14
Selecting a Treatment Regimen
Table 6. Renal and Hepatic Dosing (continued)
ARVs
Generic Name
(Abbreviation)
Trade Name
Usual Daily
Dose
a
Dosing in Renal
Insufficiency
b
Dosing in Hepatic
Impairment
Integrase Inhibitors (INSTIs)
Dolutegravir
(DTG)
Tivicay
®
50 mg once
daily or 50 mg
bid
No dosage adjustment
necessary
Child-Pugh Class A or B:
• No dosage adjustment
Child-Pugh Class C:
• NOT recommended
Raltegravir
(RAL)
Isentress
®
400 mg bid No dosage adjustment
necessary
Mild-to-Moderate
Hepatic Insufficiency:
• No dosage adjustment
necessary
Severe Hepatic
Insufficiency:
• No recommendation
Fixed-dose Combinations
Truvada
®
1 tablet PO
once daily
CrCl
(mL/min)
Dose No dosage
recommendation
30-49 1 tablet
q48h
<30 or
on HD
NOT rec.
Atripla
®
1 tablet PO
once daily
NOT recommended
for use in patients with
CrCl <50 mL/min.
Instead use the
individual drugs
of the fixed-dose
combination and
adjust TDF and FTC
doses according to
CrCl level.
No dosage
recommendation; use
with caution in patients
with hepatic impairment.
Complera
®
1 tablet PO
once daily
Child-Pugh Class A
or B:
• No dosage adjustment
Child-Pugh Class C:
• No dosage
recommendation
Stribild
®
1 tablet once
daily
EVG/cobi/TDF/FTC
should NOT be
initiated in patients
with CrCl <70 mL/min.
Discontinue EVG/
cobi/TDF/FTC if
CrCl declines to
<50 mL/min while
patient is on therapy.
Mild-to-Moderate
Hepatic Insufficiency:
• No dosage adjustment
necessary
Severe Hepatic
Insufficiency:
• NOT recommended
rec., recommended.
a
Refer to Appendix B, Tables 1-6 for additional dosing information.
b
Including with chronic ambulatory peritoneal dialysis and hemodialysis.
c
On dialysis days, take dose aer HD session.
