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Do Not Coadminister

Darunavir/Cobicistat/ Emtricitabine/Tenofovir alafenamide (DRV/c/FTC/TAF)

Dolutegravir/Lamivudine/ Tenofovir-DF (DTG/3TC/TDF; TLD)

Quality of Evidence: Very Low

Summary:

Dolutegravir/lamivudine/tenofovir-DF and Symtuza (darunavir, cobicistat, emtricitabine, tenofovir alafenamide) are both indicated for use as complete regimens for the treatment of HIV-1 infection and should not be administered with other antiretroviral products. Furthermore, Symtuza contains emtricitabine and tenofovir alafenamide and must not be administered with products containing lamivudine and tenofovir-DF.

Description:

Dolutegravir, lamivudine and tenofovir disoproxil fumarate tablets should not be co-administered with emtricitabine, due to the similarity between emtricitabine and lamivudine, and consequently expected additive toxicity and no benefit in efficacy. Dolutegravir, lamivudine and tenofovir disoproxil fumarate tablets should not be administered with any other medicines containing tenofovir alafenamide.
Dolutegravir, Lamivudine, and Tenofovir Disoproxil Fumarate Tablets WHOPAR part 4, Strides Pharma Ltd, August 2024.

No effect on the pharmacokinetic parameters of emtricitabine was observed with tenofovir-DF. Coadministration of tenofovir-DF (300 mg once daily) and emtricitabine (200 mg once daily for 7 days) had no effect on emtricitabine AUC and Cmax but Cmin increased by 20% (n=17).
Dolutegravir, Lamivudine, and Tenofovir Disoproxil Fumarate Tablets Prescribing Information, Strides Pharma Inc, September 2023.

Symtuza should not be administered concomitantly with medicinal products containing lamivudine or tenofovir disoproxil (as fumarate, phosphate or succinate).
Symtuza Summary of Product Characteristics, Janssen-Cilag Ltd, June 2023.

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