This
rise is mediated through inhibition of the renal transporter
OCT-2, but the reduced creatinine secretion does not translate
into a lower glomerular filtration rate.64 Elevations in
transaminases occur in 5%, are generally mild, and occur at a
similar rate as with raltegravir, darunavir–ritonavir, and efavirenz.62
In the limited number of patients with hepatitis B or
C coinfection, the incidence of transaminase elevation rises
to 16%, most likely reflecting immune reconstitution, and
is lower than that observed with raltegravir and efavirenz,
but higher than that with darunavir–ritonavir.62 Elevation in
total cholesterol, low-density lipoprotein, and triglycerides
observed with PIs is absent with dolutegravir.62 Creatine
kinase elevations are common, largely asymptomatic, and
mild, with only 5% being grade III or IV in severity.62
Hypersensitivity reactions were extremely uncommon,
occurring in less than 1%, and tend to occur shortly after
treatment initiation.62