Drug Interaction Report

Dolutegravir and Etravirine: Interaction Details

A pharmacist-reviewed analysis of the Dolutegravir and Etravirine 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

Etravirine

Intelence
+

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
established
Severity
Major

What happens

Reduced dolutegravir exposure and reduced efficacy of dolutegravir

Interaction Deep Dive

Etravirine (a CYP3A inducer)4, reduced the Cmax and AUC of dolutegravir (a CYP3A substrate) with coadministration in drug interaction studies, but coadministration of etravirine plus darunavir/ritonavir or lopinavir/ritonavir decreased this effect. Accordingly, do not administer dolutegravir with etravirine unless atazanavir/ritonavir, darunavir/ritonavir, or lopinavir/ritonavir are concurrently administered 231.

Why it happens (mechanism)

Induction of CYP3A-mediated metabolism of dolutegravir

Literature reports

1 report — tap to read

a) Dolutegravir Cmax and AUC were reduced with etravirine coadministration in drug interaction studies (n=16), but improved with coadministration of darunavir/ritonavir (n=9) or lopinavir/ritonavir (n=8). The dolutegravir-with/without-etravirine geometric mean ratio for Cmax (0.48 [90% CI, 0.43 to 0.54]) and AUC (0.29 [90% CI, 0.26 to 0.34]) were decreased with etravirine 200 mg twice daily administration in patients treated with dolutegravir 50 mg/day. However, the reduction in the AUC and Cmax ratios were less pronounced when dolutegravir 50 mg once daily was coadministered with etravirine 200 mg plus darunavir 600 mg and ritonavir 100 mg twice daily (geometric mean ratio, AUC 0.75 [90% CI, 0.69 to 0.81]; Cmax 0.88 [90% CI, 0.78 to 1]). Geometric mean ratios for both Cmax (1.07 [90% CI, 1.02 to 1.13]) and AUC (1.11 [90% CI, 1.02 to 1.2]) increased when dolutegravir 50 mg once daily was coadministered with etravirine 200 mg plus lopinavir 400 mg and ritonavir 100 mg twice daily 231.

Common questions

Can I take Dolutegravir and Etravirine 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 Etravirine 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.

Questions for your pharmacist

  • Does my dose of Dolutegravir or Etravirine 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, 2024. 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, 2024. DailyMed
  4. Product Information: INTELENCE(R) oral tablets, etravirine oral tablets. Janssen Therapeutics (per FDA), Titusville, NJ, 2013. DailyMed
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Etravirine

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Dolutegravir

Keep reading about Dolutegravir

All Dolutegravir interactions (51) Dolutegravir drug information
Also serious with: Dofetilide Ensitrelvir Abametapir Letermovir Injection
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:

Etravirine + Activated Charcoal Grapefruit St. John's Wort Acacia Rigidula Adrafinil African Wild Potato Alkanna Alpine Ragwort + 161 more
Dolutegravir + Activated Charcoal Calcium St. John's Wort Bitter Melon Black Pepper Breadfruit Brussels Sprout Bulbine Natalensis + 57 more

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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.