HIV integrase strand-transfer inhibitor
Raltegravir
Brand names: Isentress
Adult dose
Dose: 400mg PO BD or 1.2g (2x600mg) OD (HD formulation)
Route: PO
Frequency: BD or OD
Clinical pearls
- HIV-1 (treatment-naive and -experienced); pregnancy-friendly
- INSTI class — high genetic barrier in newer agents
Contraindications
- Hypersensitivity
Side effects
- Headache
- GI upset
- Insomnia
- Hepatotoxicity
- Severe skin reactions (DRESS, SJS)
- Rhabdomyolysis (rare)
- Depression
Interactions
- Polyvalent cation antacids (separate by 4h)
- Rifampicin
- Strong UGT1A1 inducers
Monitoring
- LFTs
- CK if symptomatic
- HIV VL/CD4
Reference: BNF; BHIVA; https://bnf.nice.org.uk/drugs/raltegravir/. 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