Dolutegravir

Rifapentin

Contraindicated.

No pharmaceutical opinion available for this interaction.

Mechanism

Rifapentin can induce the metabolism (CYP 3A4) and decrease the plasma concentration of Dolutegravir.

Dolutegravir

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Recommendations

Juluca : Concomitant administration contraindicated.

Alternative solution(s)

Rifapentin

Pharmacodynamic effects

Recommendations

Avoid association. Choose an alternative.

Alternative solution(s)

See rifabutin + dolutegravir and rifampin + dolutegravir.

Monitor

Tests

Pharmacokinetic parameters

Comment

Ref #3343 : This study was stopped prematurely due to serious toxicities, possibly related to high isoniazid exposure (67-92% higher than expected), observed in 2 of 3 subjects receiving 3 doses of weekly isoniazid/rifapentine (wHP) with once daily dolutegravir. Limited PK data from these subjects showed decreased dolutegravir exposure by 46% and Cmin values by 74% with wHP co-administration. Researchers suggest to avoid co-administration.

Reference
  • 3343
    Brooks KM, Pau AK, George JM, Alfaro R, Kellogg A et al. Early Termination of a PK Study Between Dolutegravir and Weekly Isoniazid/Rifapentine. CROI 2017, Seattle, WA USA, February 13-16 2017. Abstract #409a.
  • 3441
    Dolutegravir/Rilpivirine (Juluca), ViiV Healthcare ULC, Quebec, Canada, 5 fév. 2020.