Comprehensive medication guide to Juluca including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$500 copay depending on plan tier; typically placed on Tier 4–5 (specialty) on most commercial and Medicare Part D plans. Prior authorization required by most insurers. ViiV Connect Savings Card can reduce commercially insured patient cost to as little as $0/month.
Estimated Cash Pricing
$5,000–$5,100 retail for a 30-tablet (one-month) supply; approximately $3,681 with a SingleCare or similar prescription discount card. No generic is available as of 2026.
Medfinder Findability Score
55/100
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Juluca is a prescription antiretroviral medication used to treat HIV-1 infection in adults. It contains two drugs — dolutegravir 50 mg (an integrase strand transfer inhibitor, or INSTI) and rilpivirine 25 mg (a non-nucleoside reverse transcriptase inhibitor, or NNRTI) — combined in a single pink, oval tablet taken once daily with a meal.
First approved by the FDA on November 21, 2017, Juluca was the first complete two-drug, single-pill, once-daily HIV regimen in the United States. It is manufactured by ViiV Healthcare in collaboration with Janssen (part of Johnson & Johnson). Juluca is not a first-line therapy for newly diagnosed patients — it is specifically designed as a switch regimen for adults who are already virologically suppressed (HIV-1 RNA below 50 copies/mL) and have been stable on another antiretroviral regimen for at least six months with no prior treatment failure.
Juluca's two-drug design eliminates the nucleoside/nucleotide reverse transcriptase inhibitor (NRTI) backbone found in most three-drug HIV regimens, reducing exposure to drugs like tenofovir and abacavir. This makes it a preferred option for patients with renal concerns, bone density issues, or those who want to minimize long-term NRTI exposure.
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Juluca works by simultaneously blocking two enzymes that HIV depends on to replicate inside the human body. HIV is a retrovirus that must convert its RNA into DNA (reverse transcription) and then insert that DNA into the host cell's chromosomes (integration) before it can reproduce and spread to other cells.
Rilpivirine — the NNRTI component — binds to reverse transcriptase and jams it, preventing HIV from converting its RNA into DNA. Without this step, the virus cannot establish infection in the cell. Dolutegravir — the INSTI component — blocks integrase, the enzyme that inserts viral DNA into the host genome. Even if some viral DNA is produced, dolutegravir prevents it from becoming permanently integrated, halting viral replication.
By targeting two completely different steps in HIV's lifecycle, Juluca makes it much harder for the virus to develop resistance — any mutation that helps HIV escape one drug would still be blocked by the other. Dolutegravir is particularly notable for its high genetic barrier to resistance, meaning HIV must accumulate many mutations to overcome it, which rarely happens in adherent patients.
50 mg / 25 mg — tablet
One tablet (dolutegravir 50 mg + rilpivirine 25 mg) taken once daily with a full meal. The only available dose.
Juluca is not listed on the FDA Drug Shortage Database as of 2026 — there is no manufacturer-level supply disruption. However, patients frequently encounter access barriers that make Juluca feel unavailable. As a specialty medication, Juluca is distributed primarily through specialty pharmacy networks rather than standard retail pharmacies.
Most retail chains like CVS and Walgreens do not stock Juluca at the standard retail level — it must be filled through their specialty pharmacy divisions (CVS Specialty, Walgreens Specialty) or through specialty mail-order services like Accredo or Optum Specialty. Prior authorization is also required by most insurance plans, which can delay fills by days to weeks if not proactively managed.
If you're struggling to find Juluca at a pharmacy near you, medfinder can help. You provide your medication, dosage, and location — medfinder calls pharmacies near you to check which ones can fill your prescription, then texts you the results. This saves patients hours of searching.
Juluca is not a controlled substance, so it can be prescribed by any licensed U.S. prescriber with a valid DEA registration — including physicians (MD/DO), nurse practitioners (NPs), and physician assistants (PAs) — as long as they are authorized to prescribe in their state. However, because Juluca requires careful patient selection (confirmed viral suppression, no prior treatment failure, specific resistance profile requirements), it is primarily prescribed by providers with HIV care expertise.
Infectious disease (ID) specialists — the primary prescribers of Juluca
HIV specialists (AAHIVS-certified providers)
Primary care physicians (PCPs) with HIV experience
Nurse practitioners and physician assistants with HIV clinical experience (prescriptive authority varies by state)
Juluca can also be prescribed through telehealth by qualified providers who review the patient's HIV history, recent viral load and CD4 results, and resistance testing. Telehealth platforms such as Folx Health, PlushCare, and Nurx offer HIV management services. Patients can use the AAHIVM HIV Care Directory at hivcare.org or Ryan White health centers (findahealthcenter.hrsa.gov) to locate HIV-experienced providers near them.
No. Juluca (dolutegravir/rilpivirine) is not a controlled substance. It is not scheduled by the Drug Enforcement Administration (DEA) and has no known abuse potential. There are no restrictions on prescription refills due to controlled substance regulations.
Juluca does require a valid prescription from a licensed healthcare provider. Because it is a specialty medication, prescriptions must typically be filled through specialty pharmacy channels. Prior authorization from insurance is required by most plans, but this is an insurance requirement — not a controlled substance restriction.
Most patients tolerate Juluca well. In pivotal clinical trials (SWORD-1 and SWORD-2), the following side effects were reported in at least 2% of participants:
Diarrhea (most common)
Headache
Nausea
Fatigue
Abdominal discomfort, flatulence
Decreased appetite
DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) — a rare but potentially life-threatening hypersensitivity reaction
Severe skin and hypersensitivity reactions
Liver problems (elevated liver enzymes; higher risk with hepatitis co-infection)
Depression and mood changes (including thoughts of self-harm — seek immediate care)
Immune reconstitution inflammatory syndrome (IRIS)
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Biktarvy
Bictegravir/emtricitabine/tenofovir alafenamide — three-drug once-daily single pill; widely available at retail pharmacies; no food requirement; approved for treatment-naive and switch patients
Dovato
Dolutegravir/lamivudine — two-drug regimen like Juluca but with lamivudine instead of rilpivirine; same manufacturer (ViiV Healthcare); approved for treatment-naive and virologically suppressed adults
Cabenuva
Cabotegravir/rilpivirine — monthly long-acting injectable; eliminates daily pills; requires clinic visits; same rilpivirine component as Juluca; approved for virologically suppressed adults
Triumeq
Abacavir/dolutegravir/lamivudine — three-drug regimen with same dolutegravir component; requires HLA-B*5701 testing before use; ViiV Healthcare; generic components available
Prefer Juluca? We can find it.
Proton pump inhibitors (omeprazole, pantoprazole, etc.)
majorContraindicated. PPIs reduce stomach acid, dramatically lowering rilpivirine absorption. Risk of treatment failure and resistance.
Dofetilide (Tikosyn)
majorContraindicated. Dolutegravir significantly increases dofetilide blood levels, causing risk of fatal cardiac arrhythmias.
Rifampin / Rifapentine
majorContraindicated. Strong CYP3A inducers that sharply reduce rilpivirine levels, causing treatment failure.
St. John's wort
majorContraindicated. Potent CYP3A inducer that reduces both dolutegravir and rilpivirine to subtherapeutic levels.
Carbamazepine / Phenytoin / Phenobarbital
majorContraindicated. CYP3A inducers that significantly reduce rilpivirine concentrations.
Metformin
moderateDolutegravir inhibits OCT2/MATE1 transporters, increasing metformin blood levels. Dose adjustment of metformin may be needed; monitor blood glucose closely.
H2 blockers (famotidine, cimetidine)
moderateCan be used with Juluca if taken at least 4 hours before or 12 hours after Juluca. Timing is critical.
Antacids (calcium, aluminum, magnesium-containing)
moderateTake Juluca at least 2 hours before or 6 hours after antacids or supplements with polyvalent cations. Cations bind dolutegravir and reduce absorption.
QT-prolonging medications
moderateRilpivirine can prolong the QT interval. Use caution when coadministering with other QT-prolonging drugs; consider ECG monitoring.
Rifabutin
moderateUnlike rifampin, rifabutin can be coadministered with Juluca, but requires addition of an extra 25-mg rilpivirine tablet (Edurant) once daily with food.
Juluca represents a meaningful advance in HIV treatment — a two-drug regimen that achieves viral suppression without the NRTI backbone, giving providers and patients an option that may better protect long-term kidney and bone health. Clinical trial data confirm its efficacy: 95% of patients remained virologically suppressed at 48 weeks in the pivotal SWORD studies.
Access remains the primary challenge. Juluca's specialty drug status, high retail price (~$5,000/month), and frequent prior authorization requirements mean that patients need proactive support from their providers and access to savings programs like the ViiV Connect Savings Card and ADAP. Commercially insured patients can often reduce their cost to $0/month with manufacturer assistance. Uninsured patients may receive Juluca at no cost through the ViiV Healthcare Patient Assistance Program or ADAP.
If you're having trouble finding Juluca at a pharmacy near you, medfinder can help — we call pharmacies near you to find which ones can fill your Juluca prescription, so you don't have to spend hours on hold. Your viral health is too important to let access barriers get in the way.
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