Liverpool HIV Interactions

Interaction Checker

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No Interaction Expected

Lopinavir/ritonavir (LPV/r)

Dolutegravir (DTG)

Quality of Evidence: Low

Summary:

Lopinavir/ritonavir has no clinically significant effect on the pharmacokinetics of dolutegravir. Coadministration of lopinavir/ritonavir (400/100 mg twice daily) and dolutegravir (30 mg once daily had no effect on dolutegravir Cmax, and decreased AUC and Ctrough by 3% and 6%. Coadministration with lopinavir/ritonavir and etravirine had no significant effect on dolutegravir exposure (AUC, Cmax and Ctrough increased by 10%, 7% and 28%, respectively). When compared to historical data, dolutegravir did not appear to affect the pharmacokinetics of lopinavir or ritonavir. No dose adjustment is necessary.

Description:

Coadministration with lopinavir/ritonavir had no significant effect on dolutegravir exposure (AUC and C24 decreased by 4% and 6%, with no change in Cmax). Coadministration with lopinavir/ritonavir and etravirine had no significant effect on dolutegravir exposure (AUC, Cmax and Ctrough increased by 10%, 7% and 28%, respectively). There was no effect on lopinavir or ritonavir exposure. No dose adjustment is necessary.

Tivicay Summary of Product Characteristics, ViiV Healthcare, March 2019.

Lopinavir/ritonavir had no clinically significant effect on the pharmacokinetics of dolutegravir. Coadministration of lopinavir/ritonavir (400/100 mg twice daily) and dolutegravir (30 mg once daily) to 15 subjects had no effect on dolutegravir Cmax, and decreased AUC and Ctrough by 3% and 6%. Using cross-study comparisons to historical pharmacokinetic data, dolutegravir did not appear to affect the pharmacokinetics of lopinavir or ritonavir.

Tivicay US Prescribing Information, Viiv Healthcare, July 2019.

Coadministration of dolutegravir (30 mg once daily) and lopinavir/ritonavir (400/100 mg twice daily) was studied in 15 HIV-negative subjects. Coadministration had no significant effects on dolutegravir pharmacokinetics (no change in Cmax, 3% decrease in AUC, 2% increase in Ctrough). The authors recommend no dose adjustment when dolutegravir is coadministered with lopinavir/ritonavir. Note, this study was performed with a dose of dolutegravir lower than the licensed one

The effect of lopinavir/ritonavir and darunavir/ritonavir on the HIV integrase inhibitor S/GSK1349572 in healthy participants. Song I, Min SS, Borland J, et al. J Clin Pharmacol, 2011, 51: 237-242.

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