Coadministration has not been studied. Folic acid is metabolized to dihydrofolic acid and tetrahydrofolic acid with the aid of reduced diphosphopyridine nucleotide and folate reductases. A pharmacokinetic interaction is unlikely with folic acid itself. However, folic acid may be administered in a multivitamin preparation which may also contain polyvalent cations. Simultaneous coadministration of a multivitamin preparation decreased dolutegravir exposure by ~33%. Dolutegravir should be administered 2 hours before or 6 hours after medications containing polyvalent cations, such as multivitamin preparations. Medicinal products that reduce dolutegravir exposure (e.g. multivitamins) should be avoided in the presence of integrase class resistance.