| Interaction Color Code | Clinical Bottom Line | Clinical Effects | Drug 1 effect | Drug 2 dose | Drug 2 effect | Management | |
|---|---|---|---|---|---|---|---|
| Dolutegravir Iron 96 | Yellow: Adjust dosing | Adjust dosing to avoid reduced levels of dolutegravir | Potential decrease in antiretroviral efficacy if given with iron. |
Cmax decreased 57%, AUC decreased 54%, Cmin decreased 56% when administered simultaneously with ferrous fumarate, fasting conditions. No significant change in dolutegravir Cmax or AUC if given simultaneously with ferrous fumarate, with food or if given 2 hours after ferrous fumarate. |
324 mg | Not studied |
Administer dolutegravir 2 hours before or 6 hours after taking medications containing polyvalent cations. Alternatively, administer dolutegravir simulatenously with iron supplements and with food. |
| Bictegravir Iron 65 | Yellow: Adjust dosing | Adjust dosing to avoid reduced levels of bictegravir | Potential decrease in antiretroviral efficacy |
If administered simultaneously in the fasted state Cmax decreased 71%, AUC decreased 63%. If administered simultaneously in the fed state Cmax decreased 25%, AUC decreased 16% |
324 mg single dose | Not reported |
Bictegravir should be administered simultaenously with iron supplements, with food. Monitor for virologic efficacy. |
