Standard Dosing in Adults

Treatment-Naive Patients

Scenario	Dose	Frequency
Standard dosing (no enzyme inducers)	50 mg	Once daily
With rifampicin or other strong inducers	50 mg	Twice daily

Treatment-Experienced Patients

Patient Type	Dose	Frequency
Integrase inhibitor-naive	50 mg	Once daily
With integrase resistance mutations	50 mg	Twice daily

Pediatric Dosing

Dolutegravir is approved for pediatric patients weighing at least 3 kg. Dosing is weight-based.

Weight-Based Dosing (Once Daily)

Body Weight	Dose	Formulation
3 kg to <6 kg	5 mg	Dispersible tablet (10 mg split)
6 kg to <10 kg	10 mg	Dispersible tablet (TAPIVIR DT 10)
10 kg to <14 kg	15 mg	Dispersible tablet (10 mg + 5 mg)
14 kg to <20 kg	20 mg	Dispersible tablet (2 × 10 mg)
20 kg to <30 kg	30 mg	Dispersible tablet (3 × 10 mg)
≥30 kg	50 mg	Film-coated tablet (TAPIVIR 50)

Pediatric Dosing with Enzyme Inducers (Twice Daily)

When used with rifampicin or other strong enzyme inducers, double the once-daily dose and administer twice daily.

Dosing in Special Populations

Renal Impairment

Mild impairment (eGFR 60-89 mL/min): No dose adjustment needed
Moderate impairment (eGFR 30-59 mL/min): No dose adjustment needed
Severe impairment (eGFR <30 mL/min): Limited data; use with caution
End-stage renal disease (ESRD): No dose adjustment needed; dolutegravir is minimally renally eliminated

Hepatic Impairment

Mild impairment (Child-Pugh A): No dose adjustment needed
Moderate impairment (Child-Pugh B): No dose adjustment needed; use with caution
Severe impairment (Child-Pugh C): Limited data; use with caution; consider dose adjustment

Pregnancy

Standard dose: 50 mg once daily
Some experts recommend 50 mg twice daily in third trimester due to reduced plasma concentrations
Therapeutic drug monitoring may be considered
Dolutegravir is recommended for use in pregnant women with HIV

Postpartum Period

Return to standard dosing (50 mg once daily) after delivery
Monitor for potential drug interactions with postpartum medications

Administration Instructions

General Administration

Tablets should be swallowed whole with water
May be taken with or without food
Food increases absorption by approximately 50%; consistent administration with or without food is recommended
Take at the same time each day to maintain consistent plasma concentrations

Dispersible Tablets (TAPIVIR DT 10)

Can be swallowed whole with water
Can be dispersed in water or other liquid
To disperse: Add tablet to small amount of liquid (approximately 5 mL), stir until dispersed, and drink immediately
Strawberry flavor aids palatability for pediatric patients

Timing with Other Medications

Antacids: Take dolutegravir 2 hours before or 6 hours after antacids containing aluminum or magnesium
Calcium supplements: Take dolutegravir 2 hours before or 6 hours after calcium supplements
Iron supplements: Take dolutegravir 2 hours before or 6 hours after iron supplements
Other antiretrovirals: May be taken at the same time as other antiretroviral agents

Missed Dose Instructions

If a dose is missed, take it as soon as remembered
If it is almost time for the next dose, skip the missed dose
Do not double the dose to make up for a missed dose
Maintain consistent dosing schedule to optimize efficacy

Overdose Management

No specific antidote for dolutegravir overdose
Treatment is supportive and symptomatic
Activated charcoal may reduce absorption if administered shortly after overdose
Monitor vital signs and clinical status
Hemodialysis unlikely to be effective due to high protein binding
Contact poison control center or seek emergency medical care for overdose

Drug Interactions Requiring Dosage Adjustment

Enzyme Inducers (Require Twice-Daily Dosing)

Rifampicin: Increase to 50 mg twice daily
Phenytoin, carbamazepine, phenobarbital: Consider 50 mg twice daily
St. John's Wort: Avoid or use 50 mg twice daily

No Dosage Adjustment Needed

Protease inhibitors (ritonavir, cobicistat)
Integrase inhibitors
NRTIs and NNRTIs
Most other antiretroviral agents

For Doctors Resources

SMPC PIL (Patient Information) Clinical Data & Efficacy Dosage & Administration Interactions & Contraindications

Quick Dosing Reference

Adults: 50 mg once daily
With inducers: 50 mg twice daily
Pediatric: Weight-based dosing
Renal impairment: No adjustment
Hepatic impairment: No adjustment (mild-mod)
Pregnancy: 50 mg once daily

Important Notes

Separate from antacids by 2-6 hours
Take at same time daily
Food increases absorption

Medical Information

For dosing questions or special circumstances, contact our medical team.

Dosage & Administration Guide