HIV integrase strand transfer inhibitor (INSTI)
Elvitegravir
Brand names: component of Stribild/Genvoya
Adult dose
Dose: Only as fixed-dose combination with cobicistat-FTC-TAF/TDF
Route: Oral
Frequency: OD
Clinical pearls
- First-generation INSTI; largely superseded by dolutegravir / bictegravir (no booster required, higher resistance barrier) per BHIVA
- Always prescribed as fixed-dose combination
Contraindications
- Concurrent strong CYP3A4 inducers
- Severe renal impairment (TDF combo)
- Hypersensitivity
Side effects
- Diarrhoea
- Headache
- Nausea
- Renal effects (cobicistat/TDF)
- Increased creatinine (cobicistat artefact)
Interactions
- Cobicistat boosting → many CYP3A4 interactions
Monitoring
- VL/CD4
- Renal function
- LFTs
Reference: BNF; BHIVA HIV guidelines; EACS; https://bnf.nice.org.uk/drugs/elvitegravir/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- DIPSS — Dynamic International Prognostic Scoring System for Myelofibrosis · Cancer Prognosis
- BALL Score for Relapsed/Refractory CLL · Leukaemia
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023