If you have been prescribed REYDIN this medicine is used to treat HIV-1 infection in adults over 18 years of age. It is a combination tablet, which means three HIV medicines are combined into one film-coated tablet.
Quick facts: REYDIN is a Schedule 4 medicine in South Africa. It is taken once a day by mouth, with or without food, and it should be started by a healthcare professional who is experienced in managing HIV infection. It is not suitable for everyone, and there are important warnings about pregnancy, liver problems, kidney problems, lactic acidosis, and medicine interactions.
What it is and what it is used for
REYDIN contains three active ingredients:
- Lamivudine 300 mg
- Tenofovir disoproxil fumarate 300 mg
- Dolutegravir 50 mg
It comes as a film-coated tablet.
This medicine is used to treat Human Immunodeficiency Virus-1 (HIV-1) in adults older than 18 years.
REYDIN is not indicated for the treatment of chronic hepatitis B virus (HBV) infection. The source also states that its safety and effectiveness have not been established in people who have both HBV and HIV.
How it works
REYDIN helps to treat HIV-1 by combining three active ingredients in one tablet. In everyday terms, this combination works against the virus so that treatment can help control HIV in your body.
It is important to understand that REYDIN is a treatment for HIV, but it does not reduce the risk of passing HIV to others through sexual contact or blood contamination. You still need to keep taking the right precautions to protect other people.
Even while taking HIV treatment, you can still develop other infections and HIV-related complications, so regular follow-up with your doctor remains important.
Who should NOT use this medicine
Do not use REYDIN if you:
- are allergic to dolutegravir, lamivudine, tenofovir disoproxil fumarate, or any of the other ingredients in the tablet
- have kidney failure
- have liver disease
- are pregnant
- are breastfeeding
- are planning to become pregnant
- are a woman of child-bearing age who is not using effective contraception
- are taking heart medicines for an irregular heartbeat that contain dofetilide or pilsicainide
- are taking metformin for type 2 diabetes
- are taking hepatitis B treatment containing adefovir dipivoxil
- are taking another HIV medicine containing didanosine
- are younger than 18 years
Warning: REYDIN should also not be taken with other medicines that contain any of its active ingredients, namely:
- dolutegravir
- lamivudine
- tenofovir disoproxil fumarate
Warnings and precautions (Read before use)
Before you start taking REYDIN, and while you are on treatment, there are important things to watch out for.
Get medical advice urgently if you develop signs of an allergy
Tell your doctor straight away if you develop:
- a rash
- fever with rash
- a general feeling of being unwell
- tiredness
- muscle or joint aches
- sores or oral scrapes
- eye infection
- swelling of the face
- swelling of the skin
- signs of a serious liver infection
These may be signs of a serious allergic or hypersensitivity reaction.
Be alert for lactic acidosis and liver problems
The source includes a major warning that too much acid in the body due to lactic acid and a serious enlarged fatty liver, including fatal cases, have been reported with medicines of this type.
Tell your doctor if you develop symptoms such as:
- nausea
- vomiting
- abdominal pain
- feeling generally unwell
- loss of appetite
- weight loss
- rapid or deep breathing
- muscle weakness
You may be more likely to develop lactic acidosis if you:
- are female
- are very overweight (obese)
- have been on HIV medicines for a long time
Liver monitoring is especially important if hepatitis B is involved
REYDIN is not intended to treat chronic hepatitis B. The source says that if a person has both HIV and HBV and stops the combination tablet, they may develop a severe acute worsening of hepatitis B.
If you have both infections and stop REYDIN, your liver function should be closely monitored for at least several months by a healthcare professional. If needed, you may have to be prescribed treatment for hepatitis B.
Also tell your doctor if you:
- have liver problems, including hepatitis B or C
- develop signs of liver injury
The source states that antiviral medicine can cause serious and even fatal liver-related side effects in some people, and your doctor may monitor your liver enzymes.
Watch for infections when starting treatment
If you have advanced HIV infection, your immune system may be weak. Once treatment starts and your immune system begins to recover, older hidden infections can flare up and cause inflammation.
These may include signs such as:
- localised swelling
- redness
- heat in an area
- pain
The source describes this as a form of immune recovery reaction and advises you to contact your doctor if symptoms of infection appear.
Blood tests and monitoring may be needed
Tell your healthcare professional if you have:
- increased cholesterol
- high blood glucose
- high lactate levels
- insulin resistance
The source says your healthcare professional may do regular blood tests to check that your metabolic processes remain normal.
Kidney problems need special care
Tell your doctor if you:
- have kidney disease
- are taking medicines that can be toxic to the kidneys
The source also says older adults should use REYDIN with caution because liver and kidney function may be reduced.
Bone and joint problems can happen
Tell your healthcare professional if:
- you have had bone problems before
- you develop joint aches, joint pain, joint stiffness, or difficulty moving
The source says your doctor may check your bone mineral density or prescribe medicines to support it. It also notes that these joint symptoms may be linked to osteonecrosis.
Changes in body fat may occur
Some people taking REYDIN or other HIV medicines may notice changes in body fat, for example:
- more fat on the upper back and neck (“buffalo hump”)
- more fat in the breasts
- more fat around the trunk
- loss of fat from the legs, arms, or face
The source says the cause and long-term effects are not known at this time.
Pancreatitis is another concern
Tell your doctor if you develop stomach pain, especially if it may suggest pancreatitis (inflammation of the pancreas).
Children exposed before birth
The source says that if a child was exposed to treatment before birth, symptoms such as poor growth, muscle weakness, hearing or visual problems, learning difficulties, heart, liver or kidney disease, gastrointestinal or nervous system problems, loss of involuntary body functions, or dementia may suggest a mitochondrial disorder. This should be considered for any such child.
Driving and using machinery
REYDIN may cause:
- dizziness
- impaired concentration
- drowsiness
Do not drive or operate machinery until you know how the medicine affects you.
Alcohol
Not specified in the source.
Pregnancy, planning pregnancy, and breastfeeding
You should not take REYDIN if you are pregnant or breastfeeding.
You should also not take it if you plan on becoming pregnant, and women of child-bearing age should use effective contraception while taking REYDIN.
The source warns that REYDIN could seriously harm your unborn child if you become pregnant while on treatment or if you start it in the first few weeks of pregnancy.
If you are thinking about having a baby:
- do not stop REYDIN on your own
- do not stop using contraception until you have spoken to your healthcare professional
If you think you may be pregnant:
- go to your healthcare professional for a pregnancy test
- ask for advice about your future HIV treatment
- ask for a pregnancy management plan
Mothers should not breastfeed their infants while taking REYDIN.
Interactions
Always tell your doctor, pharmacist, or other healthcare professional about all medicines you are taking. This includes:
- prescription medicines
- over-the-counter medicines
- complementary medicines
- traditional medicines
Medicines that should not be taken with REYDIN
The source says REYDIN should not be used with:
- other products containing dolutegravir, lamivudine, or tenofovir
- heart medicines containing dofetilide or pilsicainide
- metformin
- hepatitis B medicines containing adefovir dipivoxil
- HIV medicines containing didanosine
Medicines that may lower REYDIN levels
These include:
- rifampicin
- efavirenz
- nevirapine
- ritonavir
- tipranavir
- combination HIV medicines containing fosamprenavir and ritonavir
- combination HIV medicines containing darunavir and ritonavir
- phenobarbitone
- phenytoin
- oxcarbazepine
- carbamazepine
- St John’s Wort
- some antacids containing magnesium, aluminium, or calcium
Practical advice: The source says REYDIN must be taken 2 hours before or 6 hours after products containing magnesium, calcium, iron, or aluminium.
Medicines whose levels may be increased by REYDIN
The source says REYDIN can increase the levels of:
- metformin
- dofetilide
- pilsicainide
- isoniazid
- atazanavir
- abacavir
- didanosine
If REYDIN is taken with didanosine, the source says you may need closer monitoring, and the didanosine dose may need to be reduced.
Medicines that need extra caution
Use caution if you take medicines that can damage the kidneys, for example:
- vancomycin
- aminoglycosides such as gentamycin, amikacin, tobramycin, neomycin
- amphotericin B
- foscarnet
- ganciclovir
- pentamidine
The source also says that taking REYDIN together with high doses of co-trimoxazole or trimethoprim should be avoided if you have a kidney condition or disease.
Medicines the source says are not affected
The source says REYDIN is not affected by and does not influence the levels of:
- emtricitabine
- lopinavir
- ritonavir
It also says REYDIN is not affected by and does not change the levels of:
- methadone
For hepatitis B treatment, the source says medicines containing ribavirin are not affected and do not alter REYDIN levels.
Food interactions
REYDIN can be taken with or without food.
How to take (Step-by-step)
Take REYDIN exactly as your healthcare professional has instructed.
Usual dose
The usual dose is:
- one tablet by mouth once daily
It can be taken:
- with food
- without food
Who can take it
REYDIN can only be used by:
- adults over 18 years of age
Important treatment advice
- Treatment should be started by a healthcare professional experienced in HIV care.
- Do not stop treatment early.
- Do not change your dose unless your healthcare professional tells you to.
- Do not share your medicine with anyone else.
Stopping early may:
- worsen your condition
- make your body resistant to the medicine
If you are also taking rifampicin
The source says that if you take tuberculosis treatment containing rifampicin, you should consult your healthcare professional.
If you miss a dose
The source gives one clear instruction:
- Do not take a double dose to make up for a forgotten dose.
Further missed-dose instructions are not specified in the source.
If you take too much
In the event of an overdose:
- consult your doctor or pharmacist
- if neither is available, contact the nearest hospital or poison control centre
Simple adherence reminders based on the source
Because REYDIN is taken once daily, it may help to:
- take it at the same time each day
- keep taking it for as long as your healthcare professional tells you
- check with your doctor or pharmacist if you are unsure how to take it
Dosing table
| Age or weight | Dose | Frequency | Maximum daily dose |
|---|---|---|---|
| Adults over 18 years | 1 tablet orally | Once daily | Not specified in the source |
| Children and adolescents under 18 years | Do not use | Not applicable | Not applicable |
Possible side effects
Not everyone gets side effects, but it is important to know what to look out for.
Serious — seek urgent help
Stop taking REYDIN and get urgent medical help if you develop:
- swelling of the hands, feet, ankles, face, lips, mouth, or throat
- difficulty swallowing
- difficulty breathing
- rash or itching
- fainting
- yellowing of the skin or eyes (jaundice)
The source says these may be signs of a serious allergic reaction.
Other serious reactions listed in the source include:
- bronchospasm
- fast or irregular breathing
- swelling around the face
- shortness of breath
- a sudden drop in blood pressure
Seek urgent help if you develop signs of hepatitis such as:
- tiredness
- nausea and vomiting
- stomach pain or discomfort, especially on the right side under the ribs
- clay-coloured stools
- loss of appetite
- mild fever
- dark urine
- joint pain
- jaundice
Also get urgent medical attention if you have symptoms of:
- lactic acidosis / hyperlactataemia
- kidney damage or kidney failure
- pancreatitis
- rhabdomyolysis
- immune reconstitution syndrome (IRS) at the beginning of treatment
For IRS, the source mentions symptoms such as:
- fever
- cough
- trouble breathing
- blurred vision
- painful swallowing
- weakness and numbness in the legs
- night sweats
- weight loss
- mouth ulcers or blisters
Common
The following side effects were reported frequently in the source:
- sleeplessness
- headache
- dizziness
- abnormal dreams
- diarrhoea
- nausea
- vomiting
- upper abdominal pain
- abdominal pain
- abdominal discomfort
- abdominal swelling
- cramps
- flatulence or wind
- loss of appetite
- indigestion
- rash
- itching
- hair loss
- tiredness
- feeling unwell
- fever
- lack of energy
- increase in liver enzymes in the blood
- muscle disorders
- painful joints
- muscle pain
- peripheral neuropathy (nerve damage affecting feeling or movement)
Less common or other important side effects listed in the source
Tell your healthcare professional if you notice symptoms linked to:
- neutropenia
- fever
- painful swallowing
- gingival pain
- skin abscesses
- painful ears
- anaemia
- tiredness
- unusually rapid heartbeat
- shortness of breath
- difficulty concentrating
- dizziness
- pale skin
- leg cramps
- sleeplessness
- blood clotting problems
- serious bleeding
- purple, red, or brown bruises
- red blood cell aplasia
- fatigue
- lethargy
- reduced exercise tolerance
- paleness
- lipodystrophy
- bigger waist or breasts
- fat around the neck, jaw, or upper back
- loss of fat under the skin of the face, arms, or legs
- more visible leg veins due to fat loss
- thrombocytopenia
- tiny red or purple spots on the skin
- bruising
- nosebleeds
- bleeding gums
- blood in urine or stool
- heavy menstrual periods
- pancreatitis
- stomach pain
- nausea
- vomiting
- abnormal urine tests
- rhabdomyolysis
- dark, red, or cola-coloured urine
- reduced urine output
- weakness
- muscle stiffness
- muscle pain
- muscle tenderness
- increased amylase levels
- severe abdominal pain
- loss of appetite
- fever
- nausea
- temporary increase in liver enzymes
- fatigue
- nausea
- anorexia
- discomfort over the liver area
- softening of bones, sometimes contributing to breaks
- kidney damage or kidney failure
- weakness
- shortness of breath
- confusion
- abnormal heart rhythm
- loss of appetite
- high blood pressure
Note: If your general health gets worse, or you notice any side effect not listed above, speak to your doctor, pharmacist, or other healthcare professional.
Storage and disposal
Store REYDIN:
- at or below 30 °C
- in the original container
- with the container tightly closed
Do not:
- store it in the bathroom
- throw unused medicine into drains or sewerage systems such as toilets
Keep all medicines:
- out of the reach and sight of children
Return unused medicine to your pharmacist.
Expiry guidance
Not specified in the source.
What the medicine contains
Active ingredients
Each REYDIN tablet contains:
- lamivudine 300 mg
- tenofovir disoproxil fumarate 300 mg
- dolutegravir 50 mg (as dolutegravir sodium)
Other ingredients
The source lists the following inactive ingredients:
- croscarmellose sodium
- hydroxypropyl methyl cellulose
- magnesium stearate
- mannitol
- microcrystalline cellulose
- opadry blue
- povidone
- sodium starch glycolate
The opadry blue coating contains:
- polyvinyl alcohol
- talc
- titanium dioxide
- indigo carmine
- glycerol esters of fatty acids
- sodium lauryl sulfate
- brilliant blue aluminium lake
Important excipient information
REYDIN contains:
- mannitol 145 mg (sugar)
The source also says mannitol may have a laxative effect.
Pack information and appearance
REYDIN is described as a:
- blue
- capsule-shaped
- biconvex
- film-coated tablet
It is debossed with:
- “C” on one side
- plain on the other side
Pack sizes
The source lists these pack sizes:
- 28 tablets in a white HDPE bottle with a white non-child-resistant cap, plus two 2 g silica gel bags, packed in a carton
- 30 tablets in an HDPE bottle with a white non-child-resistant cap, plus two 2 g silica gel bags, packed in a carton
South African registration details
- Scheduling status: S4
- Registration number: 52/20.2.8/0451.450
- Registration holder: CIPLA MEDPRO (PTY) LTD, Bellville, RSA
Practical FAQs (based ONLY on the source)
Can I take REYDIN with food?
Yes. The source says the usual dose is one tablet once daily, with or without food.
Can I take REYDIN if I am pregnant?
No. The source says do not take REYDIN if you are pregnant.
What if I want to fall pregnant?
You should not use REYDIN if you plan on becoming pregnant. Do not stop treatment or contraception on your own. Speak to your healthcare professional first.
Can I breastfeed while taking this medicine?
No. The source says mothers should not breastfeed while taking REYDIN.
Can I drive while taking REYDIN?
Possibly not at first. The source says REYDIN may cause dizziness, drowsiness, or impaired concentration, so do not drive or use machinery until you know how it affects you.
What should I do if I miss a dose?
The source says do not take a double dose to make up for the forgotten dose. Any further missed-dose advice is not specified in the source.
What should I do if I take too much?
Contact your doctor or pharmacist. If neither is available, go to the nearest hospital or contact a poison control centre.
Can I use antacids with REYDIN?
Be careful. The source says some antacids containing magnesium, aluminium, or calcium can lower REYDIN levels. REYDIN must be taken 2 hours before or 6 hours after products containing magnesium, calcium, iron, or aluminium.
Can I take REYDIN with my other HIV medicines?
Not always. The source says it should not be taken with other medicines containing dolutegravir, lamivudine, tenofovir disoproxil fumarate, or didanosine. It also lists several other HIV medicines that may interact, so your healthcare professional should review all your treatment.
Does REYDIN stop me from passing HIV to others?
No. The source clearly states that REYDIN does not reduce the risk of passing HIV to others through sexual contact or blood contamination.
Plain-language summary
If you are taking REYDIN, the most important points are that it is a once-daily HIV treatment for adults over 18, it must be taken exactly as prescribed, and you should not stop early. It can be taken with or without food, but it has important interactions with several medicines, especially some antacids, TB treatment, heart medicines, diabetes treatment, and certain other HIV medicines.
Seek medical help urgently if you develop signs of an allergic reaction, liver problems, lactic acidosis, kidney problems, or severe symptoms after starting treatment. Do not use REYDIN during pregnancy or breastfeeding, and speak to your healthcare professional before making any changes to your treatment.
