dolutegravir
Tivicay (dolutegravir) is an integrase inhibitor from ViiV Healthcare for HIV-1 infection, always used with other antiretrovirals. It blocks the viral integrase enzyme so HIV cannot splice its genes into infected cells, keeping viral levels suppressed.
This page is based on FDA prescribing information and the EMA medicine record for dolutegravir, cross-checked with MedlinePlus; the mechanism is explained in plain language, and analogies are used only where they stay accurate.
How it works
Explains what the medicine does in the body, not dosing, side effects, or safety.
An analogy
HIV tries to photocopy itself by first gluing its instruction sheet into the cell's own manual. Integrase is the glue. Dolutegravir caps the glue bottle, so the sheet never sticks; the cell never gets the instructions, and no new viruses are assembled from that cell.
In simple terms
For HIV to multiply, it must insert its genetic code into the DNA of the cells it infects. An enzyme called integrase performs that insertion. Dolutegravir binds the active site of integrase and blocks the strand transfer step, so viral DNA cannot integrate. Used with other antiretrovirals, it drives the amount of virus in the blood down to undetectable levels and lets immune cells recover.
In depth
Dolutegravir chelates the two-metal ion active site of HIV integrase, selectively blocking the strand transfer step of retroviral DNA integration while having little effect on human enzymes. It has a high barrier to resistance, retains activity against many raltegravir- and elvitegravir-resistant variants, and a long half-life supporting once-daily dosing. These properties made it a backbone of modern first-line combination regimens.
See it in motion
A schematic animation of the mechanism — simplified for clarity, not drawn to scale.
How dolutegravir, an HIV integrase strand-transfer inhibitor, works
- For HIV to multiply, it must insert its genetic code into the DNA of the cells it infects.
- Dolutegravir binds the active site of integrase and blocks the strand transfer step, so viral DNA cannot integrate.
- Dolutegravir chelates the two-metal ion active site of HIV integrase, selectively blocking the strand transfer step of retroviral DNA integration while having little effect on human enzymes.
- It has a high barrier to resistance, retains activity against many raltegravir- and elvitegravir-resistant variants, and a long half-life supporting once-daily dosing.
Target: HIV integrase
A viral enzyme that inserts HIV's genetic material into the DNA of the infected cell; without this step the virus cannot establish a lasting, copyable infection.
Approved uses
Approved uses differ by country and change over time. Always follow your local prescribing information.
Approved uses in United States
FDA- In combination with other antiretroviral agents, for the treatment of HIV-1 infection in adults, treatment-naive or treatment-experienced
- In combination with other antiretroviral agents, for the treatment of HIV-1 infection in pediatric patients aged at least 4 weeks and weighing at least 3 kg who are treatment-naive or INSTI-naive
Approved uses in European Union
EMA- In combination with other anti-retroviral medicinal products, for the treatment of HIV-infected adults, adolescents and children of at least 6 years of age and weighing at least 14 kg
Official sources
The statements on this page trace back to these records.
- Tivicay (dolutegravir) — Summary of product characteristics and package leaflet, English version
European Medicines Agency
- U.S. Food and Drug Administration: dolutegravir prescribing information
U.S. Food and Drug Administration
- MedlinePlus: dolutegravir
MedlinePlus, U.S. National Library of Medicine
- National Cancer Institute: dolutegravir
National Cancer Institute
This page explains how the medicine works — it isn’t the patient leaflet. For anything that applies to you, read the leaflet that came with your medicine or ask your pharmacist.
MedUnfold provides educational content and is not medical advice. Always follow your local prescribing information and healthcare professional.