Tivicay and coffee?
Feb 18, 2014
Dear Dr. Young
I take 50 mg Tivicay (with Epzicom) and I read up on the pharmacokinetics and it says 'Dolutegravir is metabolized by UGT1A1 with some contribution from CYP3A.' And goes on to say that drugs which induce UGH1A1 and other UGH1X enzymes may decrease Dolutegravir's plasma concentration and affect the effectiveness of the medication. Another search shows that Coffee (regular as well as decaf) is a strong inducer of UGH1A1 and some people drink coffee because it cleanses the body of toxins. Green tea also induces this enzyme but not black tea or Cola.
So my understanding is that inducing this enzyme means that the liver (and other organs where this enzyme is active) makes the body mop up and get rid of the medication more rapidly. I've looked for an excuse to stop the several cups of coffee A friend from London brought over excellent English black tea so I'm not missing my daily Joe too much.
Your thoughts much valued.
Response from Dr. Young
Hello and thanks for posting.
This interaction shouldn't cause significant decreases in dolutegravir (Tivicay) levels- in virus sensitive to integrase inhibitors, the drug has a wide margin of effectiveness so that small changes in drug levels aren't expected to have any differences in outcomes.
Go ahead and keep drinking the joe.
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