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 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)

Phenytoin

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.

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.