Drug Interaction Report

ADJUST DOSING INTERVAL: Coadministration with antacids, mineral supplements, or other medications containing polyvalent cations such as magnesium, aluminum, calcium, and iron may decrease the bioavailability of oral cabotegravir. The proposed mechanism involves chelation of cabotegravir by polyvalent cations, forming a complex that is poorly absorbed from the gastrointestinal tract. The interaction has not been studied with cabotegravir, but has been reported with other integrase strand transfer inhibitors (INSTIs).

MANAGEMENT: To minimize the risk of reduced viral susceptibility and resistance development associated with subtherapeutic levels of cabotegravir, medications containing polyvalent cations such as antacids and mineral supplements should be administered at least 2 hours before or 4 hours after the oral cabotegravir dose.

ADJUST DOSING INTERVAL: Bowel cleansing products can increase the gastrointestinal transit rate. Oral medications administered within one hour of the start of administration of the bowel cleansing solution may be flushed from the gastrointestinal tract and not properly absorbed.

MANAGEMENT: Patients should be advised that absorption of oral medications may be impaired during bowel cleansing treatment. Oral medications (e.g., anticonvulsants, oral contraceptives, antidiabetic agents, antibiotics) should not be administered during and within one hour of starting bowel cleansing treatment whenever possible. However, if concomitant use cannot be avoided, monitoring for reduced therapeutic effects may be advisable.