Bictegravir, emtricitabine, and tenofovir alafenamide and Omeprazole and sodium bicarbonate interaction
Bictegravir, emtricitabine, and tenofovir alafenamide and Omeprazole and sodium bicarbonate: both prescribing labels 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.
From the Omeprazole and sodium bicarbonate (Konvomep) label · effective 2025-12-16
Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir and nelfinavir) when used concomitantly with omeprazole may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology ( 12.3 )] .
Increased exposure of other antiretroviral drugs (e.g., saquinavir) when used concomitantly with omeprazole may increase toxicity [see Clinical Pharmacology ( 12.3 )] .
Table 5: Clinically Relevant Interactions Affecting Drugs Co-Administered with Omeprazole and Interaction with Diagnostics Antiretrovirals Clinical Impact: The effect of PPIs on antiretroviral drugs is variable.
There are other antiretroviral drugs which do not result in clinically relevant interactions with omeprazole.
Other antiretrovirals : See prescribing information for specific antiretroviral drugs.
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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.