The short answer
Magnesium-containing products may interfere with dolutegravir absorption. The clearest human evidence concerns a combined magnesium/aluminum antacid. Use a pharmacist-confirmed schedule; the antacid instruction is dolutegravir at least two hours before or six hours afterward.
What this answer covers
Oral magnesium products with oral dolutegravir. Antacids, laxatives and nutritional supplements are distinguished. No direct magnesium-glycinate clinical experiment was located in this targeted check.
- Supplement or preparation
- magnesium
- Medication ingredient
- dolutegravir
What is directly demonstrated?
A sixteen-person experiment found much lower dolutegravir exposure with a liquid magnesium/aluminum antacid. Because both metals were present, the result cannot quantify magnesium alone. It also cannot supply a percentage reduction for a glycinate capsule or every other salt.
How should I separate them?
Current label and NIH antacid guidance specify dolutegravir at least two hours before, or six hours after, the interfering product. WHO mineral-product guidance also includes magnesium supplements in this schedule. The broad supplement advice is a precaution informed by the interaction mechanism, rather than trials of every formulation.
Does taking magnesium with food solve it?
Do not assume that it does. The specific simultaneous-with-food exception concerns calcium or iron supplements in TIVICAY instructions. A magnesium-only supplement or magnesium antacid needs its own assessment. Mixed mineral products make the ingredient list especially important.
What information should I bring?
Show the pharmacist the magnesium salt, elemental amount and reason for use, such as constipation, heartburn or nutritional supplementation. Include the complete HIV medicine list. A regimen that is practical and consistently followed matters more than guessing a gap from another mineral’s instructions.
Evidence and practical considerations
Absorption & effectiveness
Magnesium-containing products may interfere with dolutegravir absorption. The clearest human evidence concerns a combined magnesium/aluminum antacid. Use a pharmacist-confirmed schedule; the antacid instruction is dolutegravir at least two hours before or six hours afterward.
- Exact scope
- Oral magnesium products with oral dolutegravir. Antacids, laxatives and nutritional supplements are distinguished. No direct magnesium-glycinate clinical experiment was located in this targeted check. with Dolutegravir, exact RxCUI 1433868, IN. TIVICAY contains dolutegravir sodium expressed as dolutegravir active-moiety strength in its label. This provides the explicit salt-to-IN bridge. Oral tablets are the primary scope; no automatic extrapolation to another integrase inhibitor or a different combination regimen. TIVICAY PD is not interchangeable milligram for milligram.
- Medication form and route
- oral
What remains uncertain
- The controlled exposure result belongs to a mixed antacid. Nutritional-magnesium advice involves an explicit preparation/class extension; neither a glycinate-specific effect size nor a universal food exception is established.
Factors that may matter: exact preparation and dose; food and administration order; complete antiretroviral regimen.
Read the supporting source summaries
Source 1: regulatory prescribing information
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: People prescribed oral dolutegravir, including tablet and pediatric suspension formulations with separate dosing instructions.
Specifies dolutegravir two hours before or six hours after named mineral products; calcium/iron supplements have a simultaneous-with-food exception for TIVICAY. St. John’s wort co-use is to be avoided because a dosing recommendation cannot be established.
How this applies: Restricted to the preparation and conditions described in this article.
The table includes both measured and predicted interactions. It does not quantify every mineral salt, product or botanical extract. Formulations and combination tablets require their own instructions.
Source 2: primary human pharmacokinetic trial
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: Sixteen healthy participants in the antacid/multivitamin crossover experiment; a separate twelve-person omeprazole experiment.
AUC fell 74% with concurrent mixed aluminum/magnesium antacid and 26% when the antacid followed two hours later. One tested multivitamin lowered AUC 33%, judged modest by the authors.
How this applies: Restricted to the preparation and conditions described in this article.
Abstract-level assessment. Mixed antacid does not isolate aluminum or magnesium; a specific multivitamin does not represent every formula. No long-term virologic comparison.
Source 3: WHO clinical decision guidance
smart.who.int · Source check Sep 10, 2026
Population: People taking a dolutegravir-containing regimen.
The decision rule separates dolutegravir at least two hours before or six hours after these products and recommends monitoring virologic response.
How this applies: Restricted to the preparation and conditions described in this article.
Implementation guidance rather than a clinical trial. It does not provide a zinc-specific effect size or replace the formulation-specific calcium/iron food exception in current prescribing information.
Source 4: government clinical guideline
clinicalinfo.hiv.gov · Source check Sep 10, 2026
Population: Adults and adolescents receiving antiretroviral therapy.
Supports product-specific spacing and the calcium/iron food exception; says not to coadminister St. John’s wort with dolutegravir.
How this applies: Restricted to the preparation and conditions described in this article.
Clinical guidance combines measured and predicted effects. The DTG supplement instructions specifically discuss calcium and iron; the zinc heading is not a zinc-only human experiment.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Article prepared | |
| Current prescribing instructions and original research checked. Article written with product-specific timing and explicit limits of the evidence. | |
| Research summary published |
Article revision: cbfe42d398095bac
This guide brings together the evidence records used by our interaction checker. Each finding retains its own preparation limits, research date, and source summaries.
Full citations require verification. Reading this answer and the source summaries does not.
Taking other supplements or medications?
Use the checker to explore your other combinations. Ask a pharmacist to review the exact products, amounts and medical conditions in your complete list.
Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.