Dolutegravir versus Nevirapine
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Study Design
In an open-label study, 10 adult HIV-infected subjects on stable abacavir/lamivudine (ABC/3TC 600/300 mg daily) and nevirapine (NVP 400 mg daily) received dolutegravir (DTG 50mg daily) for 5 days.1 NVP was then discontinued while DTG (50 mg daily) and ABC/3TC (600/300 mg daily) were continuously administered for 2 weeks.
Study Results
When DTG (50 mg daily) was given with NVP (400 mg daily), DTG exposure (AUC) and plasma concentration at the end of the dosing interval (Ctrough) were significantly decreased by 19% [95% CI; 0.69, 0.94] and 34% [0.47,0.92], respectively, compared with DTG administered alone.1 Cmax remained relatively unchanged: 95% CI; 0.92 [0.83,1.02].
Study Conclusions
Concomitant use of NVP and DTG may decrease DTG plasma concentrations.1-3 Authors stated that a small subset of individuals would require a doubling of the dose of DTG with twice daily intake, should this combination be utilized.1 However, current NIH guidelines and the DTG (TivicayŽ) product monograph state that NVP and DTG should not be used concomitantly 2,3 as data are insufficient to make dosage recommendations.
References
Dailly E, Allavena C, Gregoire M, Reliquet V, Bouquie R, Billaud E, Jolliet P. Influence of nevirapine administration on the pharmacokinetics of dolutegravir in patients infected with hiv-1. Journal Of Antimicrobial Therapy. 2015; : .
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