Drug General Information (ID: DDIJVA3O62)
Drug Name			Bictegravir		Drug Info		Ferrous fumarate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiviral Agents				Iron Supplement
Structure

Mechanism of Bictegravir-Ferrous fumarate Interaction (Severity Level: Major)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Bictegravir				Ferrous fumarate
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 Ferrous fumarate due to formation of complexes caused by Bictegravir

Recommended Action
Management		When used with antacids containing aluminum, magnesium or calcium, bictegravir may be taken under fasting conditions 2 hours before the antacids. Routine administration of bictegravir simultaneously with, or 2 hours after, antacids containing aluminum, magnesium or calcium is not recommended. When used with supplements containing calcium or iron, bictegravir and the supplements may be taken together with food.

References
1	Cerner Multum, Inc. "Australian Product Information.".
2	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
3	Product Information. Biktarvy (bictegravir/emtricitabine/tenofovir). Gilead Sciences, Foster City, CA.