Coadministration of multivitamins (fasted intake) decreased dolutegravir AUC, Cmax and C24 by 33%, 35% and 32%, respectively, due to complex binding to polyvalent ions. The stated reductions in dolutegravir exposure were observed with the intake of dolutegravir during fasted conditions. In fed state, the changes in exposure following intake together with calcium or iron supplements were modified by the food effect, resulting in an exposure similar to that obtained with dolutegravir administered in the fasted state. When taken with food, Dovato and multivitamins can be taken at the same time. If Dovato is taken in a fasted state, such supplements should be taken a minimum 2 hours after or 6 hours before the intake of Dovato.

Coadministration may decrease dolutegravir concentrations. Coadministration of a multivitamin preparation (One-A-Day, single dose) and dolutegravir (50 mg, single dose) administered simultaneously decreased dolutegravir Cmax, AUC and Ctrough by 35%, 33% and 32%, respectively. When taken with food, Dovato and multivitamins can be taken at the same time. Under fasting conditions, Dovato should be taken 2 hours before or 6 hours after taking supplements containing calcium or iron.

Coadministration of a multivitamin preparation with high metal divalent cation content (One-A-Day, single dose) and dolutegravir (50 mg, single dose) was studied in 16 HIV-negative subjects and was found to decrease dolutegravir AUC, Cmax and Ctrough by 33%, 35% and 32%, respectively.