Q and A

Question

Will dolutegravir effect how much Metformin my body absorbs?

I have a question regarding the dosage of dolutegravir and Metformin intake together. I have been on dolutegravir since 2020. My doctor prescribed me metformin 1000 mg daily. On the Liverpool HiV drugs interaction site it says that daily 50 mg dolutegravir dose sufficiently increases plasma concentration of metformin. My doctor doesn’t know about my HIV positive status, can you please advise if I should take half tab of Metformin (together with DTG) or just 1000 mg as it is prescribed by my doctor?

Answer

Hi, how are you doing?

You are correct, there is an interaction between Metformin and dolutegravir and this should be monitored.

This is because doultegravir can significantly increase how much metformin is absorbed by the body. This means there is a risk of hypoglyceamia (low blood sugar).

1000 mg of Metformin is the recommended starting dose when administering with dolutegravir. However this should be done under medical supervision to prevent complications.

In addition, when starting Metformin renal function (kidneys) should be monitored alongside. This is because Metformin is excreted from the body by the kidneys and poor kidney function would increase the level of metformin in the body.

Are you comfortable to discuss this with your doctor?  At i-base we are not doctors and cannot suggest dose adjustments in line with drug interactions. This needs to be a decision made between yourself and your healthcare provider.

Josh.

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