OBJECT DRUGS

• Dolutegravir (Tivicay)

PRECIPITANT DRUGS

Binding Agents:

• Antacids
• Calcium supplements
• Iron
• Magnesium supplements
• Sucralfate (Carafate)

Comment:

Polyvalent cations may inhibit dolutegravir absorption. The reduction in dolutegravir bioavailability can be substantial; in one study magnesium-aluminum hydroxide antacid reduced dolutegravir absorption by 74%.

Class 3: Assess Risk & Take Action if Necessary

• Circumvent/Minimize: Minimize the interaction by giving dolutegravir 2 hours before or 6 hours after the binding agent.
• Monitor: If dolutegravir is administered with binding agents, monitor for reduced dolutegravir effect.