Bictegravir/lenacapavir (Bixlenvo®), a new daily oral single tablet regimen, was approved by the FDA in August 2026 for the treatment of HIV-1 in adults who are virologically suppressed on a stable antiretroviral regimen with no known or suspected resistance to bictegravir or lenacapavir. Bixlenvo requires a two-day initiation dose with lenacapavir (Sunlenca®), after which Bixlenvo is taken orally once a day.
CYP3A4 and UGT1A1 are involved in the metabolism of bictegravir and lenacapavir and pharmacokinetic interactions are expected with inhibitors and inducers of these enzymes. The Bixlenvo Prescribing Information contraindicates coadministration with dofetilide and strong CYP3A inducers, whereas coadministration is not recommended with moderate CYP3A inducers, nor with combined P-gp, UGT1A1, and strong CYP3A inhibitors. Full details regarding the use of bictegravir/lenacapavir are available in the Bixlenvo Prescribing Information from Gilead.
Bictegravir/lenacapavir has been added to the interaction checker on the website and to the iChart app. New pharmacokinetic fact sheets have been added for lenacapavir (oral) and lenacapavir (sc), and the bictegravir fact sheet has been revised. Interaction summary charts have been updated to include bictegravir/lenacapavir, as well other recent additions and updates. A program of updates has started for the remaining prescribing resources on the website.
