Table 1.
Key drug interactions of dolutegravir
| Interacting drug class | Interacting drug | Effect on dolutegravir or interacting drug concentration | Dose recommendation |
|---|---|---|---|
| Antiretrovirals | |||
| NRTIs | TDF | No significant effect was observed | No change in dose |
| NNRTIs | EFV | Significant reduction in DTG plasma concentration | Increase dose of DTG to 50 mg twice daily |
| ETR | Significant reduction in DTG plasma concentration | Do not administer DTG with ETR alone | |
| ETR/DRV/RTV | No significant effect was observed | DTG and ETR can be used only if DRV/r is also included in the regimen | |
| PIs | ATV/r | Increase in DTG plasma concentration | No change in dose |
| Acid-reducing agents | |||
| Bivalent cations including calcium, iron, or zinc supplements, or with vitamin-D supplements | Significant reduction in DTG plasma concentration, but no interaction with PPI | Administer antacids or bivalent containing supplements 2 h after or 6 h before DTG dosing | |
| Antituberculous agents | |||
| RIF | Significant reduction in DTG plasma concentration | Increase the DTG dosing frequency to 50 mg twice daily | |
| RBT | No significant effect was observed | No change in dose | |
| Oral contraceptives | |||
| Ortho-cyclen | No significant effect was observed | No change in dose | |
| Antihepatitis C virus agents | |||
| PIs | BCV | No significant effect was observed | No change in dose |
| TRV | No significant effect was observed | No change in dose | |
| Opioid agonist | |||
| Methadone | No significant effect was observed | No change in dose |
Abbreviations: ATV/r, atazanvir/ritonavir; BCV, boceprevir; DTG, dolutegravir; DRV/RTV, darunavir/ritonavir; EFV, efavirenz; ETR, etravirine; h, hour; NNRTIs, nonnucleoside reverse transcriptase inhibitors; NRTIs, nucleoside reverse transcriptase inhibitors; PIs, protease inhibitors; RBT, rifabutin; RIF, rifampin; TDF, tenofovir disoproxil fumarate; TRV, telaprevir.