Quick answer

Ask your pharmacist or doctor before combining. The dolutegravir label documents 2 supplements: calcium and iron, including multivitamins that contain them. Both can lower the level of the medicine, and the label sets a different rule when they are taken with food. MedlinePlus names a wider group of mineral products.^1,2,3

Key facts

The label says oral calcium or iron supplements, including multivitamins that contain them, lower dolutegravir levels.¹
NIH's calcium sheet says calcium taken at the same time can reduce dolutegravir blood levels substantially, apparently through chelation.⁴
MedlinePlus adds antacids, laxatives and multivitamins with aluminum, magnesium or calcium to the products that need a schedule.³
The label and MedlinePlus both change the rule for these supplements when dolutegravir is taken with food.^1,3
MedlinePlus names one herbal product, St. John's wort, as a possible interaction.³

What is dolutegravir, and why do mineral supplements matter with it?

MedlinePlus says dolutegravir is an HIV integrase inhibitor used to treat HIV infection, and that it works by lowering the amount of HIV in the blood. It is taken by mouth once or twice a day, with or without food, and the food part matters here because it changes the supplement rule.³

NIH's calcium sheet gives the likely mechanism: calcium taken at the same time can cut dolutegravir blood levels substantially, apparently through chelation, which means the mineral binds the medicine.⁴

What does the dolutegravir label say about calcium and iron?

Calcium is the better documented of the two: the label and both of NIH's calcium sheets name dolutegravir.^1,4,5

Ask your pharmacist how far apart to take them

Calcium supplements taken at the same time as dolutegravir can lower its blood levels considerably. Its label explains when the two may be taken together with food and when they must be kept apart.^1,4,5

On the medicine's label

Iron rests on the label alone. NIH's iron sheets do not mention dolutegravir, so the label is the source to ask about, including for a multivitamin that carries iron.²

Ask your pharmacist how far apart to take them

Oral iron supplements, including multivitamins with iron, lower blood levels of the medicine dolutegravir. Its label explains when they may be taken together with food and when they must be kept apart.²

On the medicine's label

Does taking dolutegravir with food change the rule?

The label and MedlinePlus both describe two situations, with food and without, and give a different rule for each. This page does not repeat either rule, because applying one depends on how you take dolutegravir and which product you use, and mixing them up is easy.^1,3

Ask your pharmacist to say the rule for your own routine, in terms of your own doses and your own supplement, and to write it down.

Which other products does MedlinePlus name for dolutegravir?

MedlinePlus names a wider group than calcium and iron. It lists antacids, laxatives and multivitamins that contain aluminum, magnesium or calcium, along with calcium supplements, iron supplements, sucralfate and buffered medicines such as buffered aspirin. It also names one herbal product, St. John's wort.³

These are pointers for your pharmacy visit, not entries on this page. MedlinePlus also asks people to tell their doctor and pharmacist about every vitamin and nutritional supplement before starting.³

What do on the label and separate doses mean for calcium and iron?

Both entries are on the label and both carry the tag separate doses. Calcium is also in NIH's sheets, and iron is on the label only. Separate doses marks an official source asking for a schedule between the two, and here that schedule depends on food.

What should you ask your pharmacist about dolutegravir and supplements?

Which of my products contain calcium or iron, including my multivitamin and any antacid?
Do I take dolutegravir with food, and what rule applies to each supplement in that case?
What rule applies on the days I take it without food?
Does my herbal product, such as St. John's wort, appear on any list for this medicine?
Who should I tell before I start a new supplement?

Questions people ask

What vitamins should not be taken with dolutegravir?

The label names multivitamins that contain calcium or iron, and MedlinePlus names multivitamins with aluminum, magnesium or calcium. For any other vitamin the sources checked do not address it. That is not a finding either way, so ask your pharmacist.^1,3

Do calcium supplements affect dolutegravir?

NIH and the label say calcium taken at the same time can lower dolutegravir blood levels considerably. The label explains when the two may be taken together with food and when they must be kept apart.^1,4

Can I take a multivitamin with dolutegravir?

Multivitamins that contain calcium or iron are named by the label, so it depends on what is in yours. Bring the Supplement Facts panel to your pharmacist.²

Does food change the rule for dolutegravir and supplements?

Yes, in both the label and MedlinePlus the rule for these supplements differs when dolutegravir is taken with food. Ask your pharmacist to apply it to your own routine.^1,3

What supplements interact with dolutegravir?

Calcium and iron are documented, and MedlinePlus adds antacids, laxatives, magnesium and aluminum products, and St. John's wort. Anything else is not addressed by the sources checked, which is not a finding either way, so ask your pharmacist.^1,3

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Sources

This page is information, not medical advice. Talk to your doctor or pharmacist about your own situation.