Liverpool HIV Interactions

Do Not Coadminister

Emtricitabine/Tenofovir alafenamide for PrEP (FTC/TAF, PrEP)

Dolutegravir/Lamivudine/ Tenofovir-DF (DTG/3TC/TDF; TLD)

Quality of Evidence: Very Low

Summary:

Emtricitabine and tenofovir alafenamide used as PrEP are not expected to be coadministered with antiretrovirals. In addition, emtricitabine/tenofovir alafenamide should not be coadministered with other products containing emtricitabine, lamivudine, tenofovir alafenamide or tenofovir-DF. Emtricitabine and tenofovir alafenamide are unlikely to affect the exposure of antiretroviral drugs initiated after discontinuation of emtricitabine and tenofovir alafenamide for PrEP.

Description:

Dolutegravir, lamivudine and tenofovir disoproxil fumarate tablets should not be co-administered with emtricitabine, due to the similarity between emtricitabine and lamivudine, and consequently expected additive toxicity and no benefit in efficacy. Dolutegravir, lamivudine and tenofovir disoproxil fumarate tablets should not be administered with any other medicines containing tenofovir alafenamide.

Dolutegravir, Lamivudine, and Tenofovir Disoproxil Fumarate Tablets WHOPAR part 4, Strides Pharma Ltd, August 2024.

No effect on the pharmacokinetic parameters of emtricitabine was observed with tenofovir-DF. Coadministration of tenofovir-DF (300 mg once daily) and emtricitabine (200 mg once daily for 7 days) had no effect on emtricitabine AUC and Cmax but Cmin increased by 20% (n=17).

Dolutegravir, Lamivudine, and Tenofovir Disoproxil Fumarate Tablets Prescribing Information, Strides Pharma Inc, September 2023.

Descovy should not be administered concomitantly with medicinal products containing lamivudine or tenofovir disoproxil. Coadministration of dolutegravir (50 mg once daily) and tenofovir alafenamide (10 mg once daily, given as elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide fixed-dose combination tablet) had no effect on the AUC and Cmax of tenofovir alafenamide, nor on the AUC, Cmax and Cmin of dolutegravir.

Descovy Summary of Product Characteristics, Gilead Sciences Ltd, April 2022.

Based on drug interaction studies conducted with the components of Descovy, no clinically significant drug interactions have been either observed or are expected when Descovy is combined with dolutegravir. Coadministration of dolutegravir (50 mg once daily) and tenofovir alafenamide (10 mg once daily) was studied in 10 subjects. Tenofovir alafenamide Cmax and AUC increased by 24% and 19%; dolutegravir Cmax, AUC and Cmin increased by 15%, 2% and 5%, respectively.

Descovy US Prescribing Information, Gilead Sciences Inc, January 2022.

Coadministration of dolutegravir (50 mg once daily) with emtricitabine/tenofovir alafenamide (200/10 mg, once daily) was studied in 10 healthy volunteers in a crossover study. Tenofovir alafenamide AUC and Cmax increased by 17% and 24%, respectively. Tenofovir AUC and Cmax increased by 25% and 10%, respectively. Dolutegravir pharmacokinetic parameters were similar to historical controls.

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