Bictegravir

Calcium (antacid)

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 calcium 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)

Calcium (antacid)

Pharmacodynamic effects

Recommendations

Alternative solution(s)

Monitor

Tests

CD4+

Viral load HIV

Pharmacokinetic parameters
Parameters
Reference number
# patients
HIV
Dose
Frequency
AUC
Cmax
Bictegravir
3392 3392
14 14
- -
50 mg 50 mg
x 1 x 1
- 33% + 3%
- 42% - 10%
Calcium (antacid)
3392 3392
14 14
- -
1200 mg * 1200 mg †
x 1 * x 1 †
   
   
Comment

Ref #3392 : * Simultaneous administration with bictegravir, fasted.
† Simultaneous administration with bictegravir, fed.

Reference
  • 3392
    Bictegravir/emtricitabine/tenofovir alafenamide (BIKTARVY), Gilead Sciences, Ontario, Canada, 28 février 2020.