Liverpool HIV Interactions

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No Interaction Expected

Rilpivirine (RPV)

Dolutegravir (DTG)

Quality of Evidence: Very Low

Summary:

No clinically significant pharmacokinetic interaction was observed between rilpivirine and dolutegravir. Coadministration of rilpivirine (25 mg once daily) and dolutegravir (50 mg once daily) increased dolutegravir Cmax, AUC and Ctrough by 13%, 12% and 22%, respectively. Rilpivirine Cmax, AUC and Ctrough increased by 10%, 6% and 21%, respectively. No dosage adjustment is necessary. [Dolutegravir is available coformulated with rilpivirine as a complete regimen for the treatment of HIV-1 infection in adults to replace the current antiretroviral regimen in those who are virologically suppressed (HIV-1 RNA less than 50 copies per mL) on a stable antiretroviral regimen for at least 6 months with no history of treatment failure or known substitutions associated with resistance to either antiretroviral agent.]

Description:

Coadministration had no significant effect on dolutegravir exposure (AUC, Cmax and Ctrough increased by 12%, 13% and 22%, respectively). There was no effect on rilpivirine exposure. No dosage adjustment is necessary.

Tivicay Summary of Product Characteristics, ViiV Healthcare, March 2019.

Based on drug interaction trial results, rilpivirine can be coadministered with dolutegravir without a dose adjustment. Coadministration of rilpivirine (25 mg once daily) and dolutegravir (50 mg once daily) to 16 subjects increased dolutegravir Cmax, AUC and Ctrough by 13%, 12% and 22%, respectively. Rilpivirine Cmax, AUC and Ctrough increased by 10%, 6% and 21%, respectively. Dolutegravir is indicated in combination with rilpivirine as a complete regimen for the treatment of HIV-1 infection in adults to replace the current antiretroviral regimen in those who are virologically suppressed (HIV-1 RNA less than 50 copies per mL) on a stable antiretroviral regimen for at least 6 months with no history of treatment failure or known substitutions associated with resistance to either antiretroviral agent.

Tivicay US Prescribing Information, ViiV Healthcare, July 2019.

Coadministration of dolutegravir (50 mg once daily) and rilpivirine (25 mg once daily) was studied in 16 HIV-negative subjects. Rilpivirine increased dolutegravir AUC, Cmax and Ctrough by 12%, 13% and 22%, respectively. Similarly, rilpivirine AUC, Cmax and Ctrough increased by 6%, 10% and 21%, respectively, in the presence of dolutegravir. Dolutegravir and rilpivirine can be coadministered without dosage adjustment for either agent.

Lack of pharmacokinetic interaction between rilpivirine and integrase inhibitors dolutegravir and GSK1265744. Ford SL, Gould E, Chen S, et al. Antimicrob Agents Chemother, 2013, in press.

View all available interactions with Rilpivirine (RPV) by clicking here.