Bictegravir

Aluminium / Magnesium hydroxide

Administration time adjustment is recommended.

No pharmaceutical opinion available for this interaction.

Mechanism

Cations by chelation may reduce the absorption of Bictegravir.

Bictegravir

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Recommendations

If bictegravir taken with food: it may be taken with antacids without spacing dose.

If bictegravir taken fasting: it must be taken ideally 2 hours before or 2 hours after taking antacids.

Monitor for clinical efficacy.

Alternative solution(s)

Aluminium / Magnesium hydroxide

Pharmacodynamic effects

Recommendations

Alternative solution(s)

Monitor

Tests

CD4+

Viral load HIV

Pharmacokinetic parameters
Parameters
Reference number
# patients
HIV
Dose
Frequency
AUC
Cmax
Bictegravir
3467 3467 3467 3467
14 13 13 14
- - - -
50 mg 50 mg 50 mg 50 mg
x 1 x 1 x 1 x 1
- 79% - 13% - 52% - 47%
- 80% - 7% - 58% - 49%
Aluminium / Magnesium hydroxide
3467 3467 3467 3467
14 13 13 14
- - - -
1600/1600 mg * 1600/1600 mg † 1600/1600 mg ° 1600/1600 mg ‡
x 1 * x 1 † x 1 ° x 1 ‡
       
       
Comment

Ref #3467 : * Simultaneous administration with bictegravir, fasted.
† Administered 2 h after bictegravir fasted.
° Administered 2 h before bictegravir fasted.
‡ Simultaneous administration with bictegravir with food.

Reference
  • 3392
    Bictegravir/emtricitabine/tenofovir alafenamide (BIKTARVY), Gilead Sciences, Ontario, Canada, 28 février 2020.
  • 3467
    Mathias A, Lutz J, West S, Xiao D, Chuck S et al. Pharmacokinetics (PK) of bictegravir (BIC) in combination with polyvalent cation containing (PVCC) antacids and supplements. HIV Drug Therapy, Glasgow, Scotland, 28-31 oct 2018, Abstract P206.