Side Effects of dolutegravir: A Synthesis of Findings from 27 Studies
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This analysis is based on research papers included in PubMed, but medical research is constantly evolving and may not fully reflect the latest findings. There may also be biases towards certain research areas.
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Major Research Findings
Dolutegravir is a widely used antiretroviral drug that is effective in treating HIV infection. Many studies have shown that dolutegravir is effective in suppressing HIV. However, dolutegravir has been reported to have various side effects. 6 reported cases of new-onset diabetes mellitus in patients who received dolutegravir-based ART regimens. 12 , the Active Pharmacovigilance Project on the safety profile of Dolutegravir in Brazil, reported that gastrointestinal, neurological, and psychiatric side effects were common in patients who took dolutegravir. 2 found that integrase inhibitors, including dolutegravir, were associated with neuropsychiatric symptoms in women with HIV compared to efavirenz. 7 suggested that antiretroviral therapy containing dolutegravir may increase the excitability of pyramidal neurons in the medial prefrontal cortex of rats. 4 reported neuropsychiatric adverse effects of dolutegravir in real-life clinical practice. 22 suggested that dolutegravir-based antiretroviral therapy may increase the risk of developing diabetes mellitus. 5 reported that dolutegravir may increase the risk of neural tube defects.
Reasons for Side Effects
Dolutegravir side effects may vary depending on how the drug acts in the body or the individual patient's constitution. 7 suggested that dolutegravir may increase the excitability of pyramidal neurons in the medial prefrontal cortex of rats, leading to neuropsychiatric side effects. 2 suggested that integrase inhibitors, including dolutegravir, may act directly on the brains of women with HIV, causing neuropsychiatric symptoms.
Common Side Effects
Gastrointestinal
Gastrointestinal symptoms have been reported as a side effect of dolutegravir. 12 , the Active Pharmacovigilance Project on the safety profile of Dolutegravir in Brazil, reported that gastrointestinal side effects were common. 23 reported indigestion, constipation, diarrhea, and fatigue as side effects of dolutegravir in Korean patients.
Neurological
Neurological symptoms have been reported as a side effect of dolutegravir. 12 , the Active Pharmacovigilance Project on the safety profile of Dolutegravir in Brazil, reported that neurological side effects were common. 2 found that integrase inhibitors, including dolutegravir, were associated with neuropsychiatric symptoms in women with HIV compared to efavirenz. 7 suggested that antiretroviral therapy containing dolutegravir may increase the excitability of pyramidal neurons in the medial prefrontal cortex of rats. 4 reported neuropsychiatric adverse effects of dolutegravir in real-life clinical practice. 5 reported that dolutegravir may increase the risk of neural tube defects.
Psychiatric
Psychiatric symptoms have been reported as a side effect of dolutegravir. 12 , the Active Pharmacovigilance Project on the safety profile of Dolutegravir in Brazil, reported that psychiatric side effects were common. 2 found that integrase inhibitors, including dolutegravir, were associated with neuropsychiatric symptoms in women with HIV compared to efavirenz. 19 found that dolutegravir was not associated with mood symptoms. 4 reported neuropsychiatric adverse effects of dolutegravir in real-life clinical practice. 10 found that integrase inhibitors, including dolutegravir, were associated with reports of depression and suicidal behavior.
Metabolic
Metabolic symptoms have been reported as a side effect of dolutegravir. 6 reported cases of new-onset diabetes mellitus in patients who received dolutegravir-based ART regimens. 22 suggested that dolutegravir-based antiretroviral therapy may increase the risk of developing diabetes mellitus.
Side Effect Management
Gastrointestinal Side Effects
If gastrointestinal side effects occur, diet therapy or a change in medication may be considered. 12 , the Active Pharmacovigilance Project on the safety profile of Dolutegravir in Brazil, reported that gastrointestinal side effects were common. 23 reported indigestion, constipation, diarrhea, and fatigue as side effects of dolutegravir in Korean patients. These side effects may be reduced by diet therapy or a change in medication.
Neurological Side Effects
If neurological side effects occur, a change in medication or adjustment of the dosage may be considered. 2 found that integrase inhibitors, including dolutegravir, were associated with neuropsychiatric symptoms in women with HIV compared to efavirenz. 4 reported neuropsychiatric adverse effects of dolutegravir in real-life clinical practice. 10 found that integrase inhibitors, including dolutegravir, were associated with reports of depression and suicidal behavior. These side effects may be reduced by a change in medication or adjustment of the dosage. Consulting a psychiatrist may also be necessary.
Psychiatric Side Effects
If psychiatric side effects occur, a change in medication or adjustment of the dosage may be considered. 2 found that integrase inhibitors, including dolutegravir, were associated with neuropsychiatric symptoms in women with HIV compared to efavirenz. 4 reported neuropsychiatric adverse effects of dolutegravir in real-life clinical practice. 10 found that integrase inhibitors, including dolutegravir, were associated with reports of depression and suicidal behavior. These side effects may be reduced by a change in medication or adjustment of the dosage. Consulting a psychiatrist may also be necessary.
Metabolic Side Effects
If metabolic side effects occur, diet therapy, exercise therapy, or a change in medication may be considered. 6 reported cases of new-onset diabetes mellitus in patients who received dolutegravir-based ART regimens. 22 suggested that dolutegravir-based antiretroviral therapy may increase the risk of developing diabetes mellitus. These side effects may be reduced by diet therapy, exercise therapy, or a change in medication.
Comparison Between Studies
Commonalities
Multiple studies have suggested that dolutegravir may cause gastrointestinal, neurological, and psychiatric side effects. 12 , 2 , 4 reported these side effects. 22 suggested that dolutegravir may increase the risk of developing diabetes mellitus. These studies suggest that dolutegravir may cause a variety of side effects.
Differences
Some studies have suggested that dolutegravir side effects may be limited to specific groups. For example, 2 found that integrase inhibitors, including dolutegravir, were associated with neuropsychiatric symptoms in women with HIV compared to efavirenz. Also, 7 suggested that antiretroviral therapy containing dolutegravir may increase the excitability of pyramidal neurons in the medial prefrontal cortex of rats. These studies suggest that the side effects of dolutegravir may vary depending on the patient's age, sex, and medical condition.
Practical Applications
Dolutegravir is an effective drug for treating HIV infection, but the risk of side effects must be considered. If you are taking dolutegravir, it is important to follow your doctor's instructions and have regular checkups. In particular, if you experience neurological or metabolic symptoms, consult your doctor immediately.
Limitations of Current Research
Research on the side effects of dolutegravir is still insufficient. Further research is needed, especially regarding long-term side effects. Also, because side effects can vary depending on the individual patient's constitution and medical condition, research findings cannot be applied to everyone.
Future Research Directions
The following aspects of dolutegravir side effects require further research: * Long-term side effects * Frequency and severity of side effects * Preventive measures for side effects * Treatment for side effects These studies are expected to help us understand dolutegravir side effects more deeply and develop safer treatment methods.
Conclusion
Dolutegravir is an effective drug for treating HIV infection, but the risk of side effects must be considered. If you are taking dolutegravir, it is important to follow your doctor's instructions and have regular checkups. If you experience side effects, consult your doctor immediately. Further research on the side effects of dolutegravir is expected to help develop safer treatment methods.
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