Drug Interaction Report

Dolutegravir and Nevirapine: Interaction Details

A pharmacist-reviewed analysis of the Dolutegravir and Nevirapine 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

Nevirapine

Viramune Viramune® Viramune® XR
+

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

Decreased dolutegravir exposure with reduced efficacy

Interaction Deep Dive

Concomitant use of dolutegravir, a CYP3A substrate2, with nevirapine, a CYP3A inducer 1, may lead to decreased plasma concentrations and efficacy of dolutegravir 5. Coadministration should be avoided as data needed to make dosing recommendations are insufficient 342. If concomitant use is necessary, monitor for reduced dolutegravir efficacy and consider increasing the dose to keep dolutegravir trough concentration above 300 mcg/L 5.

Why it happens (mechanism)

Induction of CYP3A-mediated metabolism of dolutegravir by nevirapine

Literature reports

1 report — tap to read

a) In a study of 10 patients with HIV, concurrent administration of dolutegravir with a nevirapine/abacavir/lamivudine regimen resulted in significant differences in dolutegravir pharmacokinetics compared with a regimen with abacavir/lamivudine only. There was a 19% decrease in dolutegravir AUC, a 34% decrease in dolutegravir trough concentration, a 15% decrease in dolutegravir half-life, and a 23% increase in dolutegravir oral clearance 5

Common questions

Can I take Dolutegravir and Nevirapine together?

Decreased dolutegravir exposure with reduced efficacy Always confirm with your pharmacist or prescriber before making any change.

How serious is the Dolutegravir and Nevirapine 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 Nevirapine 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)

  1. Product Information: Viramune(R) oral tablets, oral suspension, nevirapine oral tablets, oral suspension. Boehringer Ingelheim Pharmaceuticals, Inc. (per FDA), Ridgefield, CT, 2012. DailyMed
  2. Product Information: TIVICAY(R) oral tablets, dolutegravir oral tablets. GlaxoSmithKline (per Manufacturer), Research Triangle Park, NC, 2013. DailyMed
  3. Product Information: TRIUMEQ PD oral tablets for suspension, abacavir, dolutegravir, lamivudine oral tablets. ViiV Healthcare (per FDA), Research Triangle Park, NC, 2022. DailyMed
  4. Product Information: TRIUMEQ oral tablets, abacavir, dolutegravir, lamivudine oral tablets. ViiV Healthcare (per FDA), Research Triangle Park, NC, 2022. DailyMed
  5. Dailly E, Allavena C, Gregoire M, et al: Influence of nevirapine administration on the pharmacokinetics of dolutegravir in patients infected with HIV-1. J Antimicrob Chemother 2015; 70(12):3307-3310. PubMed
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Nevirapine

Keep reading about Nevirapine

All Nevirapine interactions (163) Nevirapine drug information
Also serious with: Atazanavir Cobicistat Dasabuvir Ensitrelvir
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:

Nevirapine + Activated Charcoal Beer Grapefruit Siberian Cocklebur St. John's Wort Wine Acacia Rigidula Adrafinil + 172 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.