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HIV integrase strand transfer inhibitor (INSTI)

Elvitegravir

Brand names: component of Stribild/Genvoya

Elvitegravir is an HIV integrase strand transfer inhibitor used, boosted with a pharmacokinetic enhancer, as part of combination antiretroviral therapy for HIV infection.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It inhibits HIV integrase, blocking integration of viral DNA into the host genome and thereby preventing viral replication.

Prescribing in practice

  • Elvitegravir requires a pharmacokinetic booster (commonly cobicistat) to maintain effective levels, which introduces significant cytochrome P450-mediated drug interactions that must be reviewed.
  • Absorption is reduced by polyvalent cation-containing products, so separate dosing from antacids, and iron or calcium supplements.
  • Cobicistat inhibits tubular creatinine secretion, producing a rise in serum creatinine without a true fall in renal function.

Monitoring

Monitor HIV viral load and CD4 count to assess response, with renal and liver function during treatment.

Counselling the patient

  • Take with food and exactly as prescribed alongside the booster to keep drug levels effective.
  • Separate indigestion remedies, or iron and calcium supplements, from your dose.
  • Do not start new medicines without checking for interactions with your HIV team.

Evidence & guidelines

Boosted elvitegravir-based regimens are supported by randomised controlled trials and have been included in HIV treatment guidelines.

Reference: BHIVA HIV guidelines; EACS; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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