Spegra Tablet (Dolutegravir 50mg + Emtricitabine 200mg + Tenofovir Alafenamide 25mg)

Spegra Tablet is a fixed-dose HIV treatment containing dolutegravir 50mg, emtricitabine 200mg and tenofovir alafenamide (TAF) 25mg. Dolutegravir is an integrase strand-transfer inhibitor (INSTI), while emtricitabine 200mg and TAF are NRTIs. Integrase-based regimens are preferred in many current treatment guidelines because they provide rapid viral suppression and a high resistance barrier. TAF delivers lower circulating tenofovir 25mg exposure than TDF, generally reducing kidney and bone toxicity, although weight and lipid changes can be clinically relevant.

This combination is used as a complete once-daily regimen for HIV-1 infection in appropriately selected adults/adolescents where locally approved. Before initiation or switching, clinicians review prior resistance, hepatitis B status, kidney function, pregnancy considerations, and drug interactions. FTC and TAF suppress HBV; stopping them in HBV coinfection can cause severe hepatitis flare. Spegra is not a PrEP product unless specifically approved for that purpose in the jurisdiction.

Dolutegravir 50 mg + Emtricitabine 200 mg + Tenofovir alafenamide 25 mg blocks HIV integrase and prevents viral DNA from integrating into host-cell DNA. FTC and tenofovir 25mg diphosphate inhibit reverse transcriptase and terminate viral DNA elongation.

ADVANCE: Dolutegravir, emtricitabine, and tenofovir alafenamide with FTC/TAF or FTC/TDF achieved strong virologic efficacy compared with efavirenz-based ART; weight gain differed between regimens.

Integrase-regimen evidence: Multiple phase III studies established dolutegravir as a potent, high-barrier anchor drug for initial ART.

Like most antiretroviral medications, the Spegra tablet can cause side effects as your body adjusts to the treatment.

Common side effects

• Headache
• Insomnia
• Nausea
• Diarrhea
• Weight gain
• Fatigue

Serious side effects

• Severe hypersensitivity
• Hepatotoxicity
• HBV flare after discontinuation
• Drug interactions causing loss of virologic control

Important: Dose and regimen must be prescribed by the treating specialist. Tablet/vial strength is not necessarily the patient dose. Do not start, stop, split, combine, or substitute treatment based on website information.

Take a missed dose when remembered unless it is close to the next dose; do not double. Repeated missed doses can cause viral rebound and resistance.

Regular monitoring during Spegra treatment is essential for assessing safety, viral suppression, and overall health outcomes.

• HIV viral load
• Renal function
• Liver function/HBV status
• Weight and metabolic parameters
• Adherence and resistance history

• Current dolutegravir 50mg, emtricitabine 200mg and tenofovir alafenamide 25mg component prescribing information. https://hetero.com/images/pdf/DETaf_Tab_Leaf%20let_%20English.pdf.
• Current WHO/DHHS/IAS-USA HIV treatment guidelines. https://www.iasusa.org/2024/12/01/the-2024-ias-usa-hiv-treatment-and-prevention-guidelines-are-now-published/​
• National library of medicine. dolutegravir, emtricitabine and tenofovir alafenamide treatment. https://pubmed.ncbi.nlm.nih.gov/33010240/​
• National library of medicine. Clinical review report. https://www.ncbi.nlm.nih.gov/books/NBK538758/​