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Updates to the Database of ARV Drug Interactions
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The following table summarizes recent additions to the HIV InSite Database of Antiretroviral Drug Interactions. For a full description of the updates, including references to the studies from which the data were derived, go to the database, click on a specific drug name, and search for the interacting agent.

Drug Interactions with Dolutegravir
Coadministered DrugClinical EffectsMechanismsManagement
Source: McNicholl I. HIV InSite Database of Antiretroviral Drug Interactions. University of California San Francisco: Center for HIV Information; 2013.
Antacids
Maalox given simultaneously with dolutegravir
Do not coadminister simultaneously; administer dolutegravir 2 hours before or 6 hours after antacids
Antacids
Maalox given 2 hours after dolutegravir
Potentially decreased dolutegravir effectivenessAdminister dolutegravir 2 hours before or 6 hours after antacids
Atazanavir
300 mg QD with ritonavir 100 mg QD
No dosage adjustment necessary
Atazanavir
400 mg QD
Potentially decreased or increased elvitegravir, cobicistat and/or fosamprenavir effectsNo dosage adjustment necessary
BoceprevirNo dosage adjustment necessary
DarunavirNo dosage adjustment necessary
EfavirenzIncrease dolutegravir dosage to 50 mg BID
Ethinyl estradiol/norgestimateNo dosage adjustment necessary
Etravirine
200 mg BID with lopinavir/ritonavir 400/100 mg BID
No dosage adjustment necessary
Etravirine
200 mg BID
Potentially reduced dolutegravir effectivenessDo not coadminister etravirine with dolutegravir unless boosted atazanavir, darunavir, or lopinavir is used concomitantly
FosamprenavirNo dosage adjustment necessary
Lopinavir/ritonavirNo dosage adjustment necessary
MethadoneNo dosage adjustment necessary
MidazolamNo dosage adjustment necessary
Multiple vitaminPotentially decreased dolutegravir effectivenessAdminister dolutegravir 2 hours before or 6 hours after multiple vitamins
NorelgestrominNo dosage adjustment necessary
OmeprazoleNo dosage adjustment necessary
PrednisoneNo dosage adjustment necessary
RifabutinNo dosage adjustment necessary
Rifampin
600 mg QD
Decreased dolutegravir effectivenessUse dolutegravir 50 mg BID when coadministered with rifampin
RilpivirineNo dosage adjustment necessary
TelaprevirNo dosage adjustment necessary
TenofovirNo dosage adjustment necessary
TipranavirNo dosage adjustment necessary

Drug Interactions with Elvitegravir/Cobicistat
Coadministered DrugClinical EffectsMechanismsManagement
Source: McNicholl I. HIV InSite Database of Antiretroviral Drug Interactions. University of California San Francisco: Center for HIV Information; 2013.
AtazanavirPotentially decreased or increased elvitegravir, cobicistat and/or atazanavir effectsDo not coadminister
Darunavir
600 mg QD
800 mg QD
Potentially decreased or increased elvitegravir, cobicistat and/or darunavir effectsDo not coadminister
EtravirinePotentially decreased or increased elvitegravir, cobicistat and/or etravirine effectsDo not coadminister
FosamprenavirPotentially decreased or increased elvitegravir, cobicistat and/or fosamprenavir effectsDo not coadminister
Lopinavir/ritonavirPotentially decreased or increased elvitegravir, cobicistat and/or lopinavir effectsDo not coadminister
MidazolamPotentially increased midazolam effects (eg, prolonged sedation, altered mental status, respiratory depression)Do not coadminister oral midazolam; parenteral midazolam can be used with caution as a single dose
NevirapinePotentially decreased or increased elvitegravir, cobicistat and/or nevirapine effectsDo not coadminister
RifabutinIncreased rifabutin effectsDo not coadminister; consider alternative antiretrovirals
RosuvastatinIncreased rosuvastatin effectsUse with caution

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