Background: Since its approval as the first integrase inhibitor on the market, raltegravir has been well accepted for its potency in wild type and multi-drug resistant viruses, as well as its favorable side effect profile. However, current recommendations suggest that film-coated raltegravir tablets only be swallowed whole, making oral administration difficult in patients who would benefit from a crushed delivery, such as those with compromised absorption. Methods: An HIV positive patient with a perforated rectosigmoid colon was instructed to crush his evening dose of raltegravir after finding intact tablets in his ostomy bag on several mornings. An HIV-1 RNA assay and CBC were ordered one week and four months after this observation to assess virologic suppression. Results: The patient’s HIV-1 RNA viral load remained undetectable (<75 copies/mL) throughout treatment and had minimal changes in CD4 count: 1024 cells/mm3 prior to the observation, 1091 cells/mm3 one week after the observation, and 951 cells/mm3 four months after the observation. Patient noted good adherence, denied missing doses or experiencing any antiretroviral related side effects. Conclusion: Crushed raltegravir is a viable and safe option for patients with compromised intestinal absorption.
