Darunavir/Ritonavir + Dolutegravir = Unknown or no reaction

Effect on Concentration

Darunavir/Ritonavir
No change
Applies within class?
No
Dolutegravir
No change
Applies within class?
No

Pharmacologic Effects

Darunavir/Ritonavir
Effect
N/A
Applies within class?
No
Dolutegravir
Effect
N/A
Applies within class?
No

Interaction History

N/A

Last Updated 20-Jul-2018

Summary

Sources

Darunavir/Ritonavir versus Dolutegravir ^

Study Design

N=10 HIV infected patients, mainly males (n=8), under good immunological status underwent a consecutive series of therapeutic drug monitoring of dolutegravir and darunavir. Patients were switched from darunavir/ritonavir (800/100mg/daily) to darunavir/cobicistat (800/150mg/daily) while also subsequently taking dolutegravir 50mg/daily as part of the antiretroviral therapy. Blood samples measured before visit 1 and after visit 2 had to be taken 24 hours after the last drug intake, immediately before drug administration. Drug concentrations were assessed by high performance liquid chromatography and UV detection. Comparisons between the two visits were performed by paired t-tests.

Study Results

The switch from ritonavir to cobicistat resulted in a 100% increase of dolutegravir trough concentrations, whereas there was no difference in darunavir concentrations. Concomitant administration of dolutegravir and cobicistat had no effect on serum creatinine concentrations.

Study Conclusions

This study confirms that a switch from ritonavir to cobicistat resulted in a comparable boosting effect on darunavir exposure. The study also found that cobicistat significantly increased dolutegravir trough concentrations in comparison to ritonavir.

References

Gervasoni, Riva, Capetti, Rizzardini. Increased dolutegravir exposure in hiv patient switched from ritonavir to cobicistat [abstract]. Conference On Retroviruses And Opportunistic Infections. Washington DC, USA. 2017; February 2017.