References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Juluca is a once-daily single tablet containing two HIV medicines: dolutegravir (an integrase inhibitor) and rilpivirine (a non-nucleoside reverse transcriptase inhibitor). It was the first two-drug, single-tablet regimen approved for HIV and is used as a switch option for people who are already virally suppressed on a standard three-drug regimen.
Here’s what Juluca does, who it’s suitable for, and what to be aware of.
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What’s in Juluca?
| Ingredient | Class | Role |
|---|---|---|
| Dolutegravir 50mg | Integrase strand transfer inhibitor | Stops HIV inserting into CD4 cell DNA |
| Rilpivirine 25mg | NNRTI | Blocks reverse transcriptase directly |
Who Can Take Juluca?
Juluca is for adults who:
- Have been virally suppressed (undetectable viral load) on a stable regimen for at least 6 months
- Have no history of treatment failure on dolutegravir or rilpivirine
- Have no known resistance to either drug
Juluca is a switch option only — it’s not approved for starting HIV treatment in someone who isn’t yet on ART.
How to Take Juluca
Take one tablet once daily with a meal. Food is important because rilpivirine needs food for proper absorption. Taking Juluca on an empty stomach can reduce drug levels and risk treatment failure.
Why Switch to Two Drugs?
- Reduces long-term drug exposure
- Can improve kidney and bone health by removing tenofovir
- Fewer potential side effects
- Simplifies the regimen
Side Effects
Juluca is generally well tolerated. Possible side effects include:
- Insomnia or vivid dreams
- Headache
- Fatigue
- Depressive symptoms in a small number of people
- Weight gain (associated with dolutegravir)
Important Drug Interactions
- Proton pump inhibitors (omeprazole, lansoprazole) — contraindicated with rilpivirine
- H2 blockers — take 12 hours before or 4 hours after Juluca
- Antacids — take 2 hours before or 4 hours after
- Rifampicin, carbamazepine, phenytoin — contraindicated
- St John’s Wort — avoid
The acid-reducing medication restrictions are the main practical consideration with Juluca.
Read more: Dovato | Biktarvy | What is HIV?
Frequently Asked Questions
Can I start HIV treatment on Juluca?
No. Juluca is only for people who are already virally suppressed on another regimen and want to switch to a simpler, two-drug option.
Can I take heartburn medication with Juluca?
Not proton pump inhibitors. H2 blockers can be used with careful timing. If you rely on acid-reducing medicines, Juluca may not be the right choice — discuss with your HIV team.
Is Juluca as effective as three-drug treatment?
Yes, in people who are already virally suppressed. Clinical trials showed Juluca maintained viral suppression just as well as continuing a three-drug regimen.
Related reading
- Efavirenz for HIV: An Older NNRTI Still in Use
- Eviplera: How This Anti-HIV Drug Works
- Dolutegravir: A Complete Guide to This HIV Medication
- Understanding Efavirenz in HIV Treatment
- Injectable HIV Treatment: Everything You Need to Know
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
