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Drug Interactions between Biktarvy and zinc gluconate

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

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Interactions between your drugs

Major

zinc gluconate bictegravir

Applies to: zinc gluconate and Biktarvy (bictegravir / emtricitabine / tenofovir alafenamide)

ADJUST DOSING INTERVAL: Coadministration with medications or supplements containing polyvalent cations such as zinc may decrease the plasma concentrations of integrase strand transfer inhibitors (INSTIs). The proposed mechanism involves chelation of the INSTI by polyvalent cations, forming a complex that is poorly absorbed from the gastrointestinal tract.

MANAGEMENT: If concomitant use is required, monitor for virologic efficacy and administer the INSTI at least 2 hours before or 6 hours after products containing polyvalent cations such as zinc.

References (3)
  1. (2013) "Product Information. Tivicay (dolutegravir)." ViiV Healthcare
  2. (2018) "Product Information. Biktarvy (bictegravir/emtricitabine/tenofovir)." Gilead Sciences
  3. US National Library of Medicine (2019) Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/287/insti-drug-interactions

Drug and food interactions

Minor

tenofovir food

Applies to: Biktarvy (bictegravir / emtricitabine / tenofovir alafenamide)

Food enhances the oral absorption and bioavailability of tenofovir, the active entity of tenofovir disoproxil fumarate. According to the product labeling, administration of the drug following a high-fat meal increased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of tenofovir by approximately 14% and 40%, respectively, compared to administration in the fasting state. However, administration with a light meal did not significantly affect the pharmacokinetics of tenofovir compared to administration in the fasting state. Food delays the time to reach tenofovir Cmax by approximately 1 hour. Tenofovir disoproxil fumarate may be administered without regard to meals.

References (1)
  1. (2001) "Product Information. Viread (tenofovir)." Gilead Sciences

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.

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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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