Dolutegravir

Rifabutin

No clinically significant interactions were observed.

No pharmaceutical opinion available for this interaction.

Mechanism

Dolutegravir

Pharmacodynamic effects

Recommendations

Tivicay, Triumeq ou Dovato : No dosage adjustment is necessary.

Juluca : Take 25 mg of rilpivirine with Juluca tablet during co-administration.

Alternative solution(s)

Rifabutin

Pharmacodynamic effects

Recommendations

Alternative solution(s)

Monitor

Tests

Pharmacokinetic parameters
Parameters
Reference number
# patients
HIV
Dose
Frequency
Duration (days)
AUC
Cmax
Cmin
Dolutegravir
2723
9
-
50 mg
QD
14
- 5%
+ 15%
- 30% *
Rifabutin
2723
9
-
300 mg
QD
14
 
 
 
Comment

Ref #2723 : * This decrease is unlikely to be clinically significant effect in integrase inhibitor-naive patients.

Ref #3662: To characterize the pharmacokinetics of dolutegravir when co-administered with rifabutin, this analysis includes data from two existing studies in a model describing the population pharmacokinetics of dolutegravir. Simulations showed that rifabutin decreased the volume of distribution of dolutegravir by 33.1%, but did not affect the area under the concentration-time curve. They also demonstrated that when 50 mg of dolutegravir is co-administered with rifabutin QD, the probability of achieving trough concentrations above the IC90 of 0.064 mg/L was greater than 99%.

Reference
  • 2723
    Dooley KE, Sayre P, Borland J, et al. Safety, tolerability, and pharmacokinetics of the HIV integrase inhibitor dolutegravir given twice daily with rifampin or once daily with rifabutin: results of a phase 1 study among healthy subjects. J Acquir Immune Defic Syndr, 2013, 62(1): 21-27.
  • 2869
    Dooley KE, Sayre P, Borland J, et al. Safety, tolerability, and pharmacokinetics of the HIV integrase inhibitor dolutegravir given twice daily with rifampin or once daily with rifabutin: results of a phase 1 study among healthy subjects. J Acquir Immune Defic Syndr. 2013 Jan; 62(1): 21–27.
  • 3662
    Kawuma AN, Wasmann RE, Dooley KE, Maartens G and P Denti. Drug-drug interaction between rifabutin and dolutegravir: A population pharmacokinetic model. Br J Clin Pharmacol. 2023 Mar; 89 (3): 1216-1221.
  • 2868
    Dolutegravir (Tivicay), ViiV Soins de santé ULC, Quebec, Canada, 31 janv. 2020.
  • 3120
    Dolutégravir/abacavir/lamivudine (Triumeq), ViiV Soins de santé ULC, Québec, Canada, 22 nov. 2021.
  • 3441
    Dolutegravir/Rilpivirine (Juluca), ViiV Soins de santé ULC, Quebec, Canada, 5 juillet 2023.
  • 3497
    Dolutegravir/Lamivudine (Dovato), ViiV Soins de santé ULC, Québec, Canada, 27 juin 2023.