Understanding drug interactions with Dolutegravir is essential for safe prescribing and optimal treatment outcomes.

Medications Affecting Absorption:
Antacids, calcium supplements, iron supplements, and multivitamins containing polyvalent cations can reduce Dolutegravir absorption. Take Dolutegravir 2 hours before or 6 hours after these products.

Acid-Reducing Agents:
H2 receptor antagonists should be taken at least 12 hours before or 4 hours after Dolutegravir. Proton pump inhibitors may reduce Dolutegravir levels.

Rifampin:
Rifampin significantly reduces Dolutegravir levels. When used together, increase Dolutegravir dose to 50mg twice daily.

Anticonvulsants:
Carbamazepine, phenytoin, and phenobarbital may reduce Dolutegravir levels. Alternative anticonvulsants or increased Dolutegravir dosing may be needed.

Metformin:
Dolutegravir increases metformin levels. Metformin dose adjustment may be necessary when starting or stopping Dolutegravir.

St. John Wort:
This herbal supplement significantly reduces Dolutegravir levels and should be avoided.

Other Antiretrovirals:
Most antiretroviral combinations with Dolutegravir are safe, but some require dose adjustments.

Management Strategies:
Careful medication review, patient education, timing adjustments, and monitoring help manage interactions effectively.