https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=11402
https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=11402
No pharmaceutical opinion available for this interaction.
Carbamazepine may induce the metabolism (UGT 1A1 and CYP3A) and decrease the plasma concentration of Dolutegravir.
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.
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–
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As clinically indicated: valproic acid, brivaracetam, clobazam, clonazepam, ethosuximide, gabapentin, lacosamide, lamotrigine, levetiracetam, pregabalin, rufinamide, stiripentol, tiagabine, topiramate, vigabatrin, zonisamide.
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Dolutegravir plasma level
CD4+
Viral load HIV
| Reference number |
|---|
| # patients |
| HIV |
| Dose |
| Frequency |
| Duration (days) |
| AUC |
| Cmax |
| Cmin |
| T1/2 |
| 3054 |
|---|
| 14 |
| - |
| 50 mg |
| QD |
| 5 |
| - 49% |
| - 33% |
| - 73% |
| - 43% |
| 3054 |
|---|
| 14 |
| - |
| 100-300 mg * |
| BID |
| 5 |
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.