Table 2.

Approved and investigational single-tablet regimens (STR)

Approved STR	HIV viral load/CD4 restrictions	Testing requirements	CrCl restrictions	Drug–drug interactions	Genetic barrier to resistance and dosing considerations
Dolutegravir/abacavir/lamivudine	None	HLA-B*5701a	CrCl <50 ml/min: use is not recommended	Carbamazepine, efavirenz, fosamprenavir/r, rifampin tipranavir/r: administer 50 mg PO BID Al, Ca, Fe, Mg containing products: administer DTG-containing product 2 h before or 6 h after. Alternatively, DTG and supplements with Ca or Fe can be taken together with food Metformin: limit daily dose of metformin to 1000 mg daily Etravirine: use not recommended unless administered with boosted-PI (atazanavir, darunavir, or lopinavir) Avoid use with nevirapine, oxcarbazepine, phenobarbital, phenytoin, St. John’s wort	High barrier to resistance May be taken with or without food
Darunavir/cobicistat/tenofovir alafenamide/emtricitabineb	None	None	CrCl <30 ml/min: use likely not recommended	Numerous interactions exist since DRV and COBI are metabolized by CYP3A4 Avoid use with alfuzosin, amiodarone, apixaban, carbamazepine, cisapride, dronedarone, ergot derivatives, lurasidone, oral midazolam, lovastatin, phenobarbital, phenytoin, quinidine, pimozide, ranolazine, rifampin, rivaroxaban, salmeterol, sildenafild, simvastatin, St. John’s wort, ticagrelor, triazolam	High barrier to resistance Recommended to take with food
Elvitegravir/cobicistat/tenofovir disoproxil fumarate/emtricitabine	None	None	CrCl <70 ml/min at initiation of therapy: Initial use is not recommended CrCl <50 ml/min during therapy: Continued use is not recommended	Numerous interactions exist since EVG and COBI are metabolized by CYP3A4c Al, Ca, Mg-containing antacids: separate by 2 h from antacid administration Avoid use with alfuzosin, carbamazepine, ergot derivatives, oral midazolam, lovastatin, phenobarbital, phenytoin, pimozide, rifampin, sildenafild, simvastatin, St. John’s wort, triazolam	Low-medium barrier to resistance Recommended to take with food
Elvitegravir/cobicistat/tenofovir alafenamide/emtricitabine	None	None	CrCl <30 ml/min: use is not recommended	Refer to section above	Low-medium barrier to resistance Recommended to take with food
Rilpivirine/tenofovir disoproxil fumarate/emtricitabine	Use is not recommended if: CD4 count <200 cells/mm3 OR HIV RNA >100,000 copies/ml	None	CrCl <50 ml/min: use is not recommended	Al, Ca, Mg-containing antacids: Administer antacids at least 2 h before or 4 h after RPV H2RA: Administer H2RA at least 12 h before RPV or at least 4 h after RPV Rifabutin: administer an additional 25 mg dose of RPV daily while on rifabutin Avoid use with carbamazepine, dexamethasone, oxcarbazepine, phenobarbital, phenytoin, rifampin, rifapentine, St. John’s wort	Low barrier to resistance Recommended to take with food (at least 400 kcal)
Rilpivirine/tenofovir alafenamide/emtricitabine	Use is not recommended if: CD4 count <200 cells/mm3 OR HIV RNA >100,000 copies/ml	None	CrCl <30 ml/min: Use is not recommended	Refer to section above	Low barrier to resistance Recommended to take with food (at least 400 kcal)
Efavirenz/tenofovir disoproxil fumarate/emtricitabine	None	None	CrCl <50 ml/min: use is not recommended	Numerous interactions exist since EFV induces CYP3A and CYP2B6c Once-daily fosamprenavir: add an additional 100 mg or RTV daily (for a total daily dose of 300 mg) Oral ethinyl estradiol/norgestimate or etonogestrel implant: a reliable method of barrier contraception must be used in addition to hormonal contraceptives. Methadone: monitor for signs of withdrawal Rifabutin: dose of rifabutin needs to be increased in the presence of EFV Rifampin: an additional dose of EFV 200 mg daily is needed Avoid use with atazanavir, lopinavir, and other NNRTIs Avoid use with voriconazole because the dose of EFV has to be reduced to 300 mg daily	Low barrier to resistance Take at bedtime on an empty stomach

Al aluminum, Ca Calcium, COBI cobicistat, CrCl creatinine clearance, DRV darunavir, DTG dolutegravir, EFV efavirenz, Fe iron, H ₂ RA histamine₂-receptor antagonist, Mg magnesium, NNRTI non-nucleoside reverse transcriptase inhibitor, PI protease inhibitor, RPV rilpivirine, r or RTV Ritonavir

^aAll patients should receive allele testing (HLA-B*5701) prior to initiating therapy to minimize the likelihood of a hypersensitivity reaction characterized by rash, fever, shortness of breath, and generalized malaise. If the patient tests positive for HLA-B*5701, abacavir-containing regimens should be avoided

^bCurrently an investigational drug

^cRefer to package insert for a complete listing of drug-drug interactions

^dWhen used for the treatment of pulmonary arterial hypertension