Kocitaf

This is a combination tablet from Mylan (Viatris). Each tablet holds dolutegravir (DTG) 50 mg, emtricitabine (FTC) 200 mg and tenofovir alafenamide (TAF) 25 mg. Per the Mylataf label for the same formula, it is a white to off-white oval tablet marked M and TD1. Markings for this tablet itself were not found, so rely on the box and bottle you receive.

DTG is an integrase inhibitor that blocks the virus from inserting its genetic material into the cell. FTC is an NRTI that stops the virus building its genetic material. Tenofovir alafenamide is a prodrug of tenofovir, converted inside the cell into the active form that also ends the viral DNA chain.

It is a complete single-tablet regimen for HIV-1 infection in adults and children weighing at least 40 kg, per the Mylataf label. It treats people who already have HIV; no PrEP use is given.

The fixed tablet cannot be adjusted, so people under 40 kg are given separate tablets.

Usual dose. One tablet once a day at the same time daily, for people with kidney filtration of 30 mL/min or more. The fixed tablet cannot be split or adjusted.

Food. The Mylataf label says absorption of all three medicines in the fixed tablet is not affected by food, so it can be taken with or without food.

Liver impairment. No change in Child-Pugh A. For B and C the Mylataf label lists a contraindication, while the Descovy and Tivicay labels allow A and B. The documents differ, so the care team should assess.

Older people. Use with caution; kidney, liver or heart function may be reduced.

The figures come from different kinds of measurement, so they are shown separately.

• Descovy (FTC+TAF) in people with HIV: nausea is the most common, at 10% or more.
• Tivicay (DTG): moderate to severe effects at 2% or more are insomnia, tiredness and headache (SINGLE, 144 weeks: 3%, 2%, 2%).
• WHO document for the TLD tablet (DTG part): diarrhoea 18%, nausea 13%, headache 13%.
• Mylataf (no percentages): frequent are abnormal dreams, dizziness, diarrhoea, vomiting, rash, itching, raised liver enzymes, triglycerides and blood sugar.

Creatinine can rise slightly early on with DTG without a true loss of kidney filtration. Rare serious effects are in the FAQ on signs needing urgent care.

• Hepatitis B: test before starting. FTC and TAF also act on hepatitis B, and stopping can trigger a severe flare.
• Kidneys: kidney impairment and Fanconi syndrome are reported with TAF medicines, mostly with other factors. Check creatinine, kidney filtration and urine tests before and during use; avoid kidney-harming medicines.
• Bones: the Mylataf label advises considering a bone density check with prior fractures or osteoporosis risk factors.
• Mental health: suicidal thoughts are reported with DTG, mainly with prior depression. Report marked mood changes.
• Immune recovery: usually in the first 3 months, more so with a low CD4 count, a recovering immune system can unmask a hidden infection.
• Liver and lactic acidosis: DTG can cause hepatitis even without prior liver disease; NRTIs carry a rare lactic acidosis warning.

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.

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

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

In short: if kidney filtration sits between 30 and 49, or bones and kidneys are a concern, this tablet allows a wider kidney range. If rifampicin is needed and kidneys are normal, Acriptega can be adjusted by the book. 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. No study covers the full fixed tablet.

• Dofetilide: must not be combined (the Mylataf label also names pilsicainide).
• Rifampicin, rifabutin, rifapentine, St. John's wort: not recommended, because TAF levels fall.
• Carbamazepine, oxcarbazepine, phenytoin, phenobarbital: DTG and TAF levels fall; consider another anticonvulsant. Mylataf also describes an extra DTG 50 mg dose 12 hours apart.
• Efavirenz: an extra DTG 50 mg dose 12 hours apart. Nevirapine: avoid.
• Metformin: DTG raises metformin. The Mylataf label lists it as a contraindication, the Tivicay label says to weigh benefit and risk; do not combine without advice.
• Products already containing FTC, lamivudine or tenofovir: do not double up.
• Kidney-harming medicines: acyclovir, valacyclovir, aminoglycosides, high-dose or multiple NSAIDs; they raise levels and kidney risk.
• Antacids, calcium, iron: space the doses; see the FAQ.

Hormonal contraceptives and methadone need no change.

The sources 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 long each medicine stays.

• DTG: half-life about 14 hours.
• FTC: median plasma half-life about 10 hours.
• TAF: about 0.51 hours in plasma, but its active form, tenofovir diphosphate, lasts 150 to 180 hours inside cells.

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

Where to buy Kocitaf?

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