Dolutegravir: uses, dosing, side effects & brands
Dolutegravir is a human immunodeficiency virus integrase strand transfer inhibitor sold in the U.S. under 3 brand and generic names, for hiv infections. Below: what the FDA label says, every product that contains it, what the pills look like, and its recall record.
Key facts
- Drug class
- Human Immunodeficiency Virus Integrase Strand Transfer Inhibitor
- Treats
- Hiv Infections
- Available as
- Tablet
- Sold as
- 3 products — Dolutegravir Sodium, Tivicay and Tivicay Pd
- Prescription?
- Prescription only
- Generic available?
- Yes
- Half-life
- about 14 hours
How dolutegravir is dosed
From the FDA label for Tivicay (application NDA204790). Other dolutegravir products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.
May be taken without regard to food. ( 2.2 , 2.6) UGT = uridine diphosphate glucuronosyltransferase; CYP = cytochrome P450. a Rilpivirine dose is 25 mg once daily for those switching to dolutegravir plus rilpivirine. b Alternative combinations that do not include metabolic inducers should be considered where possible. Adult Population Recommended Dose Treatment-naïve or treatment-experienced INSTI-naïve or virologically suppressed (HIV-1 RNA <50 copies per mL) adults switching to dolutegravir plus rilpivirine a ( 2.1 ) 50 mg once daily Treatment-naïve or treatment-experienced INSTI-naïve when coadministered with certain UGT1A or CYP3A inducers ( 2.1 , 7.2 , 7.3 ) 50 mg twice daily INSTI-experienced with certain INSTI-associated resistance substitutions or clinically suspected INSTI resistance b ( 2.1 , 12.4 ) 50 mg twice daily Pediatric Patients: Treatment-naïve or treatment-experienced INSTI-naïve patients aged at least 4 weeks and weighing at least 3 kg. See Tables 2 , 3 , and 4 for complete pediatric dosing recommendations. ( 2.3 , 2.4 , 2.5 ). TIVICAY and TIVICAY PD are not bioequivalent and are not substitutable on a milligram-per-milligram basis. a If certain UGT1A or CYP3A inducers are coadministered, then adjust the weight-based dose of TIVICAY to twice daily. ( 2.3 , 2.4 , 7.2 , 7.3 ) Pediatric Population Body Weight Recommended Dose a TIVICAY PD Tablets for Oral…
Dolutegravir side effects
The following serious adverse drug reactions are discussed in other sections of the labeling: Hypersensitivity reactions [see Warnings and Precautions ( 5.1 )] . Hepatotoxicity [see Warnings and Precautions ( 5.2 )]. Immune Reconstitution Syndrome [see Warnings and Precautions ( 5.4 )] . The most common adverse reactions of moderate to severe intensity and incidence at least 2% (in those receiving TIVICAY in any one adult trial) are insomnia, fatigue, and headache. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact ViiV Healthcare at 1-877-844-8872 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch . 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug and may not reflect the rates observed in practice. Clinical Trials Experience in Adult Subjects Treatment-Naïve Subjects: The safety assessment of TIVICAY in HIV‑1–infected treatment-naïve subjects is based on the analyses of data from 2 international, multicenter, double-blind trials, SPRING-2 (ING113086) and SINGLE (ING114467) and data from the international, multicenter, open-label FLAMINGO (ING114915) trial. In SPRING-2, 822 subjects were randomized and received at least 1 dose of either TIVICAY 50 mg once daily or raltegravir 400 mg…
Who shouldn’t take dolutegravir
TIVICAY and TIVICAY PD are contraindicated in patients: with previous hypersensitivity reaction to dolutegravir [see Warnings and Precautions ( 5.1 )]. receiving dofetilide due to the potential for increased dofetilide plasma concentrations and the risk for serious and/or life-threatening events [see Drug Interactions ( 7 )] . Previous hypersensitivity reaction to dolutegravir. ( 4 ) Coadministration with dofetilide. ( 4 )
Dolutegravir drug interactions
Refer to the full prescribing information for important drug interactions with TIVICAY or TIVICAY PD. ( 4 , 7 ) Drugs that are metabolic inducers may decrease the plasma concentrations of dolutegravir. ( 7.2 , 7.3 ) TIVICAY or TIVICAY PD should be taken 2 hours before or 6 hours after taking cation-containing antacids or laxatives, sucralfate, oral supplements containing iron or calcium, or buffered medications. When taken with food, TIVICAY and supplements containing calcium or iron can be taken at the same time. ( 7.3 ) 7.1 Effect of Dolutegravir on the Pharmacokinetics of Other Agents In vitro, dolutegravir inhibited the renal organic cation transporters, OCT2 (IC 50 = 1.93 microM) and multidrug and toxin extrusion transporter (MATE) 1 (IC 50 = 6.34 microM). In vivo, dolutegravir inhibits tubular secretion of creatinine by inhibiting OCT2 and potentially MATE1. Dolutegravir may increase plasma concentrations of drugs eliminated via OCT2 or MATE1 (dofetilide, dalfampridine, and metformin, Table 8 ) [see Contraindications ( 4 ), Drug Interactions ( 7.3 )] . In vitro, dolutegravir inhibited the basolateral renal transporters, organic anion transporter (OAT) 1 (IC 50 = 2.12 microM) and OAT3 (IC 50 = 1.97 microM). However, in vivo, dolutegravir did not alter the plasma concentrations of tenofovir or para-amino hippurate, substrates of OAT1 and OAT3. In vitro, dolutegravir did not inhibit (IC 50 greater than 50 microM) the following: cytochrome P450 (CYP)1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP3A, uridine diphosphate glucuronosyltransferase (UGT)1A1, UGT2B7, P-glycoprotein (P-gp), breast cancer resistance protein (BCRP), bile salt export pump (BSEP), organic anion transporter polypeptide (OATP)1B1, OATP1B3, OCT1, multidrug resistance protein (MRP)2, or MRP4. In vitro, dolutegravir did not induce CYP1A2, CYP2B6, or CYP3A4. Based on these data and the results of drug interaction trials, dolutegravir is not expected to affect the pharmacokinetics of drugs that are substrates of these enzymes or transporters. 7.2 Effect of Other Agents on the Pharmacokinetics of Dolutegravir Dolutegravir is metabolized by UGT1A1 with some contribution from CYP3A. Dolutegravir is also a substrate of UGT1A3, UGT1A9, BCRP, and P-gp in vitro. Drugs that induce those enzymes and transporters may decrease dolutegravir plasma concentration and reduce the therapeutic effect of dolutegravir. Coadministration of dolutegravir and other drugs that inhibit these enzymes may increase dolutegravir plasma concentration. Etravirine significantly reduced plasma concentrations of dolutegravir, but the effect of etravirine was mitigated by coadministration of lopinavir/ritonavir or darunavir/ritonavir and is expected to be mitigated by atazanavir/ritonavir ( Table 8 ) [see Drug Interactions ( 7.3 ), Clinical Pharmacology ( 12.3 )] . In vitro, dolutegravir was not a substrate of OATP1B1 or OATP1B3. 7.3 Established and Other Potentially Significant Drug Interactions Table 8 provides clinical recommendations as a result of drug interactions with TIVICAY or TIVICAY PD. These recommendations are based on either drug interaction trials or predicted interactions due to the expected magnitude of interaction and potential for serious adverse events or loss of efficacy [ s ee Dosage and Administration ( 2 ), Clinical Pharmacology ( 12.3 )]. Table 8. Established and Other Potentially Significant Drug Interactions: Alterations in Dose or Regimen May Be Recommended Based on Drug Interaction Trials or Predicted Interactions [see Dosage and Administration ( 2 )] INSTI = integrase strand transfer inhibitor. a See Clinical Pharmacology ( 12.3 ) Table 11 or Table 12 for magnitude of interaction. b The lower dolutegravir exposures observed in INSTI-experienced patients (with certain INSTI-associated resistance substitutions or clinically suspected INSTI resistance [see Microbiology ( 12.4 )] ) upon coadministration with certain inducers may result in loss of therapeutic effect and development of resistance to TIVICAY or other coadministered antiretroviral agents. Concomitant Drug Class: Drug Name Effect on Concentration of Dolutegravir and/or Concomitant Drug Clinical Comment HIV-1 Antiviral Agents Non-nucleoside reverse transcriptase inhibitor: Etravirine a ↓Dolutegravir Use of TIVICAY or TIVICAY PD with etravirine without coadministration of atazanavir/ritonavir, darunavir/ritonavir, or lopinavir/ritonavir is not recommended. Non-nucleoside reverse transcriptase inhibitor: Efavirenz a ↓Dolutegravir Adjust dose of TIVICAY to twice daily for treatment-naïve and treatment-experienced, INSTI-naïve adult patients. In pediatric patients, increase the weight-based dose of TIVICAY or TIVICAY PD to twice daily (Tables 2 , 3 , and 4 ). Use alternative combinations that do not include metabolic inducers where possible for INSTI-experienced patients with certain INSTI-associated resistance substitutions or clinically suspected INSTI resistance. b Non-nucleoside reverse transcriptase inhibitor: Nevirapine ↓Dolutegravir Avoid coadministration with nevirapine because there are insufficient data to make dosing recommendations. Protease inhibitors: Fosamprenavir/ritonavir a Tipranavir/ritonavir a ↓Dolutegravir Adjust dose of TIVICAY to twice daily for treatment-naïve and treatment-experienced, INSTI-naïve adult patients. In pediatric patients, increase the weight-based dose of TIVICAY or TIVICAY PD to twice daily (Tables 2 , 3 , and 4 ). Use alternative combinations that do not include metabolic inducers where possible for INSTI-experienced patients with certain INSTI-associated resistance substitutions or clinically suspected INSTI resistance. b Other Agents Dofetilide ↑Dofetilide Coadministration is contraindicated with TIVICAY or TIVICAY PD [see Contraindications ( 4 )] . Carbamazepine a ↓Dolutegravir Adjust dose of TIVICAY to twice daily in treatment-naïve or treatment-experienced, INSTI-naïve adult patients. In pediatric patients, increase the weight-based dose of TIVICAY or TIVICAY PD to twice daily (Tables 2 , 3 , and 4 ). Use alternative treatment that does not include carbamazepine where possible for INSTI-experienced patients with certain INSTI-associated resistance substitutions or clinically suspected INSTI resistance. b Oxcarbazepine Phenytoin Phenobarbital St. John’s wort ( Hypericum perforatum ) ↓Dolutegravir Avoid coadministration with TIVICAY or TIVICAY PD because there are insufficient data to make dosing recommendations. Medications containing polyvalent cations (e.g., Mg or Al): Cation-containing antacids a or laxatives Sucralfate Buffered medications ↓Dolutegravir Administer TIVICAY or TIVICAY PD 2 hours before or 6 hours after taking medications containing polyvalent cations. Oral calcium or iron supplements, including multivitamins containing calcium or iron a ↓Dolutegravir When taken with food, TIVICAY and supplements or multivitamins containing calcium or iron can be taken at the same time. Under fasting conditions, TIVICAY or TIVICAY PD should be taken 2 hours before or 6 hours after taking supplements containing calcium or iron. Potassium channel blocker: Dalfampridine ↑Dalfampridine Elevated levels of dalfampridine increase the risk of seizures. The potential benefits of taking dalfampridine concurrently with TIVICAY or TIVICAY PD should be considered against the risk of seizures in these patients. Metformin ↑Metformin Refer to the prescribing information for metformin for assessing the benefit and risk of concomitant use of TIVICAY or TIVICAY PD and metformin. Rifampin a ↓Dolutegravir Adjust dose of TIVICAY to twice daily for treatment-naïve and treatment-experienced, INSTI-naïve adult patients. In pediatric patients, increase the weight-based dose of TIVICAY or TIVICAY PD to twice daily (Tables 2 , 3 , and 4 ). Use alternatives to rifampin where possible for INSTI-experienced patients with certain INSTI-associated resistance substitutions or clinically suspected INSTI resistance. b 7.4 Drugs without Clinically Significant Interactions with Dolutegravir Based on drug interaction trial results, the following drugs can be coadministered with dolutegravir without a dose adjustment: atazanavir/ritonavir, darunavir/ritonavir, elbasvir/grazoprevir, methadone, midazolam, omeprazole, oral contraceptives containing norgestimate and ethinyl estradiol, prednisone, rifabutin, rilpivirine, sofosbuvir/velpatasvir, and tenofovir [see Clinical Pharmacology ( 12.3 )] .
Every dolutegravir product we track (3)
Same active ingredient — different manufacturer, form, price and FDA recall record. That last one is what our independent score measures.
| # | Drug | Rating | Type | Form | Generic? | Pharmacy pays | |
|---|---|---|---|---|---|---|---|
| 1 | 70/100 | Prescription | Tablet | No data | — | View → | |
| 2 | Not yet rated | Prescription | Tablet | No data | — | View → | |
| 3 | Not yet rated | Prescription | Tablet | No data | — | View → |
What dolutegravir pills look like
Imprint codes, colour and shape from the FDA’s labelling data. Match the imprint on your pill — or search any imprint.
Combination products containing dolutegravir
A combination is a different drug — different dosing, different warnings. It is listed here so you can find it, not so you can substitute it.
Dolutegravir recalls
From the FDA Enforcement database. A recall covers specific lots — not the drug as a whole.
Can you crush or split dolutegravir?
At least one dolutegravirproduct is labelled to be swallowed whole — crushing an extended-release tablet releases the whole day’s dose at once. Which applies depends on the form you were given.
What each dolutegravir label says about crushing, splitting and chewingHow long dolutegravir keeps
No dolutegravir label we read sets a separate limit for after opening, but they do specify how it must be stored — and the stability behind any date assumes those conditions.
Does dolutegravir expire? The in-use limits and storage rules from its labelsDolutegravir and breastfeeding
From LactMed, the US National Library of Medicine’s Drugs and Lactation Database — quoted, not rewritten.
Full LactMed record for dolutegravir: levels in milk, effects in breastfed infants, and the drugs it would consider insteadDolutegravir is detectable in maternal milk in low amounts. It appears that elimination by newborn infants is prolonged, and the drug has been detected in infant plasma during breastfeeding. Dolutegravir has been used safely in HIV-positive mothers during breastfeeding and is recommended as a first-line drug during breastfeeding. Achieving and maintaining viral suppression with antiretroviral therapy decreases breastfeeding transmission risk to less than 1%, but not zero. Individuals with HIV who are on antiretroviral therapy with a sustained undetectable viral load and who choose to breastfeed should be supported in this decision. If a viral load is not suppressed, banked pasteurized donor milk or formula is recommended.
National Institute of Child Health and Human Development, record revised July 15, 2026. LactMed states its information is not a substitute for professional judgement.
What people report to the FDA about dolutegravir
The FDA Adverse Event Reporting System (FAERS) collects reports from patients and clinicians. It holds 1,629 reports naming dolutegravir, and the FDA flagged 95% of those reports as serious. The effects reported most often — leaving out reports about overdose, misuse or the condition being treated, which dominate the raw list for common medicines:
- exposure during pregnancy410 reports
- hypertension350 reports
- headache340 reports
- pyrexia338 reports
- hyperhidrosis326 reports
- hepatic enzyme increased320 reports
- immunodeficiency317 reports
- joint swelling315 reports
Read these as a signal, not a rate. A report does not mean dolutegravir caused the effect — anyone can file one, and many describe people taking several medicines for several conditions. Crucially there is no denominator: FAERS does not record how many people took the drug, so these counts cannot be turned into “X% of patients” — a bigger number often just means a more widely used or more talked-about drug. Duplicates exist, and publicity drives reporting. For what is actually established, read the FDA label section above.
Source: openFDA drug/event (FAERS), retrieved August 25, 2026.
How long dolutegravir stays in your system
The elimination half-life of dolutegravir is about 14 hours. This is the terminal (elimination) half-life, which the TIVICAY label gives as "approximately 14 hours," based on population pharmacokinetic analyses; the label reports no separate distribution-phase half-life. Dolutegravir is not a prodrug, and the label describes no active metabolite — it is metabolized mainly by UGT1A1 (with some CYP3A) to an ether glucuronide and oxidative metabolites that the label does not characterize as active, and just over half the dose leaves unchanged in the feces. On populations the label names: age had no clinically relevant effect on dolutegravir pharmacokinetics; mild and moderate kidney impairment had no clinically relevant effect on exposure, and in severe kidney impairment (CrCl under 30 mL/min) exposure was actually lower, not higher (AUC down 40%), with too little information to recommend dosing in people on dialysis; in moderate liver impairment (Child-Pugh B) exposure was similar to healthy controls, and severe liver impairment (Child-Pugh C) has not been studied. The label frames these as changes in exposure rather than stating a revised half-life for each group. People with UGT1A1 genotypes conferring poor metabolism had 32% lower clearance and 46% higher AUC. This figure describes how long the drug itself is cleared from plasma — it is not a drug-test detection window (metabolites can be detected far longer) and not dosing guidance.
DailyMed — TIVICAY (dolutegravir sodium) tablet, film coated — Clinical Pharmacology (12.3) ↗Half-life is how long the body takes to clear half a dose. It is not the same as how long a drug test can detect it, and it varies with age, kidney and liver function.
Related calculators
Frequently asked questions
What is dolutegravir?
TIVICAY contains dolutegravir, as dolutegravir sodium, an HIV INSTI.
What kind of drug is dolutegravir?
The FDA classifies dolutegravir as a human immunodeficiency virus integrase strand transfer inhibitor. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.
How long does dolutegravir stay in your system?
The elimination half-life of dolutegravir is about 14 hours — that is how long the body takes to clear half of a dose. This is the terminal (elimination) half-life, which the TIVICAY label gives as "approximately 14 hours," based on population pharmacokinetic analyses; the label reports no separate distribution-phase half-life. Dolutegravir is not a prodrug, and the label describes no active metabolite — it is metabolized mainly by UGT1A1 (with some CYP3A) to an ether glucuronide and oxidative metabolites that the label does not characterize as active, and just over half the dose leaves unchanged in the feces. On populations the label names: age had no clinically relevant effect on dolutegravir pharmacokinetics; mild and moderate kidney impairment had no clinically relevant effect on exposure, and in severe kidney impairment (CrCl under 30 mL/min) exposure was actually lower, not higher (AUC down 40%), with too little information to recommend dosing in people on dialysis; in moderate liver impairment (Child-Pugh B) exposure was similar to healthy controls, and severe liver impairment (Child-Pugh C) has not been studied. The label frames these as changes in exposure rather than stating a revised half-life for each group. People with UGT1A1 genotypes conferring poor metabolism had 32% lower clearance and 46% higher AUC. This figure describes how long the drug itself is cleared from plasma — it is not a drug-test detection window (metabolites can be detected far longer) and not dosing guidance. Half-life is not the same as how long a drug test can detect the drug, and it varies with age, kidney and liver function.
Can you take dolutegravir with other medicines?
It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run dolutegravir against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.
What brand names is dolutegravir sold under?
We track 3 dolutegravir-containing products in the U.S.: Dolutegravir Sodium, Tivicay and Tivicay Pd. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.
What forms does dolutegravir come in?
Across the brands we track, dolutegravir is currently marketed as tablet, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.
Is there a generic dolutegravir?
Yes. Our catalog lists 1 generic dolutegravir product alongside the brand versions. A generic has the same active ingredient and must meet the FDA's bioequivalence standard; it usually costs less. Ask your pharmacist which one your plan covers.
Has dolutegravir been recalled?
The FDA's Enforcement database lists 1 recall record whose product description mentions dolutegravir. The most recent: Tivicay PD (dolutegravir) 5mg Tablets for Oral Suspension (May 17, 2024). A recall applies to specific lots, not to the drug as a whole — check the record for the affected lot numbers.
Cite this page
- APA
- pharmaranks. (2026, July 24). Dolutegravir: uses, dosing, side effects & brands. https://pharmaranks.com/drugs/dolutegravir
- MLA
- “Dolutegravir: uses, dosing, side effects & brands.” pharmaranks, 24 July 2026, https://pharmaranks.com/drugs/dolutegravir.
We summarise public FDA and NIH sources — for a clinical claim, cite the primary source we link to as well.
Sources: FDA openFDA drug label, National Drug Code Directory, and Enforcement (recall) database. This page reproduces public FDA data and is not medical advice. Dosing is set by your prescriber.
Read the full FDA label for dolutegravir on DailyMed (NIH) ↗.