Fact Sheet 466
Elvitegravir is a drug used for antiviral therapy against HIV. It is manufactured by Gilead.
Elvitegravir is the second “integrase inhibitor” drug. When HIV infects a cell, it combines its genetic code into the cell's own code. This is shown in fact sheet 400, step 5. Elvitegravir blocks this process. When elvitegravir blocks integration, HIV infects a cell but cannot make more copies of itself.
Elvitegravir was first part approved in 2012 as part of the combination antiretroviral (ARV) Stribild (see fact sheet 473), and was approved in 2014 as Viteka for use in treatment-experienced adults.
Viteka must be taken in combination with a protease inhibitor together with ritonavir and another ARV. It’s approved for use with some protease inhibitors.
While antiretroviral therapy (ART) is now recommended for all people living with HIV, there are no absolute rules about when to start ART. You and your health care provider should consider your CD4 cell count (see fact sheet 124), your viral load (see fact sheet 125), any symptoms you are having, and your attitude about taking HIV medications. Fact Sheet 404 has more information about guidelines for the use of antiviral medications.
The HIV virus is sloppy when it makes copies of its genetic code (RNA). Many new copies of HIV are mutations: they are slightly different from the original virus. Some mutations can continue to multiply even when you are taking an antiviral drug. When this happens, the drug will stop working. This is called "developing resistance" to the drug. See Fact Sheet 126 for more information on resistance.
Resistance to elvitegravir is not yet well understood. Sometimes, if you develop resistance to one drug, you will also have resistance to other antiviral drugs. This is called "cross-resistance." Because elvitegravir is in a new class of antiviral drugs, it seems to have no cross-resistance with antiviral drugs in older classes. However, some cross-resistance is expected between raltegravir (Isentress, see fact sheet 465) and dolutegravir (Tivicay, see fact sheet 467).
With combination therapy (taking more than one antiviral drug at the same time), HIV mutates much more slowly. Resistance takes longer to develop. It is very important to take antiviral medications according to instructions, on schedule, and not to skip or reduce doses.
Elvitegravir is taken as one 85 mg pill once daily for people taking ritonavir (see fact sheet 442)-boosted atazanavir (see fact sheet 447) or lopinavir (Kaletra, see fact sheet 446). Elvitegravir is taken as one 150 mg tablet, once daily for people taking the ritonavir-boosted protease inhibitors darunavir, fosamprenavir or tipranavir (see fact sheets 450, 448, 449)
Stribild is taken one pill, once daily.
Antacids that contain magnesium or aluminum may interfere with the way that elvitegravir gets into your system, and should be taken 4 hours apart.
Elvitegravir and Stribild should be taken with food.
Elvitegravir is usually very well tolerated. If side effects occur, the most common side effects are diarrhea, and rash.
Elvitegravir has been studied to see if it interacts with other drugs. Drug interactions may affect the potency or side effects of elvitegravir or may affect the way that other drugs work. The antiretroviral medications efavirenz (see fact sheet 432) and nevirapine (see fact sheet 431) cause lower elvitegravir levels and should not be taken together. Rifampin, used to treat tuberculosis (see fact sheet 518), medications used to treat seizures and St. John’s wort decrease blood levels of elvitegravir.
Elvitegravir has not been studied with all medicines, over-the-counter drugs or vitamin or herbal supplements. Studies are underway. Be sure your doctor knows about all medications and supplements that you are taking.
Elvitegravir is the second drug in a new class, integrase inhibitors. It stops HIV from inserting its genetic code into an infected cell. This prevents the virus from making new copies of HIV. Evlitegravir helps control HIV, even when it is resistant to other medications.
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