No pharmaceutical opinion available for this interaction.
Cations by chelation may reduce the absorption of Dolutegravir.
Primarily metabolized via UGT1A1 with some contribution from CYP3A. Renal elimination of unchanged drug was low (< 1% of the dose). UGT1A9 and 1A3, P-gp and BCRP (in vitro)
OCT2 and MATE 1
Possible decrease of clinical efficacy.
Tivicay, Triumeq or Dovato : If taken with food: it may be taken with calcium without spacing dose. If taken fasting: it must be taken 2 hours before or 6 hours after taking calcium.
Tivicay, Triumeq or Dovato : If dolutegravir is prescribed at 50 mg BID and dolutegravir resistance is demonstrated, avoid combination with calcium or iron supplement.
If combination can not be avoided taking dolutegravir with food should be preferred, perform dolutegravir plasma level monitoring and closely monitor clinical effectiveness.
Juluca : If taken with food: it may be taken with calcium without spacing dose. If taken fasting: it must be taken 4 hours before or 6 hours after taking calcium.
Monitor for clinical efficacy.
Dolutegravir plasma level
Viral load HIV
|50 mg||50 mg||50 mg|
|x 1 *||x 1 †||x 1|
|- 39%||+ 9%||- 6%|
|- 37%||+ 8%||- 10%|
|- 39%||+ 7%||± 0%|
|1200 mg||1200 mg||1200 mg|
|x 1 *||x 1 †||x 1 °|
Ref #2981 : * Administered simultaneously fasten; † Administered simultaneously with food; ° Calcium administered 2 hours after dolutegravir.
Co-administration of dolutegravir with calcium or iron under fed condition, or dosing dolutegravir 2 hours prior to the administration of these supplements yielded dolutegravir exposures similar to those when dolutegravir was given alone under fasted conditions.
However, taking vitamins (containing 162 mg of calcium, 100 mg of magnesium, iron, zinc and copper) had no clinically significant impact on the concentration of dolutegravir. For more details, see multivitamins + dolutegravir.