Treatment of HIV-1 infection in adults and pediatric pts at least 4 wks of age and weighing at least 3 kg.

Treatment of mild, moderate, or severe dementia of Alzheimer's disease. OFF-LABEL: Treatment of behavioral syndromes in dementia, dementia associated with Parkinson's disease, Lewy body dementia.

Contraindications: Hypersensitivity to dolutegravir. Co-administration of dofetilide. Cautions: Diabetes, hepatic/renal impairment, history of hepatitis or tuberculosis, prior hypersensitivity reaction to INSTIs.

Contraindications: History of hypersensitivity to donepezil, other piperidine derivatives. Cautions: Asthma, COPD, bradycardia, bladder outflow obstruction, history of ulcer disease, those taking concurrent NSAIDs, supraventricular cardiac conduction disturbances (e.g., sick sinus syndrome, Wolff-Parkinson-White syndrome), seizure disorder.

Inhibits HIV integrase by blocking strand transfer of retroviral DNA integration (essential for HIV replication cycle). Therapeutic Effect: Interferes with HIV replication, slowing progression of HIV infection.

Reversibly inhibits enzyme acetylcholinesterase, increasing concentration of acetylcholine at cholinergic synapses, enhancing cholinergic function in CNS. Therapeutic Effect: Slows progression of Alzheimer's disease.

Widely distributed. Metabolized in liver. Peak plasma concentration: 2-3 hrs. Excreted in feces (53%), urine (31%). Half-life: 14 hrs.

Well absorbed after PO administration. Protein binding: 96%. Extensively metabolized. Eliminated in urine, feces. Half-life: 70 hrs.

Pregnancy/Lactation: May increase risk of neural tube defects when used at conception and in early pregnancy. Breastfeeding not recommend due to risk of postnatal HIV transmission. Unknown if distributed in human breast milk. Children: Safety and efficacy not established in pts less than 4wks or weighing under 3 kg or who are INSTI-experienced with documented or clinically suspected resistance to other INSTIs. Elderly: May have increased risk of adverse effects or worsening hepatic, renal, cardiac function.

Pregnancy/Lactation: Unknown if drug is distributed in breast milk. Children: Safety and efficacy not established. Elderly: No age-related precautions noted.

DRUG: Medications containing aluminum, calcium, magnesium or iron; strong CYP3A4 inducers (e.g., carbamazepine, phenytoin, rifampin), nonnucleoside reverse transcriptase inhibitors (e.g., efavirenz, etravirine, nevirapine); protease inhibitors (e.g., fosampre-navir/ritonavir, tipranavir/ritonavir, sucralfate) may decrease concentration/effects. May increase concentration/effect of metformin. HERBAL:St John's wort may decrease therapeutic effect. FOOD: None known. LAB VALUES: May increase serum ALT, AST, bilirubin, cholesterol, creatinine, creatine kinase (CK), glucose, lipase, triglycerides. May decrease creatinine clearance, neutrophils.

DRUG: Anticholinergic agents (e.g., glycopyrrolate, scopolamine) may decrease therapeutic effect. May increase concentration/effects of antipsychotic agents, beta blockers (e.g., atenolol, carvedilol, metoprolol), succinylcholine. HERBAL: None significant. FOOD: None known. LAB VALUES: None significant,

Tablets: 10 mg, 25 mg, 50 mg. Tablets, Soluble: 5 mg.

Tablets: 5 mg, 10 mg, 23 mg. Tablets (Orally Disintegrating): 5 mg, 10 mg. Transdermal System: patch provides 5 mg/day, 10 mg/day.

Rare (3%-1%): Insomnia, headache, nausea.

Frequent (11%–8%): Nausea, diarrhea, headache, insomnia, nonspecific pain, dizziness. Occasional (6%–3%): Mild muscle cramps, fatigue, vomiting, anorexia, ecchymosis. Rare (3%–2%): Depression, abnormal dreams, weight loss, arthritis, drowsiness, syncope, frequent urination.

Hypersensitivity reaction including rash, fever, angioedema, difficulty breathing, skin blistering/peeling, arthralgia, lethargy was reported. Pts co-infected with hepatitis B or C have increased risk for viral reactivation, worsening of hepatic function, and may experience hepatic decompensation and/or failure if therapy is discontinued. May cause redistribution/accumulation of body fat (lipodystrophy). May induce immune recovery syndrome (inflammatory response to dormant opportunistic infections such as Mycobacterium avium, cytomegalovirus, PCP, tuberculosis, or acceleration of autoimmune disorders such as Graves' disease, polymyositis, Guillain-Barré).

Overdose may result in cholinergic crisis (severe nausea, increased salivation, diaphoresis, bradycardia, hypotension, flushed skin, abdominal pain, respiratory depression, seizures, cardiorespiratory collapse). Increasing muscle weakness may occur, resulting in death if muscles of respiration become involved. Antidote: Atropine sulfate 1–2 mg IV with subsequent doses based on therapeutic response.