Drug General Information (ID: DDIFT59OAN)
Drug Name			Elvitegravir		Drug Info		Zinc gluconate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiviral Agents				Minerals And Electrolytes
Structure

Mechanism of Elvitegravir-Zinc gluconate Interaction (Severity Level: Major)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Elvitegravir				Zinc gluconate
Mechanism		Binds to polyvalent cations				Polyvalent cations
Key Mechanism Factor 1
		Factor Name		Chelation
		Factor Description		Chelation is a direct drug interaction that usually involves the formation of dimers or trimers, resulting in larger complexes and poorer absorption.
Mechanism Description		Decreased absorption of Zinc gluconate due to formation of complexes caused by Elvitegravir

Recommended Action
Management		If concomitant use is required, monitor for virologic efficacy and administer the INSTI such as elvitegravir or raltegravir at least 2 hours before or 6 hours after supplements containing polyvalent cations such as zinc.

References
1	Product Information. Biktarvy (bictegravir/emtricitabine/tenofovir). Gilead Sciences, Foster City, CA.
2	Product Information. Tivicay (dolutegravir). ViiV Healthcare, Research Triangle Park, NC.
3	US National Library of Medicine "Guidelines for the use of antiretroviral agents in adults and adolescents with HIV.".