ir alafenamide.
Co-administration of rifabutin may decrease tenofovir alafenamide plasma concentrations.
Co-administration is not recommended due to the expected decrease of tenofovir alafenamide.
Rifapentine
(Induction of CYP3A and P-gp)
Interaction not studied with any of the components of Biktarvy.
Co-administration of rifapentine may decrease bictegravir and tenofovir alafenamide plasma concentrations.
Co-administration is not recommended.
HIV-1 Antiviral Agents
Atazanavir (300 mg once daily), Cobicistat (150 mg once daily), Bictegravir1
(Inhibition of CYP3A, UGT1A1, and P-gp/BCRP)
Bictegravir:
AUC: ↑ 306%
Cmax: ↔
Co-administration is not recommended.
Atazanavir (400 mg once daily), Bictegravir1
(Inhibition of CYP3A and UGT1A1)
Bictegravir:
AUC: ↑ 315%
Cmax: ↔
Hepatitis C Virus Antiviral Agents
Boceprevir
Interaction not studied with any of the components of Biktarvy.
Co-administration with boceprevir has the potential to adversely affect the intracellular activation and clinical antiviral efficacy of tenofovir alafenamide based on in vitro data.
Co-administration is not recommended.
Ledipasvir/Sofosbuvir (90 mg/400 mg once daily), Bictegravir/Emtricitabine/ Tenofovir alafenamide2
Bictegravir:
AUC: ↔
Cmin: ↔
Cmax: ↔
Emtricitabine:
AUC: ↔
Cmin: ↔
Cmax: ↔
Tenofovir alafenamide:
AUC: ↔
Cmax: ↔
Ledipasvir:
AUC: ↔
Cmin: ↔
Cmax: ↔
Sofosbuvir:
AUC: ↔
Cmax: ↔
Sofosbuvir metabolite GS-331007:
AUC: ↔
Cmin: ↔
Cmax: ↔
No dose adjustment is required upon co-administration.
Sofosbuvir/Velpatasvir/ Voxilaprevir (400/100/100+100 mg3 once daily), Bictegravir/Emtricitabine/ Tenofovir alafenamide
(Inhibition of P-gp/BCRP)
Bictegravir:
AUC: ↔
Cmin: ↔
Cmax: ↔
Emtricitabine:
AUC: ↔
Cmin: ↔
Cmax: ↔
Tenofovir alafenamide:
AUC: ↑ 57%
Cmax: ↑ 28%
Sofosbuvir:
AUC: ↔
Cmax: ↔
Sofosbuvir metabolite GS-331007:
AUC: ↔
Cmin: ↔
Cmax: ↔
Velpatasvir:
AUC: ↔
Cmin: ↔
Cmax: ↔
Voxilaprevir:
AUC: ↔
Cmin: ↔
Cmax: ↔
No dose adjustment is required upon co-administration.
Antifungals
Voriconazole (300 mg twice daily), Bictegravir1
(Inhibition of CYP3A)
Bictegravir:
AUC: ↑ 61%
Cmax: ↔
No dose adjustment is required upon co-administration.
Itraconazole
Posaconazole
(Inhibition of P-gp/BCRP)
Interaction not studied with any of the components of Biktarvy.
Co-administration of itraconazole or posaconazole may increase bictegravir plasma concentrations.
Macrolides
Azithromycin
Clarithromycin
(Inhibition of P-gp)
Not studied.
Interaction not studied. Co-administration of azithromycin or clarithromycin may increase bictegravir plasma concentrations.
Caution is recommended due to the potential effect of these agents on the bictegravir component of Biktarvy.
ANTICONVULSANTS
Carbamazepine (titrated from 100 mg to 300 mg twice a day), Emtricitabine/Tenofovir alafenamide4
(Induction of CYP3A, UGT1A1, and P-gp)
Tenofovir alafenamide:
AUC: ↓ 54%
Cmax: ↓ 57%
Interaction not studied with bictegravir.
Co-administration of carbamazepine may decrease bictegravir plasma concentrati |
