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Drug Interactions between abacavir / dolutegravir / lamivudine and Tikosyn

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

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Interactions between your drugs

Major

dofetilide dolutegravir

Applies to: Tikosyn (dofetilide) and abacavir / dolutegravir / lamivudine

CONTRAINDICATED: Coadministration with dolutegravir may increase the plasma concentrations of dofetilide. The proposed mechanism is dolutegravir inhibition of renal organic cation transporter (OCT2) and potentially multidrug and toxin extrusion transporter (MATE) 1. Dolutegravir has been shown in vivo to inhibit tubular secretion of creatinine by inhibiting OCT2. In vitro, dolutegravir inhibits both OCT2 and MATE1. Clinically, high plasma levels of dofetilide may increase the risk of QT interval prolongation, which has been associated with ventricular arrhythmias including torsade de pointes and sudden death.

MANAGEMENT: Given the risk for serious and/or life-threatening cardiovascular events associated with increased dofetilide plasma levels, concomitant use with dolutegravir is considered contraindicated.

References

  1. "Product Information. Tikosyn (dofetilide)." Pfizer U.S. Pharmaceuticals PROD (2001):
  2. "Product Information. Tivicay (dolutegravir)." ViiV Healthcare (2013):

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Drug and food interactions

Minor

dofetilide food

Applies to: Tikosyn (dofetilide)

In vitro data suggest that grapefruit juice may inhibit the CYP450 3A4 first-pass metabolism of dofetilide. Decreased first-pass metabolism may increase dofetilide concentrations and increase the risk of QT interval prolongation and arrhythmias. The clinical significance is unknown, since dofetilide has a high oral bioavailability and a low affinity for CYP450 3A4. The manufacturer recommends caution.

References

  1. "Product Information. Tikosyn (dofetilide)." Pfizer U.S. Pharmaceuticals PROD (2001):

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Minor

dolutegravir food

Applies to: abacavir / dolutegravir / lamivudine

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

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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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