Drug General Information (ID: DDIW60N5A9)
Drug Name			Raltegravir		Drug Info		Magnesium gluconate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiviral Agents				Minerals And Electrolytes
Structure

Mechanism of Raltegravir-Magnesium gluconate Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Raltegravir				Magnesium 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 Magnesium gluconate due to formation of complexes caused by Raltegravir

Recommended Action
Management		It is not known to what extent non-antacid aluminum and magnesium salts may interact with raltegravir. Until more information is available, it may be advisable to avoid taking raltegravir with any aluminum- and/or magnesium-containing product. According to the manufacturer, antacids containing calcium carbonate may be used without dose adjustment for raltegravir.

References
1	Canadian Pharmacists Association.
2	Cerner Multum, Inc. "Australian Product Information.".
3	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
4	Kiser JJ, Bumpass JB, Meditz AL, et al. "Effect of antacids on the pharmacokinetics of raltegravir in human immunodeficiency virus seronegative volunteers." Antimicrob Agents Chemother 54 (2010): 4999-5003. [PMID: 20921313]
5	Moss DM, Siccardi M, Murphy M, et al. "Divalent metals and pH alter raltegravir disposition in vitro." Antimicrob Agents Chemother 56 (2012): 3020-6. [PMID: 22450971]
6	Product Information. Isentress (raltegravir). Merck & Company Inc, West Point, PA.