What to Do When You Can't Fill Your Tivicay Prescription

If your pharmacy can't fill your Tivicay (Dolutegravir) prescription, you need options — fast. Gaps in HIV treatment can lead to viral rebound and even drug resistance, so finding an alternative quickly matters.

In this post, we'll explain what Tivicay is, how it works, and walk through real alternatives your doctor may consider if Tivicay isn't available.

Important: Never switch HIV medications on your own. All changes should be made with your healthcare provider based on your viral load, resistance testing, and overall treatment history.

What Is Tivicay?

Tivicay is the brand name for Dolutegravir, a prescription medication used to treat HIV-1 infection in adults and children. It belongs to a class of drugs called integrase strand transfer inhibitors (INSTIs). Tivicay is manufactured by ViiV Healthcare.

It's taken as a 50 mg tablet once daily (or twice daily in some situations) as part of a combination antiretroviral therapy regimen. Tivicay is not a standalone treatment — it must be used with other HIV medications.

How Does Tivicay Work?

Dolutegravir works by blocking HIV integrase, an enzyme the virus needs to insert its genetic material into your cells' DNA. By preventing this step, the virus can't replicate and your viral load drops. When taken consistently as part of a full regimen, Tivicay helps keep HIV suppressed to undetectable levels.

Alternatives to Tivicay

If you can't get Tivicay, there are several other medications in the same class or containing Dolutegravir in combination form. Here are the most common alternatives your doctor may consider:

1. Dovato (Dolutegravir + Lamivudine)

Dovato is a complete two-drug HIV regimen in a single pill. It actually contains Dolutegravir (the same active ingredient in Tivicay) combined with Lamivudine, a nucleoside reverse transcriptase inhibitor (NRTI). If your issue is finding standalone Tivicay, Dovato may be a practical solution because it includes Dolutegravir and may be easier to find as a high-volume combination product.

• Dosing: One tablet once daily
• Best for: Treatment-naive adults or those switching from a stable regimen with no history of treatment failure
• Cash price: Around $2,800–$3,200/month

2. Biktarvy (Bictegravir + Emtricitabine + Tenofovir Alafenamide)

Biktarvy is the most commonly prescribed first-line HIV medication in the United States. It contains Bictegravir, a second-generation INSTI similar to Dolutegravir. Biktarvy is a complete single-tablet regimen, meaning you don't need to take any other HIV medications with it.

• Dosing: One tablet once daily
• Best for: Treatment-naive patients or those switching from a stable regimen
• Cash price: Around $3,500–$3,800/month

3. Isentress (Raltegravir)

Isentress was the first INSTI approved by the FDA. While it's an older medication compared to Dolutegravir, it's still effective and is now available as a generic in the U.S., which can make it more affordable and accessible.

• Dosing: 400 mg twice daily (or 1200 mg once daily with Isentress HD)
• Best for: Patients who need an INSTI and prefer a generic option or have specific drug interaction concerns
• Cash price: Generic Raltegravir is significantly cheaper, around $800–$1,200/month

4. Cabenuva (Cabotegravir + Rilpivirine) — Injectable Option

Cabenuva is a long-acting injectable regimen that completely eliminates daily pills. It contains Cabotegravir (another INSTI) plus Rilpivirine and is given as two intramuscular injections once a month or every two months at a healthcare facility.

• Dosing: Monthly or every-2-month injections
• Best for: Virologically suppressed patients who want to stop taking daily pills
• Note: Requires an oral lead-in period and regular clinic visits for injections

How to Talk to Your Doctor About Switching

Before switching from Tivicay to any alternative, your provider will consider:

• Your current viral load and CD4 count
• Any history of drug resistance
• Other medications you're taking (drug interactions)
• Side effect profile of each option
• Insurance coverage and cost

If you're considering a switch due to availability, bring that up at your appointment. Your doctor can help you find the best alternative while keeping your treatment on track.

Final Thoughts

Not being able to fill your Tivicay prescription is frustrating, but there are solid alternatives available. Whether it's a combination product like Dovato (which contains Dolutegravir), a different INSTI like Biktarvy, or even an injectable option like Cabenuva, your provider has options to keep your HIV treatment working.

Before exploring alternatives, try using Medfinder to see if Tivicay is available at a pharmacy near you. And if cost is a concern, check out our guide on how to save money on Tivicay.