Acriptega

TLD is the regimen's short name, taken from its three medicines in one tablet: tenofovir disoproxil fumarate (TDF) 300 mg, lamivudine 300 mg and dolutegravir (DTG) 50 mg. Per the South African label it is a white to off-white film-coated tablet marked M and LTD.

Each medicine acts at a different point. DTG is an integrase inhibitor that blocks the virus from inserting its genetic material into the cell. Lamivudine and TDF are NRTIs that block the reverse transcriptase enzyme. Together they stop it multiplying.

It treats HIV-1 infection in adults. The WHO document says adolescents weighing at least 30 kg can use it too, while the South African label states 18 years and older. It treats people who already have HIV; no pre-exposure prevention (PrEP) use is given.

The dose of each medicine in a fixed tablet cannot be changed, so people under 30 kg, or whose kidneys need a dose adjustment, are given separate tablets instead.

Usual dose. One tablet once a day for people whose virus is not resistant to integrase inhibitors, at the same time daily, swallowed whole with water.

Food. The South African label says with or without food. Food raises DTG levels (a high-fat meal by about 66%), so WHO advises a meal when integrase inhibitor resistance is known or suspected.

Integrase inhibitor resistance. WHO adds a second DTG 50 mg dose daily, with a meal, as a separate tablet since the fixed tablet cannot be adjusted. Leave this to the care team.

Frequencies follow WHO (very common = 1 in 10 or more; common = 1 in 100 to 1 in 10).

• Very common: nausea, diarrhoea, vomiting, headache, dizziness, rash, tiredness, low blood phosphate.
• Common: insomnia, abnormal dreams, depression, anxiety, weight gain, bloating, abdominal pain, raised liver enzymes (ALT/AST), hair loss, itching, joint pain, reduced bone density.

For the DTG part, WHO reports diarrhoea 18%, nausea 13%, headache 13%. Blood creatinine can rise about 10 micromol/L in the first week and then stay steady, because the medicine reduces creatinine secretion in the tubules, not kidney filtration. Rare serious effects are in the FAQ on signs needing urgent care.

• Hepatitis B: test before starting. Lamivudine and TDF also act on hepatitis B, but the label does not give it as a treatment for that disease.
• Kidneys: TDF can reduce kidney function and lower blood phosphate. Check kidney filtration before and during use; not recommended below 50 mL/min.
• Bones: TDF reduced bone density in trials up to 144 weeks, usually improving after stopping, with no rise in fractures in the trials cited.
• Liver: WHO needs no dose change in mild to moderate impairment (Child-Pugh A, B), but the South African label rules out moderate and severe impairment. The documents differ, so the care team should assess.
• Mental health: depression and anxiety are common, suicidal thoughts less so, mainly with prior depression. Report marked mood changes.
• Immune recovery: in the first weeks to months, a recovering immune system can unmask a hidden infection.

Both are once-daily Mylan HIV combination tablets in a bottle of 30 with the same DTG 50 mg. They differ in the NRTI pair.

• TLD formula (this page): lamivudine + TDF. Not recommended below 50 mL/min kidney filtration. With rifampicin it works by raising DTG to twice daily.
• Kocitaf (Dolutegravir/Emtricitabine/Tenofovir alafenamide): TAF instead of TDF. Not recommended below 30 mL/min, for weight from 40 kg, and not recommended with rifampicin.

For bones and kidneys, in the DISCOVER trial of FTC/TAF (Descovy) against FTC/TDF (Truvada) in people without HIV, bone density rose 0.5% at the lower spine on TAF and fell 1.1% on TDF, and abnormal urine protein occurred in 0.7% against 1.5%. This is not a head-to-head test of these two tablets.

In short: if rifampicin is needed and kidneys are normal, the TLD formula can be adjusted. If kidney filtration sits between 30 and 49, or bones and kidneys are a concern, Kocitaf allows a wider kidney range but cannot be used with rifampicin. The care team chooses from test results.

These medicines must not be combined with HIV treatment, or need adjusting first. Tell the care team and pharmacist whenever a new medicine or supplement starts. Data come from each medicine, as no study covers the fixed tablet.

• Dofetilide: must not be combined, because DTG can raise its level (WHO also names fampridine).
• Rifampicin: lowers DTG by about 54%; DTG 50 mg twice daily is needed.
• Carbamazepine, phenytoin, phenobarbital, oxcarbazepine, St. John's wort, efavirenz: lower DTG. The South African label says to avoid some; the care team may add DTG or switch medicines.
• Metformin: DTG raises metformin by about 79%; WHO advises considering a metformin dose change.
• Products already containing lamivudine, emtricitabine, tenofovir or adefovir: do not double up.
• Kidney-harming medicines: high-dose or multiple NSAIDs and aminoglycosides; avoid, or check the kidneys more often.
• Antacids, calcium, iron: space the doses; see the FAQ.

Hormonal contraceptives and methadone need no dose change.

The sources used here do not say how many days the virus takes to fall below detection, which differs between people; the care team follows it with viral load tests. They do give how each medicine is absorbed and how long it stays.

• DTG: peaks about 2 hours after a dose on an empty stomach, 3 to 5 hours with food; half-life about 14 hours.
• Lamivudine: half-life in blood 5 to 7 hours, but the active form inside cells lasts about 22 hours.
• TDF: stays in the blood for 12 to 18 hours.

These numbers are why one dose a day is enough, and why skipping several days lets levels fall.

Where to buy Acriptega?

Order online at Intimo Life. Delivery across Thailand takes 1-3 working days, packed discreetly for privacy, with no product name on the parcel.