Date of report 14 May 2024
Reported case interaction between
Bictegravir and BRIVARACETAM
Bictegravir and BRIVARACETAM
![FLS Science](/static/pictures/doctor-desktop.png)
Drugs suspected to be involved in the DDI
Complete list of drugs taken by the patient
Brivaracetam 50mg/12 h
Clinical case description
HIV infection diagnosed in 2000 with good clinical control on ART (several regimens), no virological failures, all ART changes performed for simplification. BIC/FTC/TAF started in November 2021. Epilepsy diagnosed in 2019 and treated with several anti-epileptic regimens. In February 2022, his neurologist modified the current regimen (levetiracetam) to brivaracetam 50mg /12 hs. Brivaracetam is a moderate CYP3A4 inducer in vitro (although not confirmed in vivo) what could eventually lead to reduced bictegravir exposure. Although a significant drug-drug interaction was not expected, data on co-administration of these two medications are scarce. Thus, it is of interest to report real-world cases with this anti-epileptic and ART combination.
Clinical Outcome
Editorial Comment
Clinical studies have shown the absence of an inducing or inhibitory effect of brivaracetam on CYP3A4 or on drug transporters (Pgp, OATP, BCRP). It is not expected to observe relevant changes in the concentration of antiretrovirals when administered together with brivaracetam.