Academy Exchange

I have a patient on CAB/RPV who needs to start chemo which is given with intermittent doses of Dexamethasone. Dexamethasone has a drug drug interaction with both oral and injectable RPV, hastening their metabolism. I am curious if anyone has worked around this issue. Some of my thoughts were:

If I wanted to add on another layer of coverage, there are very few that are unaffected by Dex, but one could use TAF/FTC. 

LEN has the same problem with Dex, but perhaps CAB + partial RPV + partial LEN is still an improvement.

Or, a colleague suggested we could double up on the RPV by giving oral RPV when the Dex is given (or even daily, from the Dex dose until the next Cab dose?).