Abacavir, dolutegravir, and lamivudine and Rifadin

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

RifAMPin may reduce the blood levels of dolutegravir, which may make the medication less effective in treating HIV infection. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Contact your doctor if your condition worsens or you develop new infections during treatment with these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

ADJUST DOSE: Coadministration with potent inducers of UGT1A and CYP450 3A4 isoenzymes such as rifampin may significantly decrease the plasma concentrations of dolutegravir, which is primarily metabolized by UGT1A1 with some contribution from CYP450 3A4. Dolutegravir is also a substrate of UGT1A3, UGT1A9, and P-glycoprotein in vitro. In 11 study subjects, administration of dolutegravir 50 mg twice daily with rifampin 600 mg once daily decreased dolutegravir peak plasma concentration (Cmax), systemic exposure (AUC) and trough plasma concentration (Cmin; 24 hours post-dose) by 43%, 54% and 72%, respectively, compared to administration without rifampin. However, when compared to dolutegravir taken at the normally recommended dosage of 50 mg once daily, coadministration of dolutegravir and rifampin at the aforementioned dosages increased dolutegravir Cmax, AUC and Cmin by 18%, 33% and 22%, respectively.

MANAGEMENT: When prescribed in combination with rifampin, the dosage of dolutegravir should be increased to 50 mg twice daily for both adults and pediatric patients 12 years of age and older who weigh at least 40 kg. The safety and efficacy of dosages above 50 mg twice daily have not been evaluated. For concomitant use of rifampin with fixed-dose combination products containing dolutegravir, it is recommended to administer an additional 50 mg daily dose of dolutegravir approximately 12 hours from the combination product. Alternatives to rifampin that are not metabolic inducers should be considered whenever possible for integrase strand transfer inhibitor (INSTI)-experienced patients with certain INSTI-associated resistance substitutions or clinically suspected INSTI resistance.

Abacavir, dolutegravir, and lamivudine

Generic Name: abacavir / dolutegravir / lamivudine

Brand name: Triumeq

Synonyms: Abacavir, Dolutegravir, and Lamivudine

What is Abacavir, dolutegravir, and lamivudine?

Rifadin

Generic Name: rifampin

Brand name: Rifadin, Rifadin IV, Rimactane

Synonyms: n.a.

What is Rifadin?