Elvitegravir is an HIV integrase inhibitor that requires pharmacokinetic enhancement with cobicistat or ritonavir. Since 2012 it has been available in a coformulation with cobicistat, tenofovir, and emtricitabine (Stribild) for treatment-naïve adults. This month the FDA approved elvitegravir as an independent medication, for use in in combination with a ritonavir-boosted protease inhibitor (and other ARVs) in treatment-experienced adults. Its brand name is Vitekta.

It is dosed once daily, with the specific dosage determined by the coadministered ritonavir-boosted PI:

• Elvitegravir 85 mg QD with: atazanavir 300 mg QD + ritonavir 100 mg QD or lopinavir/ritonavir 400/100 mg BID
• Elvitegravir 150 mg QD with: darunavir 600 mg BID + ritonavir 100 mg BID, fosamprenavir 700 mg BID + ritonavir 100 mg BID, or tipranavir 500 mg BID + ritonavir 200 mg BID

Elvitegravir should not be used with cobicistat, except in the coformulation with cobicistat/tenofovir/emtricitabine (Stribild); thus it is not recommended with cobicistat-boosted PIs. It also is not recommended with PIs other than those indicated above

It should be taken with food.

Further information is available in the prescribing information at Drugs @FDA.

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