A boosted HIV integrase inhibitor used in a single-tablet regimen
Elvitegravir
A boosted HIV integrase inhibitor used, as part of combination therapy, in a single-tablet regimen taken with food.
What is Elvitegravir?
Elvitegravir is an HIV medicine in the integrase inhibitor group. It is always 'boosted' by another medicine (cobicistat) that keeps its levels up, and it comes as part of a single daily combination tablet. Because of the booster, it interacts with a large number of other medicines, so a full medicines list is important. It should be taken with food to work properly. 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 Elvitegravir — 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
Elvitegravir is an HIV medicine belonging to a group called integrase inhibitors. It is always given 'boosted' with another medicine (cobicistat) that raises and steadies its levels in the body, and it comes as part of a single-tablet regimen that combines several HIV medicines in one daily pill. The booster is what makes the combination effective, but it is also why this medicine interacts with many others. It is taken by mouth once a day with food 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. Elvitegravir blocks this enzyme, so the virus cannot complete this step and the amount of HIV in the body falls. Because elvitegravir is broken down quickly, it is always paired with a booster that slows its breakdown so enough stays in the body, and it is combined with other HIV medicines so the virus is attacked in more than one way. Taking it with food helps it be absorbed properly.
Company & origin
Originated / developed by: Specialist manufacturer.
An HIV medicine used in the UK as part of a single daily combination tablet, always boosted by another medicine.
Practical use
How to take Elvitegravir
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take the single daily tablet by mouth with food, at about the same time each day.
- Take it consistently and do not skip doses, as missed doses can let the virus become resistant.
- Give your team a full, up-to-date medicines list, as the booster makes it interact with many other drugs.
- Separate it from antacids, and from iron or calcium supplements, by taking them at different times as advised.
- Do not be alarmed if a kidney blood test (creatinine) reads slightly higher; this is expected from the booster and does not mean kidney damage.
Weighing it up
Advantages & disadvantages of Elvitegravir
Advantages
- Usually taken as a simple single daily tablet that combines several HIV medicines.
- Effective at suppressing HIV as part of combination therapy.
- Taken by mouth rather than by injection.
Disadvantages
- Because of its booster, it interacts with a very large number of other medicines.
- Must be taken with food, and separated from antacids and iron or calcium supplements.
- Controls HIV but does not cure it, so must be taken consistently for life.
Practical use
Good to know
The most important practical points with elvitegravir are that it must be taken with food and that, because of its booster, it interacts with a very large number of other medicines. The booster (cobicistat) works by slowing down how the body breaks down medicines, which keeps elvitegravir levels up but can also raise the levels of many other drugs, sometimes dangerously, so a complete and up-to-date medicines list is essential before adding anything, including over-the-counter and herbal products. Like bictegravir, the booster can nudge the creatinine reading on kidney tests upward without true kidney damage. It should be separated from antacids and from iron or calcium supplements, which can stop it being absorbed. As with all HIV treatment, it works as part of combination therapy and must be taken consistently to keep the virus suppressed.
Who should not take it / use with caution
- People who have had a serious allergic reaction to elvitegravir or its booster should not take it.
- It should not be combined with certain medicines that the booster can raise to dangerous levels, or that strongly lower elvitegravir levels.
- It is used under specialist supervision, with close attention to other medicines.
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 from the booster.
- Reviewing other medicines for interactions whenever something new is started.
Side effects
- Nausea, diarrhoea or other tummy upset.
- Headache.
- A harmless rise in the creatinine reading on kidney blood tests, caused by the booster.
- Less commonly, rash, or changes in liver or kidney tests, which should be reviewed.
Key interactions
- Its booster slows the breakdown of many medicines and can raise their levels, sometimes dangerously, so a full medicines list is essential.
- 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.
Available as: A single daily combination tablet taken by mouth with food.
Answers
Elvitegravir: frequently asked questions
What is elvitegravir used for?
It is an HIV integrase inhibitor used, as part of combination therapy, to suppress HIV, given in a single daily combination tablet.
Why does it need a booster?
Elvitegravir is broken down quickly, so it is always paired with a booster (cobicistat) that slows its breakdown and keeps enough in the body to work.
Why so many drug interactions?
The booster works by slowing how the body breaks down medicines, which can raise the levels of many other drugs, so a full medicines list is essential.
Do I have to take it with food?
Yes, taking it with food helps it be absorbed properly, so it should be taken with a meal as advised.
Does it cure HIV?
No. Elvitegravir 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 (boosted)
Elvitegravir belongs to the hiv integrase inhibitor (boosted) 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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