Academy Exchange

Hi Everyone,

I have a patient with perinatally acquired HIV and intellectual delays who can't swallow medication. Therefore, she gets everything via a G-tube. She is currently on liquid Abacavir, Zidovudine and Tivicay-PD all via the G-tube. She has now outgrown the Tivicay-PD dose. Has anyone ever had a patient crush and dissolve adult Tivicay 50mg in water and administer it in a G-tube? Did you do once daily or twice daily dosing?

Thanks 

Hi Lorato,

Unfortunately, there is not PK data supporting crushing film coated dolutegravir and placing in g-tube for administration per ViiV (please see attachment). We have a few patients that have crushed dolutegravir and placed in semi-solid food and drink and taken orally with success, but I see your patient has all medications administered via g-tube. If you have a genotype available, I could offer other recommendations that could be crushed and would be viable via g-tube. 

Hi Everyone,

I have a patient with perinatally acquired HIV and intellectual delays who can't swallow medication. Therefore, she gets everything via a G-tube. She is currently on liquid Abacavir, Zidovudine and Tivicay-PD all via the G-tube. She has now outgrown the Tivicay-PD dose. Has anyone ever had a patient crush and dissolve adult Tivicay 50mg in water and administer it in a G-tube? Did you do once daily or twice daily dosing?

Thanks 

I just wanted to give an update on this patient. We got home nursing covered through insurance to administer Abacavir BID, Zidovudine BID and dissolved adult Tivicay 50mg tab once daily via her Gtube. Her viral load went down to 27 after 1 month of home nursing administering medications. We then switched her to Cabenuva and she was just undetectable at her 2nd loading dose visit!

Hi Lorato,

Unfortunately, there is not PK data supporting crushing film coated dolutegravir and placing in g-tube for administration per ViiV (please see attachment). We have a few patients that have crushed dolutegravir and placed in semi-solid food and drink and taken orally with success, but I see your patient has all medications administered via g-tube. If you have a genotype available, I could offer other recommendations that could be crushed and would be viable via g-tube. 

Hi Everyone,

I have a patient with perinatally acquired HIV and intellectual delays who can't swallow medication. Therefore, she gets everything via a G-tube. She is currently on liquid Abacavir, Zidovudine and Tivicay-PD all via the G-tube. She has now outgrown the Tivicay-PD dose. Has anyone ever had a patient crush and dissolve adult Tivicay 50mg in water and administer it in a G-tube? Did you do once daily or twice daily dosing?

Thanks