Drug General Information (ID: DDIJLNB7X8)
Drug Name			Raltegravir		Drug Info		Sodium zirconium cyclosilicate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiviral Agents				Cation Exchange Resins
Structure

Mechanism of Raltegravir-Sodium zirconium cyclosilicate Interaction (Severity Level: Moderate)
Altered gastric pH Click to Show/Hide Mechanism Graph
Drug Name		Raltegravir				Sodium zirconium cyclosilicate
Mechanism		Gastric pH sensitive				Gastric alkalinizer
Key Mechanism Factor 1
		Factor Name		Gastric pH
		Factor Description		The normal pH range of gastric acid is between 1.5 and 3.5 and is highly acidic, consisting mainly of hydrochloric acid. Changes in the pH of the stomach can alter the absorption of drugs.
Mechanism Description		Decreased absorption of Raltegravir due to altered gastric pH caused by Sodium zirconium cyclosilicate

Recommended Action
Management		In general, concomitant oral medications should be administered at least 2 hours before or 2 hours after sodium zirconium cyclosilicate. Separation of dosing times is not needed if it has been determined that the concomitant medication does not exhibit pH-dependent solubility.

References
1	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2	Product Information. Lokelma (sodium zirconium cyclosilicate). Astra-Zeneca Pharmaceuticals, Wilmington, DE.