovir alafenamide. This medication combo acts as antiretroviral therapy (ART) for the treatment of HIV-1 infection in certain adults and pediatric patients. Odefsey works by inhibiting two stages in the lifecycle of HIV to prevent its replication: it blocks reverse transcriptase enzyme (through emtricitabine and tenofovir alafenamide), stopping the virus from integrating into human DNA, while rilpivirine acts as a non-nucleoside reverse transcriptase inhibitor (NNRTI). First approved by FDA in 2016, unlike some ARTs like Dovato (which comes with warnings about potential side effects such as hypersensitivity reactions and liver problems), common side effects associated with Odefsey are generally less severe - they include depression or mood changes, headache, insomnia etc., although it does carry warnings regarding lactic acidosis/severe hepatomegaly with steatosis and post treatment acute exacerbation of hepatitis B. The combined action on different stages of HIV replication can be beneficial particularly for those patients who do not respond optimally to other forms of ART treatments.
What conditions is Odefsey approved to treat?
Odefsey is an FDA-approved drug used for the treatment of:
- Human Immunodeficiency Virus (HIV) in adults and children who weigh at least 35kg
- Pre-exposure prophylaxis (PrEP), which helps prevent HIV infection in people who are at high risk.
It should be noted that Odefsey is not a cure for HIV or AIDS, but it works to control the virus and prevent its spread.
How does Odefsey help with these illnesses?
Odefsey is a complete regimen for the treatment of HIV-1 infection in certain patients. It's an antiretroviral medication that slows down the replication of HIV within your body, thus helping to keep the virus under control. Odefsey works by combining three drugs: emtricitabine, rilpivirine, and tenofovir alafenamide which act on different aspects of viral replication. Compared to Dovato, which only contains two active ingredients (dolutegravir and lamivudine), Odefsey can offer more comprehensive coverage against various strains of HIV. Also noteworthy is its action on reverse transcriptase enzymes - a mechanism unique to retroviruses like HIV - thereby reducing viral load and increasing CD4 cell count (a type of immune cell depleted by HIV). Thus, it may be prescribed when a patient requires broader protection or hasn't responded adequately to other treatments such as Dovato.
How effective are both Dovato and Odefsey?
Both Dovato and Odefsey are reliable antiretroviral drugs used in the treatment of HIV, and both were approved by the FDA within a few years of each other. They work on different stages of the HIV lifecycle and may be prescribed under varying circumstances. The effectiveness of Dovato (a combination of dolutegravir and lamivudine) and Odefsey (a combination of emtricitabine, rilpivirine, and tenofovir alafenamide) in managing HIV was directly studied in multiple clinical trials; both drug combinations demonstrated similar efficacy as well as promising safety profiles.
A 2019 review showed that Dovato is effective at suppressing viral replication from the onset of therapy with a favorable side effect profile compared to other many other antiretroviral therapies. This study reported that it's well-tolerated even among various age groups. Additionally, since it contains only two active ingredients instead three or four like most regimens, it reduces pill burden for patients.
Similarly, several studies have shown that Odefsey effectively suppresses viral load with comparable results to other common antiretrovirals. Nonetheless, use can come with potential drawbacks such as less robust data supporting its use among individuals with high baseline viral loads compared to alternative treatments such as those containing dolutegravir (which is part of Dovato). Furthermore, treatment initiation requires patients have no known resistance mutations related to any components within Odefsey.
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At what dose is Dovato typically prescribed?
For treating HIV-1 infection, Dovato should be administered as a single tablet once daily. The tablet contains 50 mg of dolutegravir and 300 mg of lamivudine. This dosage is suitable for most adults and adolescents who weigh at least 40 kg and are new to antiretroviral therapy or looking to replace their current regimen. On the other hand, Odefsey's recommended dose is one tablet per day which includes emtricitabine (200mg), rilpivirine (25mg), and tenofovir alafenamide (25mg). It should be taken with food in adults and children who weigh at least 35 kg. In both cases, the dosages shouldn't exceed one pill per day unless advised by a healthcare professional.
At what dose is Odefsey typically prescribed?
Odefsey treatment is typically initiated at a consistent dosage of one tablet per day. Each tablet contains 200 mg emtricitabine, 25 mg rilpivirine, and 25 mg tenofovir alafenamide. It's important to take Odefsey with a meal for optimal absorption. Maximum dose remains the same - one tablet per day - as increasing the dosage doesn't offer additional therapeutic benefits but may increase risk of side effects. If after several weeks there isn't sufficient response to treatment or if serious side effects occur, your healthcare provider might consider switching medication rather than adjusting the dosage of Odefsey.
What are the most common side effects for Dovato?
Common side effects of Dovato include:
- Headache
- Diarrhea
- Nausea
- Fatigue (general weakness and tiredness)
- Insomnia
- Abnormal dreams
On the other hand, Odefsey may cause side effects such as:
- Nausea
- Diarrhea
- Headache
-Bloating or gas
-Skin rash, which can be severe in rare cases
-Dizziness and lightheadedness
-Liver problems, which might be serious. Symptoms may include yellowing of your skin or the whites of your eyes, dark-colored urine, light-colored bowel movements
Most people do not have these side effects but if you experience any persistent symptoms while on either medication, it is important to consult with a healthcare professional.
Are there any potential serious side effects for Dovato?
While both Dovato and Odefsey are effective treatments for HIV, they can sometimes cause serious side effects. For Dovato:
- Severe allergic reactions: skin rash, hives, itching; difficulty breathing or swallowing; swelling of the face, throat, tongue; severe dizziness or passing out
- Liver problems: nausea or vomiting that doesn't stop, loss of appetite, stomach pain on the right upper side, yellowing of your skin or whites of your eyes (jaundice), dark urine
- Lactic acidosis (a build-up of an acid in the blood): feeling weak or fatigued; unusual muscle pain; trouble breathing; stomach pain with nausea and vomiting; cold hands and feet especially arms and legs feel cold to touch
- Changes in body fat distribution - gain in waist size but loss from legs and arms.
For Odefsey:
- Mood changes such as increased depression thoughts about suicide/self-harm.
- Kidney issues: change in amount/color of urine
- Bone problems: bone pain/softening/breaks.
- Immune system changes (Immune Reconstitution Syndrome)
If you experience any such symptoms while taking these medications consult a healthcare provider immediately.
What are the most common side effects for Odefsey?
When taking Odefsey, here are some of the side effects you might experience:
- Nausea, abdominal pain
- Insomnia or other sleep problems
- Mild rash
- Fatigue and headache
- Dizziness
- Changes in body fat distribution This medication may also cause an increase in cholesterol and triglyceride levels. It is essential to have regular check-ups with your healthcare provider while on this treatment to monitor these potential side effects closely.
Are there any potential serious side effects for Odefsey?
While Odefsey is generally well-tolerated, in rare cases, it can cause serious side effects. These may include:
- Signs of an allergic reaction such as skin rashes, hives, fever or swollen glands
- Severe reactions like difficulty breathing and swelling of the face or throat
- Changes in behavior or mood swings
- Liver problems indicated by dark urine, yellowing of the eyes/skin (jaundice), persistent nausea/vomiting
- Lactic acidosis symptoms such as muscle pain/weakness/cramps and fast/difficult breathing
- Kidney issues exhibited by changes in the amount of urine.
If you experience any of these side effects while taking Odefsey, contact your healthcare professional immediately.
Contraindications for Dovato and Odefsey?
Both Dovato and Odefsey, along with most other antiretroviral medications, may cause certain side effects in some people. If you notice an increase in symptoms such as fatigue, nausea, diarrhea or changes in your immune system (immune reconstitution syndrome), please seek immediate medical attention.
Neither Dovato nor Odefsey should be taken if you are taking or have been taking medicines that can interfere with them. This includes certain antacids, laxatives, anti-seizure drugs and St. John's wort among others. Always inform your physician about any over-the-counter medication or herbal supplements you are currently using; these substances might take a while to clear from the body and could potentially interact dangerously with Dovato and Odefsey.
Moreover, both of these medications could worsen hepatitis B infection when stopped suddenly; therefore it is important to discuss your medical history thoroughly before starting on either drug regimen.
How much do Dovato and Odefsey cost?
For the brand name versions of these drugs:
- The price for 30 tablets of Dovato (dolutegravir/lamivudine) averages around $2,500 which works out to approximately $83/day.
- The price for 30 tablets of Odefsey (emtricitabine/rilpivirine/tenofovir alafenamide) is about $3,000, working out to roughly $100/day.
Thus, if you are taking these medications as directed (one tablet per day), then brand-name Dovato costs less on a per-day treatment basis than Odefsey. However, remember that cost should not be your primary consideration in determining which antiretroviral therapy is right for you - efficacy and side effect profile also play significant roles.
Currently there are no generic options available for either Dovato or Odefsey. These medications can be expensive; however many pharmaceutical companies provide patient assistance programs to help with the costs. Please consult with your healthcare provider or pharmacist about potential aid programs that could assist you with medication expenses.
Popularity of Dovato and Odefsey
Dolutegravir/Lamivudine, in generic form as well as brand names such as Dovato, was estimated to have been prescribed to a considerable number of people in the US since its approval by the FDA in 2019. This combination therapy is increasingly being used for the treatment of HIV-1 infection due to its efficacy and tolerability profiles. With only two drugs instead of three or more found in other therapies, it reduces potential side effects and drug interactions.
Emtricitabine/Rilpivirine/Tenofovir alafenamide, also known under its brand name Odefsey, has been one of the preferred regimens for initial treatment of HIV-1 infection according to guidelines from several organizations including U.S Department of Health and Human Services (DHHS). In terms of prescription volume in recent years, Odefsey holds a significant share among antiretroviral prescriptions owing largely to its established safety profile and high barrier to resistance. However, trends may vary based on individual patient characteristics and evolving clinical guidance.
Conclusion
Both Dovato (dolutegravir/lamivudine) and Odefsey (emtricitabine/rilpivirine/tenofovir alafenamide) are used in the treatment of HIV-1 infection, with a wealth of clinical studies demonstrating their effectiveness. While both have proven to be more effective than placebo treatments, they're not typically combined due to potential drug interactions. Their mechanisms of action differ; Dovato contains an integrase inhibitor and a nucleoside reverse transcriptase inhibitor, while Odefsey combines two nucleos(t)ide reverse transcriptase inhibitors with a non-nucleoside reverse transcriptase inhibitor.
The choice between these medications often depends on individual patient needs and circumstances. For example, Dovato is sometimes favored for its once-daily dosing regimen without the need for food intake as it's required by Odefsey.
Both medications come in generic forms which can significantly reduce costs for patients paying out-of-pocket. It may take some time after beginning either medication before its full effects are observed.
Side effect profiles are somewhat similar between the two drugs: both are generally well-tolerated but might cause side effects like headaches or nausea. However, each has unique risks – such as potential kidney issues with Odefsey or hypersensitivity reactions with Dovato - that should be closely monitored by healthcare providers during treatment initiation and maintenance phases.
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Refrences
- Kawuma, A. N., Wasmann, R. E., Dooley, K. E., Boffito, M., Maartens, G., & Denti, P. (2022, June 21). Population Pharmacokinetic Model and Alternative Dosing Regimens for Dolutegravir Coadministered with Rifampicin. Antimicrobial Agents and Chemotherapy. American Society for Microbiology.http://doi.org/10.1128/aac.00215-22