| Interaction Color Code | Clinical Bottom Line | Clinical Effects | Drug 1 effect | Drug 2 dose | Drug 2 effect | Management | |
|---|---|---|---|---|---|---|---|
| Rilpivirine (IM) Metformin | Green: Administer standard doses | Administer standard doses | |||||
| Dolutegravir Metformin 86 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of metformin | Potential increased adverse effects from metformin (e.g. GI side effects). |
Not studied |
500 mg BID | Cmax increased 66%, AUC increased 79%, Cmin increased 9% when given with dolutegravir once daily. If given with dolutegravir 50 mg BID, then metformin Cmax increased 111%, AUC increased 145%, and Cmin increased 14% |
Limit metformin dose to 1,000 mg per day. When starting / stopping DTG in patient on metformin, dose adjustment of metformin may be necessary to maintain optimal glycemic control and / or minimize GI symptoms. |
| Bictegravir Metformin 66 | Green: Administer standard doses | Administer standard doses | Potential increase in metformin adverse effects (gastrointestinal) |
Not reported |
500 mg BID | Cmax inccreased 28%, AUC increased 39%, Cmin increased 36% |
