Drug General Information (ID: DDIYS4WA32)
Drug Name			Dolutegravir		Drug Info		Ferrous sulfate anhydrous		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiviral Agents				Iron Supplement
Structure

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

Recommended Action
Management		Dolutegravir should be administered 2 hours before or 6 hours after medications containing polyvalent cations such as antacids, laxatives, or mineral supplements.

References
1	Product Information. Tivicay (dolutegravir). ViiV Healthcare, Research Triangle Park, NC.
2	Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm 66 (2009): 1438-67. [PMID: 19667002]