Liverpool HIV Interactions

Interaction Checker

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Potential Interaction

Dolutegravir/Abacavir/ Lamivudine (DTG/ABC/3TC)

Antacids

Quality of Evidence: Very Low

Summary:

Coadministration with dolutegravir/abacavir/lamivudine has not been studied. Triumeq (dolutegravir/abacavir lamivudine) should be administered 2 hours before or 6 hours after taking medications containing polyvalent cations, such as antacids. Simultaneous coadministration of dolutegravir (50 mg once daily) and a magnesium/aluminium containing antacid (Maalox) decreased dolutegravir Cmax, AUC and Ctrough by 72%, 74% and 74%, respectively. When antacid was administered 2 hours after dolutegravir (50 mg once daily, n=16), dolutegravir Cmax, AUC and Ctrough decreased by 18%, 26% and 30%, respectively. No interaction is expected with abacavir or lamivudine. Coadministration with antacids containing calcium carbonate has not been studied.

Description:

Magnesium/aluminium-containing antacids should be taken well separated in time from the administration of Triumeq (minimum 2 hours after or 6 hours before). Coadministration of magnesium/aluminium-containing antacids and dolutegravir decreased dolutegravir AUC and Cmax by 74% and 72% due to complex binding to polyvalent ions.

Triumeq Summary of Product Characteristics, ViiV Healthcare, June 2019.

Simultaneous coadministration of antacid (Maalox) and dolutegravir (50 mg single dose) to 16 subjects decreased dolutegravir Cmax, AUC and Ctrough by 72%, 74% and 74%, respectively. When antacid was administered 2 hours after dolutegravir (50 mg single dose, n=16), dolutegravir Cmax, AUC and Ctrough decreased by 18%, 26% and 30%, respectively. Administer Triumeq 2 hours before or 6 hours after taking medications containing polyvalent cations.

Triumeq US Prescribing Information, ViiV Healthcare, May 2019.

Healthy volunteers (n=16) received dolutegravir (50 mg single dose) alone, or simultaneously administered with a liquid antacid (Maalox, single dose), or administered 2 hours before an antacid. Simultaneous coadministration decreased dolutegravir AUC, Cmax and Ctrough by 74%, 72% and 74%, respectively. With staggered administration, dolutegravir AUC, Cmax and Ctrough decreased by 26%, 18% and 30%, respectively. Dolutegravir should be administered 2 hours before or 6 hours after an antacid.

Pharmacokinetics of the HIV integrase inhibitor S/GSK1349572 co-administered with acid-reducing agents and multivitamins in healthy volunteers. Patel P, Song, I, Borland J, et al. J Antimicrob Chemother, 2011, 66: 1567-1572.

View all available interactions with Dolutegravir/Abacavir/ Lamivudine (DTG/ABC/3TC) by clicking here.