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Drug Interactions between dolutegravir and Ferrex 150 Forte

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

multivitamin with iron dolutegravir

Applies to: Ferrex 150 Forte (multivitamin with iron) and dolutegravir

ADJUST DOSING INTERVAL: Coadministration with medications containing polyvalent cations such as aluminum, calcium, iron, or magnesium may decrease the oral bioavailability of dolutegravir. The mechanism of interaction likely involves chelation of dolutegravir by the polyvalent cation in the gastrointestinal tract. In 16 study subjects, administration of a single 50 mg dose of dolutegravir simultaneously with an antacid containing magnesium and aluminum decreased dolutegravir peak plasma concentration (Cmax), systemic exposure (AUC) and trough plasma concentration (Cmin; 24 hours post-dose) by 72%, 74% and 74%, respectively, compared to administration without the antacid. When the antacid was administered 2 hours after dolutegravir, the Cmax, AUC and Cmin of dolutegravir decreased by just 18%, 26% and 30%, respectively. Administration of single-dose dolutegravir simultaneously with a multivitamin decreased the Cmax, AUC and Cmin of dolutegravir by 35%, 33% and 32%, respectively. Coadministration of dolutegravir with calcium carbonate or ferrous fumarate under fed conditions counteracted the interaction and provided plasma exposures comparable to dolutegravir alone under fasted conditions.

MANAGEMENT: Dolutegravir should be administered 2 hours before or 6 hours after medications containing polyvalent cations such as antacids, laxatives, or mineral supplements. When taken with food, dolutegravir and supplements or multivitamins containing calcium or iron can be taken at the same time.

References

  1. (2013) "Product Information. Tivicay (dolutegravir)." ViiV Healthcare
  2. (2019) "Product Information. Dovato (dolutegravir-lamivudine)." ViiV Healthcare
  3. (2024) "Product Information. Dovato (dolutegravir-lamivudine)." ViiV Healthcare UK Ltd
  4. (2024) "Product Information. Dovato 50/300 (dolutegravir-lamiVUDine)." ViiV Healthcare
View all 4 references

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Drug and food interactions

Moderate

multivitamin with iron food

Applies to: Ferrex 150 Forte (multivitamin with iron)

ADJUST DOSING INTERVAL: Concomitant use of some oral medications may reduce the bioavailability of orally administered iron, and vice versa.

Food taken in conjunction with oral iron supplements may reduce the bioavailability of the iron. However, in many patients intolerable gastrointestinal side effects occur necessitating administration with food.

MANAGEMENT: Ideally, iron products should be taken on an empty stomach (i.e., at least 1 hour before or 2 hours after meals), but if this is not possible, administer with meals and monitor the patient more closely for a subtherapeutic effect. Some studies suggest administration of iron with ascorbic acid may enhance bioavailability. In addition, administration of oral iron products and some oral medications should be separated whenever the bioavailability of either agent may be decreased. Consult the product labeling for specific separation times and monitor clinical responses as appropriate.

References

  1. "Product Information. Feosol (ferrous sulfate)." SmithKline Beecham
  2. (2021) "Product Information. Accrufer (ferric maltol)." Shield Therapeutics

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Minor

dolutegravir food

Applies to: dolutegravir

Food increases the extent of absorption and slows the rate of absorption of dolutegravir. When administered with a low-, moderate- or high-fat meal, dolutegravir peak plasma concentration (Cmax) increased by 46%, 52% and 67%, systemic exposure (AUC) increased by 33%, 41% and 66%, and time to reach Cmax (Tmax) increased from 2 hours to 3, 4 and 5 hours, respectively, compared to administration under fasted conditions. Dolutegravir may be taken with or without food.

References

  1. (2013) "Product Information. Tivicay (dolutegravir)." ViiV Healthcare

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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