Basic Information
ID DDInter58 and DDInter205
Interaction INTERVAL: Concurrent administration of medications or oral supplements containing polyvalent cations such as aluminum, calcium, iron, or magnesium may decrease the oral bioavailability of bictegravir.
Management When used with antacids containing aluminum, magnesium or calcium, bictegravir may be taken under fasting conditions 2 hours before the antacids. Routine administration of bictegravir simultaneously with, or 2 hours after, antacids containing aluminum, magnesium or calcium is not recommended. When used with supplements containing calcium or iron, bictegravir and the supplements may be taken together with food.
References [1] Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0 [2] Cerner Multum, Inc. "Australian Product Information." O 0 [3] "Product Information. Biktarvy (bictegravir/emtricitabine/tenofovir)." Gilead Sciences, Foster City, CA. [4] Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm 66 (2009): 1438-67 [5] "Product Information. Viread (tenofovir)." Gilead Sciences, Foster City, CA.
Alternative for Aluminum hydroxide -
Alternative for Bictegravir J05A
Lamivudine Paritaprevir Glecaprevir Tenofovir alafenamide Maraviroc Simeprevir
Valaciclovir Zanamivir Lenacapavir Telaprevir Etravirine
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Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.