Antacids (Tums, Maalox, Mylanta) and Bictegravir, emtricitabine, and tenofovir alafenamide interaction
Antacids (Tums, Maalox, Mylanta) and Bictegravir, emtricitabine, and tenofovir alafenamide: the Bictegravir, emtricitabine, and tenofovir alafenamide prescribing label flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Bictegravir, emtricitabine, and tenofovir alafenamide (BIXLENVO) label · effective 2026-08-27
Routine administration of BIXLENVO together with, or 2 hours after, antacids containing Al/Mg is not recommended.
Routine administration of BIXLENVO under fasting conditions together with, or 2 hours after, supplements or antacids containing calcium or iron is not recommended.
Oral medications or supplements containing polyvalent cations (e.g., Mg, Al, Ca, Fe): Calcium or iron supplements Cation-containing antacids or laxatives Sucralfate Buffered medications ↓ bictegravir Antacids containing Al/Mg : Take BIXLENVO at least 2 hours before or 6 hours after taking antacids containing Al/Mg.
Supplements or Antacids containing Calcium or Iron : Take BIXLENVO and supplements or antacids containing calcium or iron together with food.
In pregnant individuals: Antacids containing Al/Mg : Take BIXLENVO at least 2 hours before or 6 hours after antacids containing Al/Mg regardless of food intake.
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Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.