Drug Interaction Report

Dolutegravir and Dalfampridine: Interaction Details

A pharmacist-reviewed analysis of the Dolutegravir and Dalfampridine interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Dalfampridine

Ampyra Ampyra®
+

Dolutegravir

Juluca® (as a combination product containing dolutegravir, rilpivirine) Tivicay Tivicay® Tivicay® PD
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 51 documented Dolutegravir interactions, 45 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Increased dalfampridine exposure and an increased risk of seizures

Interaction Deep Dive

Due to inhibition of renal organic cation transporter 2 (OCT2) by dolutegravir, concurrent use of dolutegravir and dalfampridine, an OCT2 substrate, may result in elevated levels of dalfampridine that increases the risk of seizures. The potential benefits of taking dalfampridine concurrently with dolutegravir should be considered against the risk of seizures in these patients2341.

Why it happens (mechanism)

Inhibition of OCT2-mediated efflux transport of dolutegravir

Common questions

Can I take Dolutegravir and Dalfampridine together?

Increased dalfampridine exposure and an increased risk of seizures Always confirm with your pharmacist or prescriber before making any change.

How serious is the Dolutegravir and Dalfampridine 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 "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Dolutegravir or Dalfampridine 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 (4)

  1. Product Information: TIVICAY oral tablets, dolutegravir oral tablets. ViiV Healthcare (per FDA), Research Triangle Park, NC, 2022. DailyMed
  2. Product Information: TRIUMEQ oral tablets, abacavir, dolutegravir, lamivudine oral tablets. ViiV Healthcare (per FDA), Durham, NC, 2023. DailyMed
  3. Product Information: TRIUMEQ PD oral tablets for suspension, abacavir, dolutegravir, lamivudine oral tablets. ViiV Healthcare (per FDA), Durham, NC, 2023. DailyMed
  4. Product Information: JULUCA oral tablets, dolutegravir rilpivirine oral tablets. ViiV Healthcare (per FDA), Research Triangle Park, NC, 2020. DailyMed
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Dalfampridine

Keep reading about Dalfampridine

All Dalfampridine interactions (11) Dalfampridine drug information
Also serious with: Trilaciclib Hydroxychloroquine Tramadol Fexinidazole
Dolutegravir

Keep reading about Dolutegravir

All Dolutegravir interactions (51) Dolutegravir drug information
Also serious with: Dofetilide Ensitrelvir Abametapir Cabotegravir
Beyond drug–drug

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:

Dalfampridine + Activated Charcoal Biofeedback Coffee Charcoal Dendrobium European Mandrake Ginkgo Glucomannan Guar Gum + 15 more
Dolutegravir + Activated Charcoal Calcium St. John's Wort Bitter Melon Black Pepper Breadfruit Brussels Sprout Bulbine Natalensis + 57 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.