Dolutegravir

Phenytoin

Dosage adjustment is recommended.

No pharmaceutical opinion available for this interaction.

Mechanism

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

Monitor for clinical efficacy.

Avoid combination in patients with resistance to integrase inhibitors.

Juluca : Concomitant administration contraindicated.

Alternative solution(s)

Phenytoin

Pharmacodynamic effects

Recommendations

Alternative solution(s)

Gabapentin, pregabalin, valproic acid, clobazam, levetiracetam, topiramate, lacosamide, clonazepam or lamotrigine.

Monitor

Tests

CD4+

Viral load HIV

Pharmacokinetic parameters

Comment

See dolutegravir and carbamazepine.

Reference
  • 2868
    Dolutegravir (Tivicay), ViiV Healthcare, Quebec, Canada, 27 août 2018.
  • 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 Healthcare, Québec, Canada, 27 août 2018.
  • 3441
    Dolutegravir/Rilpivirine (Juluca), ViiV Healthcare ULC, Quebec, Canada, 27 août 2018.