Raltegravir with Sucralfate Interaction Details
Brand Names Associated with Raltegravir
- Isentress®
- Isentress® HD
- Raltegravir
Brand Names Associated with Sucralfate
- Carafate®
- Sucralfate
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jan 04, 2024
Interaction Effect
Decreased raltegravir concentration
Interaction Summary
Raltegravir used concomitantly with products containing polyvalent cations may decrease raltegravir exposure and trough concentrations and result in loss of efficacy and potential development of viral resistance . Do not coadminister and do not stagger raltegravir administration with aluminum- or magnesium-containing antacids; choose a different acid-reducing agent. Do not coadminister raltegravir 1200-mg daily dose (Isentress(R) HD) with calcium carbonate antacids; twice daily dosing of raltegravir does not require adjustment or separation when used with calcium carbonate . Administer raltegravir at least 2 hours before or 6 hours after other polyvalent cation-containing products (eg, laxatives; sucralfate; supplements containing iron, calcium, or magnesium) .
Severity
Major
Onset
Rapid
Evidence
Theoretical
How To Manage Interaction
Raltegravir used concomitantly with products containing polyvalent cations may decrease raltegravir exposure and trough concentrations and result in loss of efficacy and potential development of viral resistance . Do not coadminister and do not stagger raltegravir administration with aluminum- or magnesium-containing antacids; choose a different acid-reducing agent. Do not coadminister raltegravir 1200-mg daily dose (Isentress(R) HD) with calcium carbonate antacids; twice daily dosing of raltegravir does not require adjustment or separation when used with calcium carbonate . Administer raltegravir at least 2 hours before or 6 hours after other polyvalent cation-containing products (eg, laxatives; sucralfate; supplements containing iron, calcium, or magnesium) .
Mechanism Of Interaction
Chelation with polyvalent cations resulting in reduced raltegravir absorption
Literature Reports
A) Coadministration of raltegravir (400 mg twice daily or 1200 mg once daily) with aluminum/magnesium hydroxide antacid decreased raltegravir trough concentrations by 49% to 63%. Coadministration with calcium carbonate antacid 3000 mg decreased raltegravir trough by 32% (raltegravir 400 mg twice daily) or 48% to 57% (raltegravir 1200 mg once daily) .
Raltegravir Overview
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Raltegravir is used along with other medications to treat human immunodeficiency virus (HIV) infection in adults and children who weigh at least 4.5 lbs (2 kg). Raltegravir is in a class of medications called HIV integrase inhibitors. It works by decreasing the amount of HIV in the blood. Although raltegravir does not cure HIV, it may decrease your chance of developing acquired immunodeficiency syndrome (AIDS) and HIV-related illnesses such as serious infections or cancer. Taking these medications along with practicing safer sex and making other life-style changes may decrease the risk of transmitting (spreading) the HIV virus to other people.
Sucralfate Overview
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Sucralfate is used to treat and prevent the return of duodenal ulcers (ulcers located in first part of the small intestine). Treatment with other medications, such as antibiotics, may also be necessary to treat and prevent the return of ulcers caused by a certain type of bacteria (H. pylori) Sucralfate is in a class of medications called protectants. It sticks to damaged ulcer tissue and protects against acid and enzymes so healing can occur.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.