We have completed a review of the interactions between ARVs and the single tablet regimens (STRs) used to treat HIV. Many (but not all) of the product labels for the STRs state that the STR should not be coadministered with other ARVs and for this reason such interactions were coded as red on the interaction checker. We have now reassessed all the interactions as, in specific clinical situations where an intensification of HIV treatment is needed, coadministration with certain ARVs would be possible from a pharmacokinetic standpoint.
As all the STRs are indicated in their product labels for use as a complete regimen for the treatment of HIV, we felt this should be reflected in the coding and so none of the ARV/STR combinations are now coded as green. Combinations have been assessed on the basis of PK interactions, dose modifications, QT prolongation risks etc and for some previously coded as red are now coded as yellow or amber. Interactions have remained as red if coadministration may result in toxicity or a lack of clinical benefit, or if there is pharmacological reason not to coadminister.
The STRs on the interaction checker are:
- Biktarvy (bictegravir, emtricitabine, tenofovir alafenamide)
- Cabenuva (long acting cabotegravir/rilpivirine)
- Delstrigo (doravirine, lamivudine, tenofovir-DF)
- Dovato (dolutegravir/lamivudine)
- Genvoya (elvitegravir, cobicistat, emtricitabine, tenofovir alafenamide)
- Juluca (dolutegravir/rilpivirine)
- Odefsey (rilpivirine, emtricitabine, tenofovir alafenamide)
- Stribild (elvitegravir, cobicistat, emtricitabine, tenofovir-DF)
- Symtuza (darunavir, cobicistat, emtricitabine, tenofovir alafenamide)
- Triumeq (dolutegravir, abacavir, lamivudine)