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Integrase inhibitors

Dolutegravir

Names: Dolutegravir, DTG, Tivicay

Approved dosage: Take one yellow 50mg tablet once a day. Dolutegravir should be taken twice a day if you have HIV known to be resistant to other integrase inhibitors. Also available in the combination tablet Triumeq.

Tips on taking it: Take the tablet either once or twice daily with or without food, preferably in the morning. If you have some resistance to integrase inhibitors, you should take it with food.  Dolutegravir tablets are small and may be a good option if you are having difficulty swallowing tablets.

Common or very common side-effects: Nausea, diarrhoea, headache, rash, itching, vomiting, abdominal pain or discomfort, difficulty in sleeping, dizziness, abnormal dreams, fatigue, flatulence, increase in liver enzymes, increase in creatine phosphokinase (enzymes produced in the muscles).

Rare side-effects: Allergic (hypersensitivity) reaction (rash, fever, muscle pain, blistering), liver inflammation.

Important warning: An allergic (hypersensitivity) reaction has been reported in some people taking dolutegravir. This is rare, but you should see a doctor immediately if you think you are experiencing an allergic reaction. The symptoms are skin rash; fever; fatigue; swelling, sometimes of the face or mouth, causing breathing problems; muscle or joint aches.

Children: Tivicay is approved for use in children aged 6 years and over.

Key drug interactions: You should not take antacids (used to treat indigestion and heartburn), calcium supplements, iron or zinc supplements or multivitamins, or medicine containing magnesium or aluminium for six hours before you take dolutegravir, or for at least two hours after taking dolutegravir.

If you are taking dolutegravir with the anti-epilepsy drugs carbamazepine, fosphenytoin, phenobarbital or oxcarbazepine, the antibiotic rifampicin or St John’s wort, your dose of dolutegravir will be increased to 50mg twice a day.

Elvitegravir

See: Stribild or Genvoya

Elvitegravir must be taken with the booster drug cobicistat. Currently, elvitegravir is only available as part of the combination pills Stribild or Genvoya.

Raltegravir

Names: Raltegravir, RAL, Isentress

Approved dosage: Take one pink 400mg tablet twice daily or two yellow 600mg tablets once a day.

Tips on taking it: Take with or without food.

Common or very common side-effects: Loss of appetite, headache, difficulty in sleeping, abnormal dreams, depression, dizziness, vertigo, restlessness, abdominal pain, bloating, flatulence, diarrhoea, nausea, vomiting, indigestion, rash, weakness, fatigue, fever, raised liver or pancreatic enzymes, raised triglycerides.

Rare side-effects: Suicidal thoughts and behaviours, liver failure, kidney failure, allergic (hypersensitivity) reaction.

Important warning: An allergic (hypersensitivity) reaction has been reported in some people using raltegravir. This reaction is rare. See your HIV clinic immediately (or A&E if out of hours) if you develop a rash together with any of these symptoms: fever; feeling generally unwell or extremely tired; muscle or joint ache; blistering of the skin; mouth ulcers; swelling of the eyes, lips, mouth or face; breathing difficulties; yellowing of the skin or eyes; dark urine; pale stools; or pain, aching or sensitivity on the right-hand side of the body, below the ribs.

Children: Chewable tablets or granules are available for under-12s.

Key drug interactions: If you are prescribed the TB drug rifampicin, your dose of raltegravir may be increased to 800mg (two pink tablets) twice daily, as rifampicin can reduce drug levels of raltegravir. You should not take any supplements that contain magnesium or aluminium if you are taking raltegravir as they will reduce its absorption. These supplements should be taken at least four hours before or after raltegravir if you are taking it twice daily.

Anti-HIV drugs

Published June 2018

Last reviewed June 2018

Next review June 2021

Contact NAM to find out more about the scientific research and information used to produce this booklet.

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.