Sustained viral suppression with once daily dolutegravir-containing regimen in presence of the strong inducer carbamazepine

Dolutegravir 50 mg twice daily (BID) dosing is currently recommended in presence of strong inducers of drug metabolism. However, this dosing has been challenged by studies showing similar rates of viral suppression with dolutegravir once daily (QD) compared to BID dosing in presence of the strong inducer rifampicin. We report the case of a 41-year-old man with sustained virological suppression and documented therapeutic dolutegravir concentration on once daily dosing while treated with the strong inducer carbamazepine. Therapeutic drug monitoring can guide the need for twice daily dosing dolutegravir in presence of strong inducers.