Hetvir 50 is dolutegravir 50 mg, an antiretroviral tablet used to treat HIV. It is an integrase inhibitor — one of the most effective classes available — and it is always taken with other HIV medicines, never on its own.
What is Hetvir 50?
Hetvir 50 contains dolutegravir 50 mg. The South African Medicine Price Registry lists it as a Schedule 4 film-coated tablet. (It appears twice, once with the ingredient duplicated — a data-entry artefact in the register rather than a double dose.)
Dolutegravir is an integrase strand transfer inhibitor, usually shortened to INSTI. To multiply, HIV must insert a copy of its genetic material into the DNA of the cell it has infected, using an enzyme called integrase. Dolutegravir blocks that step. The virus gets inside the cell but cannot establish itself there.
Three things make dolutegravir the backbone of modern HIV treatment in South Africa:
- It works quickly, bringing the viral load down faster than most older agents.
- It has a high barrier to resistance — the virus struggles to develop resistance to it, which matters enormously over a lifetime of treatment.
- It is well tolerated, with fewer of the side effects that made earlier regimens hard to stay on.
Dolutegravir 50 mg is the component in the fixed-dose combination TLD — tenofovir, lamivudine and dolutegravir in a single daily tablet — which is the standard first-line regimen in South Africa’s public sector. Hetvir 50 is that same dolutegravir supplied on its own, used where the other medicines are given separately, where a combination tablet does not suit, or where a doctor needs to adjust one part of a regimen independently.
What is Hetvir 50 commonly used for?
- Treating HIV-1 infection, in combination with other antiretrovirals. This is its only use.
- First-line treatment, most often alongside tenofovir and lamivudine.
- Second-line treatment, where a previous regimen has failed.
- Regimens needing individual components, including some cases of drug interaction, intolerance or resistance.
- Children and adolescents at appropriate weight bands, under specialist direction.
It must never be taken alone. HIV treatment always uses a combination, because a single medicine allows the virus to develop resistance. If you have been given dolutegravir on its own, there should be other antiretrovirals alongside it — check with your clinic if there are not.
It does not cure HIV. What it does, taken consistently, is suppress the virus to the point where it cannot be detected in the blood. That has two consequences worth stating clearly: your immune system recovers and stays healthy, and an undetectable viral load means HIV cannot be sexually transmitted. That is now well established, and it is one of the strongest reasons to take treatment every day without gaps.
How Hetvir 50 fits into this medicine category
| Class | Examples | How it works |
|---|---|---|
| Integrase inhibitors | Dolutegravir (Hetvir 50, Acriptega) | Blocks HIV inserting itself into cell DNA |
| NRTIs | Tenofovir, lamivudine, abacavir | Block the copying of viral genetic material |
| NNRTIs | Efavirenz, nevirapine, doravirine | Block the same enzyme by a different mechanism |
| Protease inhibitors | Lopinavir/ritonavir, atazanavir | Stop new viral particles maturing |
| Hepatitis antivirals | Tenofovir-containing products (Hetemcit) | Hepatitis B, and HIV where both are present |
| Herpes antivirals | Aciclovir | Herpes only — no effect on HIV |
A modern regimen combines classes so the virus is blocked at more than one point. See the HIV and antiviral medicines hub.
What to check before using Hetvir 50
Certain other medicines must be separated from it by hours, or avoided entirely. This is the most commonly missed practical point.
- Antacids, and supplements containing calcium, magnesium, iron or zinc, bind dolutegravir in the gut and can stop it working. Take dolutegravir at least two hours before, or six hours after these — or take them together with food, if your clinician advises that. This includes ordinary indigestion remedies and multivitamins bought without a thought.
- Rifampicin, used for TB, lowers dolutegravir levels substantially. It can be managed, but the dose must be adjusted by your doctor — never assume the usual dose is right while on TB treatment.
- Carbamazepine, phenytoin, phenobarbital and St John’s wort also reduce its levels.
- Metformin levels rise with dolutegravir; the metformin dose may need reducing.
Also tell your doctor if you:
- Have liver disease, or hepatitis B or C. Hepatitis B especially matters, because some HIV medicines also treat it, and stopping them can cause a dangerous flare.
- Have kidney problems.
- Are pregnant or planning pregnancy. Dolutegravir is now widely used in pregnancy in South Africa, but this should be a discussed decision.
- Are breastfeeding, or taking any other medicine, supplement or traditional remedy.
Practical points: take it at the same time every day, with or without food. If you miss a dose, take it as soon as you remember unless the next is nearly due — never double up. Do not run out; contact the clinic before your supply ends.
Possible cautions and when to ask a pharmacist or doctor
Common effects include headache, nausea, diarrhoea, difficulty sleeping, unusual dreams, tiredness and dizziness. Most settle within the first weeks. Some people gain weight on integrase inhibitors, which is worth raising with your clinician rather than stopping treatment over.
Seek medical attention for:
- A rash with fever, blistering, mouth ulcers, swollen glands or facial swelling — get emergency help. Serious hypersensitivity reactions are rare but real.
- Yellowing of the skin or eyes, dark urine, pale stools, or persistent right-sided abdominal pain — possible liver problems.
- New or worsening depression, anxiety, or thoughts of self-harm.
- Fever, swollen glands or new symptoms in the first weeks of treatment. As the immune system recovers it can react to infections that were previously silent — immune reconstitution inflammatory syndrome. It is treatable and is not a sign the medicine is failing.
Contact your clinic if you are struggling to take it every day, for any reason — side effects, work patterns, stigma, transport, cost. Missed doses are how resistance develops, and resistance is far harder to fix than a regimen that has been adjusted early. Clinics deal with this constantly and would far rather hear about it than see a rising viral load.
Do not stop taking it without medical advice, and do not share tablets with anyone.
Related medicine guides
Frequently asked questions
What is Hetvir 50 used for? Treating HIV-1 infection, in combination with other antiretroviral medicines. It contains dolutegravir 50 mg.
Can I take it on its own? No. HIV treatment always uses a combination. Taking one antiretroviral alone allows resistance to develop.
Is it the same as the TLD tablet? Dolutegravir is the “D” in TLD. Hetvir 50 is that component supplied separately, taken alongside the other medicines rather than in one combined tablet.
Can I take my antacid or multivitamin with it? Not at the same time. Antacids and calcium, magnesium, iron or zinc supplements can stop it working. Separate them by at least two hours before or six hours after, and ask your pharmacist.
Does it cure HIV? No. It suppresses the virus. Taken consistently it keeps the viral load undetectable, which protects your health and means HIV cannot be sexually transmitted.
What if I miss a dose? Take it as soon as you remember, unless your next dose is nearly due. Never take two at once. If you miss doses often, tell your clinic.
I’m on TB treatment — is the dose the same? Not necessarily. Rifampicin lowers dolutegravir levels and the dose usually needs adjusting. Tell whoever prescribes either medicine about the other.