https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=11399

Dolutegravir

Oxcarbazepine

Dosage adjustment is recommended.

No pharmaceutical opinion available for this interaction.

Mechanism

Oxcarbazepine may induce the metabolism (UGT 1A1 and CYP3A) and decrease the plasma concentration of Dolutegravir.

Dolutegravir

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Recommendations

Tivicay : Increase dolutegravir dose to 50 mg BID.

Triumeq or Dovato : Administer an additional dose of 50 mg dolutegravir 12 hours after Triumeq or Dovato.

Monitor for clinical efficacy.

Avoid combination in patients with resistance to integrase inhibitors.

Juluca : Concomitant administration contraindicated.

Alternative solution(s)

–

Oxcarbazepine

Pharmacodynamic effects

–

Recommendations

–

Alternative solution(s)

As clinically indicated : brivaracetam, clobazam, clonazepam, ethosuximide, gabapentin, lacosamide, lamotrigine, levetiracetam, pregabalin, rufinamide, stiripentol, tiagabine, topiramate, valproic acid, vigabatrin, zonisamide.

Monitor

–

Tests

Dolutegravir plasma level

CD4+

Viral load HIV

Pharmacokinetic parameters

–

Comment

See dolutegravir and carbamazepine.

Ref #3570: TDM data were evaluated 11 HIV-positive patients treated concomitantly with carbamazepine or oxcarbazepine and antiretrovirals for at least 3 months. All the TDM evaluations for carbamazepine and oxcarbazepine were within therapeutic ranges. Conversely, trough concentrations for dolutegravir demonstrated significantly lower values (- 83%) when compared with values usually measured in HIV-infected patients not treated with antiepileptic drugs.

Comment
Reference
  • 2868
    Dolutegravir (Tivicay), ViiV Soins de santé ULC, Quebec, Canada, 31 janv. 2020.
  • 3054
    Song I, Weller S, Patel J, Borland J, Wynne B et al. Effect of carbamazepine on dolutegravir pharmacokinetics and dosing recommendation. Eur J Clin Pharmacol 2016; 72: 665-670.
  • 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.
  • 3570
    Cattaneo D, Baldelli S, Cozzi V, Fusi M, Atzori C, et al. Drug-Drug Interactions Between Antiretrovirals and Carbamazepine/Oxcarbazepine: A Real-Life Investigation. Ther Drug Monit. 2020 Apr; 42(2): 330-334.