Drug Interaction with Dolutegravir
Medications for diabetes and epilepsy also have important drug interactions. Pregnant women with co-morbidities, e.g., diabetes or epilepsy are a high risk group who should be discussed with an expert/referred. INTERACTING DRUG EFFECT OF CO-ADMINISTRATION RECOMMENDATION Rifampicin ↓ Dolutegravir Increase DTG dose to 50 mg 12-hourly. If on TLD FDC, add DTG 50 mg 12 hours after TLD dose Polyvalent
Medications for diabetes and epilepsy also have important drug interactions.
Pregnant women with co-morbidities, e.g., diabetes or epilepsy are a high risk group who should be discussed with an expert/referred.
| INTERACTING DRUG | EFFECT OF CO-ADMINISTRATION | RECOMMENDATION |
| Rifampicin |
↓ Dolutegravir |
Increase DTG dose to 50 mg 12-hourly. If on TLD FDC, add DTG 50 mg 12 hours after TLD dose |
| Polyvalent cations (Mg2+, Fe2+, Ca2+, Al3+, Zn2+) e.g. antacids, sucralfate, multivitamin and nutritional supplements* | ↓ Dolutegravir | Calcium supplements decrease DTG concentrations if taken together on an empty stomach. To prevent this, DTG and calcium supplements can be taken at the same time if taken with food. Iron supplements decrease DTG concentrations if taken together on an empty stomach. To prevent this, DTG and iron supplements can be taken at the same time if taken with food. However, calcium and iron supplements must be taken at least 4 hours apart. Magnesium/aluminium containing antacids decrease DTG concentrations regardless of food intake and should be taken a mini |
| * Many over the counter (OTC) medications contain polyvalent cations. Clinicians should regularly ask clients about OTC medication use and advise about possible interactions. | ||
See also https://www.hivdruginteractions.org/ checker as a useful resource to check for drug interactions or the SA HIV/TB Hotline smart phone application
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South African National Department of Health, Guideline for Vertical Transmission Prevention of Communicable Infections, Version 2_August 2023