Drug interactions
Dolutegravir + Ferrous sulfate
Severity: Moderate
Dolutegravir and Ferrous sulfate: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Iron salts taken at the same time as dolutegravir bind the integrase inhibitor in the gut and reduce its absorption. Lower dolutegravir exposure can lead to reduced viral suppression and a risk of resistance.
What this interaction means in plain words
Dolutegravir and Ferrous sulfate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Dolutegravir belongs to Anti Virals; Ferrous sulfate belongs to Miscellaneous.
Why it happens
Chelation of dolutegravir by polyvalent iron cations in the gastrointestinal tract reduces its absorption.
What to do
Give dolutegravir at least 2 hours before or 6 hours after iron, or take both together with a meal. For dolutegravir/rilpivirine use a 4-hour lead interval.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Dolutegravir
Other interactions of Ferrous sulfate
Frequently asked questions
Can I take Dolutegravir with Ferrous sulfate?
MediHelp rates the interaction as moderate. Dolutegravir and Ferrous sulfate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Iron salts taken at the same time as dolutegravir bind the integrase inhibitor in the gut and reduce its absorption. Lower dolutegravir exposure can lead to reduced viral suppression and a risk of resistance.
How serious is the interaction between Dolutegravir and Ferrous sulfate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Give dolutegravir at least 2 hours before or 6 hours after iron, or take both together with a meal. For dolutegravir/rilpivirine use a 4-hour lead interval.
What other medicines interact with Dolutegravir?
MediHelp also lists interactions of Dolutegravir with, for example, Dofetilide, Aluminum hydroxide, Atidarsagene autotemcel. The full list is on the Dolutegravir page.
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