No pharmaceutical opinion available for this interaction.
Carbamazepine may induce the metabolism (UGT 1A1 and CYP3A) and decrease the plasma concentration of Dolutegravir.
UGT1A1 (51%), CYP3A (21%), UGT1A9 (6%) and UGT1A3 (3%); P-gp, BCRP (in vitro)
OCT2 and MATE 1
Possible decrease of clinical efficacy.
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.
3A4 (main), 2C8, 1A2; Active metabolite: epoxide hydrolase (CBZ-10,11- epoxide)
3A4 (potent), 2C9, 2C19, P-gp, UGT and possibly 1A2
Gabapentin, pregabalin, valproic acid, clobazam, levetiracetam, topiramate, lacosamide, clonazepam or lamotrigine.
Dolutegravir plasma level
Viral load HIV
|100-300 mg *|
Ref #3054 : * Carbamazepine dose selection was based on consideration of the range of carbamazepine clinical doses as well as risk-benefit in studying in healthy subjects.
Dolutegravir co-administered with carbamazepine were well tolerated; both AEs leading to subject withdrawal occurred with carbamazepine alone, without dolutegravir.
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.