Choice of integrase inhibitor

Integrase inhibitors are the newest family of drugs. 

There are four approved oral integrase inhibitors.

They are also in these fixed dose combinations (FDCs).

All these once-daily drugs are very effective. However, about 5% of people report mood changes or interrupted sleep. This can sometimes be reduced by taking ART in the morning.

Weight gain has been recently reported as a side effect that might be higher with dolutegravir or bictegravir, and might be higher in women compared to men.

Elvitegravir/c need to be taken with food.

The raltegravir dose involves two pills. Sometimes raltegravir is also dosed twice-daily.

Dolutegravir has a lower risk of drug resistance and it can sometimes overcome other integrase resistance (when it is used twice-daily).

The main drug interactions with INIs are with supplements that contain calcium, magnesium or aluminium. These can sometimes still be taken by separating the dosing times. See the prescribing leaflet for each drug.

Last updated: 1 October 2019.