Calcium - Dutrebis (Lamivudine, Raltegravir) Interaction

Herbal: Calcium

Drug: Lamivudine, Raltegravir
Brand names: Dutrebis

Medical Content Editor
Last updated Jun 08, 2025

Interaction Details

Lamivudine, Raltegravir is classified as belonging to the following category: Raltegravir (Isentress)

Calcium may reduce levels of raltegravir.
Pharmacokinetic research shows that taking a single dose of calcium carbonate 3000 mg along with raltegravir 400 mg twice daily modestly decreases the mean area under the curve of raltegravir, but the decrease does not necessitate a dose adjustment of raltegravir. However, a case of elevated HIV-1 RNA levels and documented resistance to raltegravir has been reported for a patient taking calcium carbonate 1 gram three times daily plus vitamin D3 (cholecalciferol) 400 IU three times daily in combination with raltegravir 400 mg twice daily for 11 months. It is thought that calcium reduced raltegravir levels by chelation, leading to treatment failure.

Interaction Rating

Moderate

Likelihood of Occurrence

Possible

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists

References

  • Insentress [package insert]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2014.
  • Roberts JL, Kiser JJ, Hindman JT, Meditz AL. Virologic failure with a raltegravir-containing antiretroviral regimen and concomitant calcium administration. Pharmacotherapy 2011;31(10):298e-302e.

Calcium Overview

Calcium is a vital nutrient found in various foods such as dairy products, certain vegetables, and many fortified items. Over 99% of the body's calcium is stored in the bones and teeth, predominantly as hydroxyapatite. The remaining calcium circulates in the blood, extracellular fluid, muscles, and other tissues, where it is essential for processes like nerve signaling, muscle contraction, vascular activities, glandular secretion, and maintaining cell membrane and capillary permeability. It also plays critical roles in enzyme reactions, respiration, kidney function, and blood clotting, and is involved in neurotransmitter and hormone release, amino acid uptake, vitamin B12 absorption, and gastrin secretion. Calcium balance changes with age: it is positive during periods of growth, stable in adulthood, and tends to become negative in older age. Calcium loss occurs through feces, urine, sweat, and shedding skin cells. In women, reduced estrogen levels decrease calcium absorption and retention, increase bone turnover, and lead to lower bone mass. Calcium supplements come in various forms, including citrate and carbonate, which differ mainly in their calcium content and absorption rates. Calcium citrate is easily absorbed and can be taken without food, making it suitable for older adults or those with low stomach acid. In contrast, calcium carbonate, which contains a higher percentage of calcium, is best absorbed when taken with meals.
See More Information Regarding Calcium

Calcium - More Interactions

Calcium interacts with 156 drugs

Interaction Rating Key

These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.

Major The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur.
Moderate Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur.
Minor Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction.
Unknown No interactions have been reported or no interaction data is currently available.

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Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Drug descriptions are provided by MedlinePlus.

Dr. Brian Staiger, PharmD

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Dr. Brian Staiger, PharmD

In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!

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