An HIV integrase inhibitor used in a single-tablet regimen
Bictegravir
An HIV integrase inhibitor used, as part of combination therapy, usually in a single-tablet regimen.
What is Bictegravir?
Bictegravir is an HIV medicine in the integrase inhibitor group. It is usually given as part of a single daily tablet that combines several HIV medicines, making treatment simple. It is generally well tolerated and has relatively few drug interactions. It can raise the creatinine reading on kidney blood tests without actually harming the kidneys, which the team understands and allows for. It is part of combination therapy, controlling HIV but not curing it, so it must be taken consistently.
Education and reference only. This is a plain-language guide to Bictegravir — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Bictegravir is an HIV medicine belonging to a group called integrase inhibitors. It is most often used as part of a single-tablet regimen, a single daily tablet that combines bictegravir with other HIV medicines, so the whole treatment is taken as one pill. It is widely used because it is simple to take, generally well tolerated, and has relatively few interactions with other medicines. It is taken by mouth once a day and is prescribed and supervised by a specialist HIV team. It is part of combination therapy and controls HIV but does not cure it.
How it works
To make new copies of itself, HIV must insert its genetic material into the DNA of the body's cells using an enzyme called integrase. Bictegravir blocks this enzyme, so the virus cannot complete this step and the amount of HIV in the body falls. Because it is combined with other HIV medicines in one tablet, the virus is attacked in more than one way at once, which helps keep it suppressed and makes resistance less likely. Keeping the virus suppressed protects the immune system and lowers the chance of passing HIV on.
Company & origin
Originated / developed by: Specialist manufacturer.
A widely used HIV medicine in the UK, given as part of a single daily combination tablet.
Practical use
How to take Bictegravir
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take the single daily tablet by mouth at about the same time each day.
- Take it consistently and do not skip doses, as missed doses can let the virus become resistant.
- Separate it from antacids, and from iron or calcium supplements, by taking them at different times as advised, since these can stop it being absorbed.
- Do not be alarmed if a kidney blood test (creatinine) reads slightly higher; this is expected and does not mean kidney damage.
- Tell your team about all your other medicines and supplements, even though it has relatively few interactions.
Weighing it up
Advantages & disadvantages of Bictegravir
Advantages
- Usually taken as a simple single daily tablet that combines several HIV medicines.
- Generally well tolerated, with relatively few drug interactions.
- Effective at suppressing HIV as part of combination therapy.
Disadvantages
- Raises the creatinine reading on kidney tests, which can be confusing even though it is harmless.
- Must be separated from antacids and iron or calcium supplements to be absorbed properly.
- Controls HIV but does not cure it, so must be taken consistently for life.
Practical use
Good to know
A helpful thing to know is that bictegravir can raise the creatinine reading on kidney blood tests without actually damaging the kidneys; this is a harmless effect of how it works, and your team takes it into account. It is generally well tolerated, with headache and tummy upset among the more common effects. It has relatively few drug interactions compared with some older HIV medicines, but a few are important: it should be separated from antacids and from iron or calcium supplements, which can stop it being absorbed, so take these at different times as advised. Because it usually comes as a single daily combination tablet, treatment is simple, but it still needs to be taken consistently. As with all HIV treatment, it works as part of combination therapy and controls the virus rather than curing it.
Who should not take it / use with caution
- People who have had a serious allergic reaction to bictegravir should not take it.
- It should not be combined with certain medicines, such as some epilepsy and tuberculosis treatments, that strongly lower its levels.
- It is used under specialist supervision, with attention to other medicines and supplements.
Monitoring
- Checking the amount of HIV in the blood (viral load) and the immune cell count (CD4) to see how well it is working.
- Reviewing kidney function, bearing in mind the expected harmless rise in creatinine.
- Watching for side effects such as sleep or mood changes over time.
Side effects
- Headache.
- Nausea, diarrhoea or other tummy upset.
- A harmless rise in the creatinine reading on kidney blood tests.
- Less commonly, sleep problems or low mood, which should be reported.
Key interactions
- Antacids, and iron or calcium supplements, can stop it being absorbed, so they must be taken at different times.
- Some epilepsy and tuberculosis medicines, and the herbal product St John's wort, can lower its levels and should be avoided.
- Tell your team about all your medicines and supplements so timing and choices can be checked.
Available as: A single daily combination tablet taken by mouth.
Answers
Bictegravir: frequently asked questions
What is bictegravir used for?
It is an HIV integrase inhibitor used, as part of combination therapy, to suppress HIV, usually given in a single daily combination tablet.
Why has my creatinine gone up?
Bictegravir can raise the creatinine reading on kidney blood tests without actually harming the kidneys; this is expected and your team takes it into account.
Can I take it with indigestion remedies?
Antacids, and iron or calcium supplements, can stop bictegravir being absorbed, so they need to be taken at different times as your team advises.
Is it easy to take?
Yes, it usually comes as a single daily tablet that combines several HIV medicines, and it is generally well tolerated with relatively few interactions.
Does it cure HIV?
No. Bictegravir controls HIV as part of combination therapy but does not cure it, so it must be taken consistently and continued long term.
The wider class
About HIV integrase inhibitor
Bictegravir belongs to the hiv integrase inhibitor class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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