Dolutegravir and Carbamazepine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Carbamazepine
Dolutegravir
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Reduced dolutegravir exposure and reduced efficacy of dolutegravir
Interaction Deep Dive
CarBAMazepine (a CYP3A and UGT1A1 inducer) coadministered with dolutegravir (CYP3A and UGT1A1 substrate) significantly reduced dolutegravir exposure (AUC by 49%, Cmax by 33%), shortened t(1/2) from 12.9 to 7.31 hours, and increased clearance by 95%5. Dolutegravir dose adjustment is required in adult and pediatric patients 34. Whenever possible, use alternatives to carBAMazepine in INSTI-experienced patients with certain INSTI-associated resistance substitutions or clinically suspected INSTI resistance 1. When administering dolutegravir-containing combination products, separate the additional dolutegravir dose by 12 hours24.
Why it happens (mechanism)
Induction of CYP3A-mediated dolutegravir metabolism by carBAMazepine
Literature reports
2 reports — tap to read
a) carBAMazepine (a CYP3A and UGT1A1 inducer) coadministered with dolutegravir (a CYP3A and UGT1A1 substrate) compared with dolutegravir administered alone significantly reduced mean dolutegravir AUC(0 to tau) from 53.8 to 27.4 mcg x hr/mL, Cmax from 4.16 to 2.77 mcg/mL, plasma concentration at the end of the dosing interval from 1.2 to 0.325 mcg/mL, and t(1/2) from 12.9 to 7.31 hours. Dolutegravir clearance was significantly increased from 0.929 to 1.83 L/hr. Healthy subjects (N=14) received dolutegravir 50 mg daily plus carBAMazepine 300 mg every 12 hours for 5 days 5.
b) The coadministration of carBAMazepine 300 mg twice daily in patients treated with dolutegravir 50 mg/day significantly decreased the dolutegravir Cmax by 33% and AUC by 49% compared with dolutegravir alone 3.
Common questions
Can I take Dolutegravir and Carbamazepine together?
Reduced dolutegravir exposure and reduced efficacy of dolutegravir Always confirm with your pharmacist or prescriber before making any change.
How serious is the Dolutegravir and Carbamazepine interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Dolutegravir or Carbamazepine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (5)
- Product Information: TIVICAY oral tablets, dolutegravir oral tablets. ViiV Healthcare (per FDA), Research Triangle Park, NC, 2022. DailyMed
- Product Information: DOVATO oral tablets, dolutegravir lamivudine oral tablets. ViiV Healthcare (per manufacturer), Research Triangle Park, NC, 2019. DailyMed
- Product Information: TRIUMEQ oral tablets, abacavir, dolutegravir, lamivudine oral tablets. ViiV Healthcare (per FDA), Durham, NC, 2023. DailyMed
- Product Information: TRIUMEQ PD oral tablets for suspension, abacavir, dolutegravir, lamivudine oral tablets. ViiV Healthcare (per FDA), Durham, NC, 2023. DailyMed
- Song I, Weller S, Patel J, et al: Effect of carbamazepine on dolutegravir pharmacokinetics and dosing recommendation. Eur J Clin Pharmacol 2016; 72(6):665-670. PubMed
Keep reading about Carbamazepine
Keep reading about Dolutegravir
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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