Abacavir / dolutegravir / lamivudine (Triumeq)

How Medicare covers it

Part D (forms used at home). Part A during a covered inpatient stay. No Part B clinician-administered form in the CMS Part B spending file.

What it treats

Treats HIV-1 infection in adults and in children at least 3 months old who weigh at least 6 kg.

What it is for, in depth

The label Indications section states Triumeq and Triumeq PD are for the treatment of HIV-1 infection in adults and in pediatric patients aged at least 3 months and weighing at least 6 kg. It is a complete fixed-dose regimen in one tablet, combining dolutegravir with abacavir and lamivudine, typically prescribed for people living with HIV-1 who can take all three components. The label limits its use: it alone is not recommended in patients with resistance-associated integrase substitutions or clinically suspected integrase strand transfer inhibitor (INSTI) resistance, because the dose of dolutegravir in it is insufficient in those subpopulations. Triumeq comes as purple, oval, film-coated tablets containing 600 mg abacavir, 50 mg dolutegravir, and 300 mg lamivudine. Triumeq PD comes as tablets for oral suspension containing 60 mg abacavir, 5 mg dolutegravir, and 30 mg lamivudine per tablet.

How it works

It is a fixed-dose combination of three HIV medicines: dolutegravir, an integrase strand transfer inhibitor (INSTI), and abacavir and lamivudine, two nucleoside analogues. The label says the three together have inhibitory activity against HIV.

How it is taken

Taken by mouth, with or without food. For adults, the label dosage is one Triumeq tablet once daily. For children, Triumeq PD tablets for oral suspension are dosed by body weight (3 to 6 tablets once daily for weights from 6 kg to under 25 kg), and children weighing at least 25 kg take one Triumeq tablet once daily. The label says Triumeq and Triumeq PD must not be substituted for each other on a milligram-per-milligram basis. Before starting, patients must be screened for the HLA-B*5701 allele and tested for hepatitis B virus (HBV) infection.

Common side effects

The label extract does not list a routine common side effects list with rates. Its Adverse Reactions section points to the serious reactions discussed elsewhere in the labeling: serious and sometimes fatal hypersensitivity reaction, exacerbations of hepatitis B, liver toxicity (hepatotoxicity), lactic acidosis and severe liver enlargement with fatty liver, immune reconstitution syndrome, and heart attack (myocardial infarction).

Serious warnings

The label warns that liver toxicity has been reported with dolutegravir-containing regimens and monitoring for it is recommended. Lactic acidosis and severe hepatomegaly (liver enlargement) with steatosis (fatty liver), including fatal cases, have been reported with nucleoside analogues. Immune reconstitution syndrome has been reported in patients treated with combination antiretroviral therapy. It is contraindicated in patients who carry the HLA-B*5701 allele, patients with a prior hypersensitivity reaction to abacavir, dolutegravir, or lamivudine, patients receiving dofetilide, and patients with moderate or severe liver impairment.

Boxed warning

Serious and sometimes fatal hypersensitivity reactions, with multiple organ involvement, have occurred with abacavir, a component of Triumeq and Triumeq PD. Patients who carry the HLA-B*5701 allele are at higher risk of a hypersensitivity reaction to abacavir, although reactions have also occurred in patients who do not carry it. Triumeq and Triumeq PD are contraindicated in patients with a prior hypersensitivity reaction to abacavir and in HLA-B*5701-positive patients. All patients should be screened for the HLA-B*5701 allele before starting, or restarting, Triumeq or Triumeq PD, unless they have a previously documented assessment. Stop Triumeq or Triumeq PD immediately if a hypersensitivity reaction is suspected, regardless of HLA-B*5701 status and even when other diagnoses are possible. After a hypersensitivity reaction, NEVER restart Triumeq or Triumeq PD or any other abacavir-containing product, because more severe symptoms, including death, can occur within hours. Also: all patients with HIV-1 should be tested for hepatitis B virus (HBV) before or when starting. Lamivudine-resistant HBV variants have been reported, and severe acute exacerbations of hepatitis B have been reported in patients co-infected with HBV and HIV-1 who discontinued lamivudine; monitor liver function closely in these patients and, if appropriate, start anti-HBV treatment.

Who should be careful

Everyone must be screened for the HLA-B*5701 allele and tested for HBV before starting. It must not be used by HLA-B*5701-positive patients, people with a prior hypersensitivity reaction to abacavir, dolutegravir, or lamivudine, people receiving dofetilide, or people with moderate or severe liver impairment. Because it is a fixed-dose tablet that cannot be dose adjusted, the label says it is not recommended in patients with creatinine clearance below 30 mL/min, and it is not recommended for children under 3 months old or weighing under 6 kg. The label also notes it alone is not recommended in patients with resistance-associated integrase substitutions or clinically suspected INSTI resistance, because the dolutegravir dose in it is insufficient in those groups.

Major interactions

The label says coadministration with other drugs can change the levels of other drugs and other drugs can change the levels of Triumeq or Triumeq PD, and that potential drug-drug interactions must be considered before and during therapy. It is contraindicated with dofetilide because dolutegravir can increase dofetilide levels and the risk of serious or life-threatening events. The label also says that when certain UGT1A or CYP3A inducers are used, the dolutegravir dosage regimen should be adjusted. The label extract does not list further specific interacting drug classes. This is information only and is not personal medical advice.

Cost and saving notes

Triumeq is a brand-name HIV combination tablet, and the package for this drug does not list a generic version of this exact three-drug combination, so do not expect a generic substitute for it. If a plan places it on a higher tier, a tier exception can be requested when the prescriber shows a lower-tier treatment would not work as well. People with limited income may qualify for Extra Help, the Part D Low-Income Subsidy, which lowers premiums and drug costs. Part D also has an annual cap on out-of-pocket drug spending, after which costs drop for the rest of the year.

Why it is in its tier

Abacavir / dolutegravir / lamivudine (Triumeq) sits on Tier 4 in 73.45% of the plans that list it (4036 of 5495 listing plans). Tier 4 is the non-preferred tier — higher copays or coinsurance. The data-visible drivers: It is a brand-only product with no generic version in the formulary data, and the CMS dashboard puts its average Part D spending at about $35,038 per beneficiary for 2024 — among the highest-cost drugs in the program, which matches where plans place it. It is listed by 100.0% of Part D plans. The tier shown is the most common one; individual plans vary.

Sources

• TRIUMEQ (ABACAVIR SULFATE, DOLUTEGRAVIR SODIUM, LAMIVUDINE) TABLET, FILM COATED TRIUMEQ PD (ABACAVIR SULFATE, DOLUTEGRAVIR SODIUM, LAMIVUDINE) KIT [VIIV HEALTHCARE COMPANY] — DailyMed
• MedlinePlus — National Library of Medicine
• MedlinePlus Drug Information

What official patient guides say

In daily life, MedlinePlus says this combination comes as a tablet taken by mouth, or tablets dissolved into a liquid, taken once daily with or without food at around the same time every day. For the tablets for suspension, MedlinePlus says they are dissolved in 15 to 20 mL of drinking water in the provided cup, swirled until fully dissolved, and swallowed completely within 30 minutes. If a dose is missed, MedlinePlus says to take it as soon as it is remembered unless it is almost time for the next dose, without doubling up, and the medicine should be stored at room temperature in its container, tightly closed, without removing the desiccant packet.

Source: MedlinePlus Drug Information

Part D formulary coverage

Source: CMS Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files — Monthly file 2026-10-15 (plan year 2027), file 2027_20261008.zip (data.cms.gov dataset ed1496ea-23e7-41f1-9292-172fa842ccfb): basic drugs formulary file + plan information file, both dated 20261031 inside the zip; downloaded and aggregated 2026-10-30. Medication RxCUI sets resolved through the NLM RxNav (RxNorm) API.

What you pay

Without insurance, the cash benchmark is 130.08188 per unit (TRIUMEQ 600-50-300 MG TABLET) — about nan for 30 units. NADAC benchmark — the average price pharmacies pay (CMS, as of 2026-11-04). Pharmacy shelf prices vary.

A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.

Sources: CMS Plan Benefit Package + formulary data; CMS NADAC · Checked 2026-11-07

Coverage by plan and tier

Of the 5,495 Medicare drug plans we track for 2027, 5,495 list Abacavir / dolutegravir / lamivudine (Triumeq) — 100% of plans. Most of those plans put it on Tier 4: 4,036 plans, 73.5% of the plans that list it. Other plans place it on Tier 5 (959 plans), Tier 3 (376 plans) or Tier 1 (123 plans). For example: Aetna Medicare Dual Extra (HMO D-SNP) puts it on Tier 5; Aetna Medicare Dual Extra Care (PPO D-SNP) puts it on Tier 5; Aetna Medicare Value Plus (PPO) puts it on Tier 5. You can compare these plans side by side on our Medicare Advantage hub. A tier is not a price. What you pay also depends on whether you have met your plan';s deductible, whether the drug costs a flat copay or a share of the price, and whether you get Extra Help or Medicaid.

Read next

• Part D in 2027: The $700 Deductible, the $2,400 Cap, and the $35 Insulin Rule
• Extra Help in 2027: Lower Drug Copays and Who Qualifies
• Checking Medicare Savings Programs and Extra Help

Part D spending averages (2024)

Source: CMS Medicare Part D Spending by Drug (Drug Spending Dashboard), release RY26 P04 V10, data through 2024 (DSD_PTD_RY26_P04_V10_DY24_BGM.csv), downloaded 2026-10-30

Companies covering this drug

Part D and Medicare Advantage plan sponsors that list this drug on a formulary, 50 at a time.