Food and medicine interaction
Calcium and iron supplements and dolutegravir (Tivicay, Dovato), an HIV medicine
EstablishedEvidence level: established. Shown in drug labeling or in controlled studies in people.
Last reviewed
What can happen
Taken together on an empty stomach, calcium and iron supplements lower dolutegravir levels. In 24 healthy adults, calcium carbonate cut dolutegravir exposure by 39 percent and ferrous fumarate by 54 percent. That could make the HIV medicine less effective.
- Why it happens
- Dolutegravir binds metal ions such as calcium and iron in the gut, so less of it is absorbed.
- At ordinary food amounts
- The concern is supplements and mineral-containing antacids or multivitamins. Taking dolutegravir with a meal removed the effect in the study.
What to do
MedlinePlus says to take these supplements 2 hours after or 6 hours before dolutegravir, or to take them together with food. Check your schedule with your HIV pharmacist, and never skip or stop dolutegravir doses.
Never stop or change a prescribed medicine without talking to the prescriber.
Common questions
Can I have calcium and iron supplements while taking HIV integrase inhibitors?
MedlinePlus says to take these supplements 2 hours after or 6 hours before dolutegravir, or to take them together with food. Check your schedule with your HIV pharmacist, and never skip or stop dolutegravir doses. The concern is supplements and mineral-containing antacids or multivitamins. Taking dolutegravir with a meal removed the effect in the study.
Sources
- NIH Office of Dietary Supplements. Calcium: Fact Sheet for Health Professionals.
- MedlinePlus (U.S. National Library of Medicine). Dolutegravir: drug information.
- Song I, et al. Pharmacokinetics of dolutegravir when administered with mineral supplements in healthy adult subjects. J Clin Pharmacol. 2015. PMID 25449994.