Dosing and Drug Interactions

Dosing

A Complete Regimen Offering Convenient Dosing for Your Adult Patients

ONCE A DAY

TAKEN ANY TIME OF DAY

NO FOOD REQUIREMENTS

Drug Interactions

Established and Other Potentially Significant Drug-Drug Interactions

AVOID

Contraindicated
Dofetilide
Avoid Coadministration
Agent Recommendations

Oxcarbazepine

Phenobarbital

Phenytoin

St John's wort (Hypericum perforatum)

Avoid coadministration with DOVATO because there are insufficient data to make dosing recommendations
Sorbitol When possible, avoid use of sorbitol-containing medicines with DOVATO
  • Because DOVATO is a complete regimen, coadministration with other ARVs for the treatment of HIV-1 infection is not recommended

ARVs=antiretrovirals.

CONSIDERATIONS

Dosing Adjustments and Considerations
Agent Recommendations
Certain UGT1A/CYP3A inducers: carbamazepine or rifampin An additional dolutegravir 50-mg dose should be taken, separated by 12 hours from DOVATO 
Medications containing polyvalent cations (eg, Mg or Al): cation-containing antacids or laxatives, sucralfate, or buffered medications

Administer DOVATO 2 hours before or 6 hours after taking medications containing polyvalent cations

Oral calcium or iron supplements, including multivitamins containing calcium or iron
When taken with food, DOVATO and supplements or multivitamins containing calcium or iron can be taken at the same time. Under fasting conditions, DOVATO should be taken 2 hours before or 6 hours after taking supplements containing calcium or iron    
Metformin
Refer to the prescribing information of metformin for assessing the benefit and risk of concomitant use of DOVATO and metformin
  • Please see Section 7 of the full Prescribing Information for additional drug interaction information

Al=aluminum; Mg=magnesium.

NO ADJUSTMENTS

Dolutegravir and Lamivudine, Components of DOVATO, Have No Clinically Relevant Effects on the Pharmacokinetics of the Following Agents
Based on available pharmacokinetics drug interaction studies
  • Prednisone
  • Midazolam
  • Rifabutin
  • Oral contraceptives containing norgestimate* and ethinyl estradiol
  • Proton pump inhibitors (omeprazole)
Based on pharmacokinetics, metabolic pathways, and/or available drug interaction studies

Hepatitis C drugs, including1,2:

  • Sofosbuvir
  • Ledipasvir/sofosbuvir3
  • Simeprevir4
  • Elbasvir/grazoprevir5
  • Daclatasvir plus sofosbuvir
  • Ombitasvir/paritaprevir/r plus dasabuvir6
  • Sofosbuvir/velpatasvir
  • Sofosbuvir/velpatasvir/voxilaprevir7
  • Glecaprevir/pibrentasvir8

*Norelgestromin is the active metabolite of norgestimate and no drug interaction is expected with norgestimate.9

References:

  1. US Department of Health and Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV. AIDSinfo website. https://aidsinfo.nih.gov/contentfiles/lvguidelines/adultandadolescentgl.pdf. Accessed April 1, 2019.
  2. American Association for the Study of Liver Diseases and Infectious Diseases Society of America. HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C. https://www.hcvguidelines.org/unique-populations/hiv-hcv. Updated May 24, 2018. Accessed April 1, 2019.
  3. Harvoni [package insert]. Foster City, CA: Gilead Sciences, Inc.; November 2017. 
  4. Olysio [package insert]. Titusville, NJ: Janssen Therapeutics; November 2017.
  5. Zepatier [package insert]. Whitehouse Station, NJ: Merck & Co, Inc.; June 2018.
  6. Viekira Pak [package insert]. North Chicago, IL: AbbVie, Inc.; July 2018.
  7. Vosevi [package insert]. Foster City, CA: Gilead Sciences, Inc.; November 2017.
  8. Mavyret [package insert]. North Chicago, IL: AbbVie, Inc.; August 2018.
  9. Song IH, Borland J, Chen S, Wajima T, Peppercorn AF, Piscitelli SC. Dolutegravir has no effect on the pharmacokinetics of oral contraceptives with norgestimate and ethinyl estradiol. Ann Pharmacother. 2015;49(7):784–789.

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