Selecting regimen and formulation for continuation

Clinical description

• Don’t change regimen without clear medical indication. Unnecessary changes spoil future

treatment options.

Do NOT change ART regimen:

• If a patient has moderate insomnia/headache after starting a regimen with DTG. However,

substitute with an alternative drug if symptoms have not disappeared after a month.

Change dosage and formulation:

• Review current weight for children and adjust dosing if necessary. (See Table 17 on page 70).
• Start a new ART Patient Card – Adult ARV Formulations for children who change from paediatric to

adult ARV formulation. File together with the old card.

Change ART regimen:

• Use Table 16 on page 68 to select the appropriate alternative regimen. Change patients with

significant side-effects immediately. Change patients with troubling side-effects that did not improve after 2 months of symptomatic treatment.

• Adjust regimen and formulation according to current weight:

o Transition all children on regimen 9P to 15PP o Move to 15PA when they reach 20kg o Move to 15A when they reach 25kg o Move to 13A once they weigh over 30kg. This is to reduce the pill burden and benefit from optimised treatment regimens.

• Add any new regimen to the ART Regimens history section on the card header and specify any non-

standard regimen here.

• Multiple contraindications / side-effects may require NS regimen (see Section 14.3 on page 71)