Drug Interactions between adagrasib and cobicistat / elvitegravir / emtricitabine / tenofovir
This report displays the potential drug interactions for the following 2 drugs:
- adagrasib
- cobicistat/elvitegravir/emtricitabine/tenofovir
Interactions between your drugs
cobicistat adagrasib
Applies to: cobicistat / elvitegravir / emtricitabine / tenofovir and adagrasib
Using adagrasib together with cobicistat, during approximately the first 8 days of treatment with adagrasib can increase the risk of adverse effects such as diarrhea, fatigue, musculoskeletal pain, hepatotoxicity, renal impairment, and an irregular heart rhythm that may be serious and potentially life-threatening. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with adagrasib. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
tenofovir cobicistat
Applies to: cobicistat / elvitegravir / emtricitabine / tenofovir and cobicistat / elvitegravir / emtricitabine / tenofovir
Using cobicistat together with tenofovir can increase the effects of tenofovir, which can cause new or worse kidney problems. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
tenofovir adagrasib
Applies to: cobicistat / elvitegravir / emtricitabine / tenofovir and adagrasib
Consumer information for this interaction is not currently available.
MONITOR: Coadministration with adagrasib may increase the plasma concentrations of drugs that are metabolized by the CYP450 3A4, 2D6 or 2C9 enzymatic pathways or are substrates of the P-glycoprotein (P-gp) efflux membrane transporter. When adagrasib 400 mg twice daily (two-thirds the approved recommended dosage) was administered with midazolam (a sensitive CYP450 3A4 substrate) and dextromethorphan (a sensitive CYP450 2D6 substrate) in pharmacokinetic studies, midazolam peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 4.8- and 21-fold, respectively, while dextromethorphan Cmax and AUC increased by 1.9- and 1.8-fold, respectively. Adagrasib at the approved recommended dosage of 600 mg twice daily is predicted to increase midazolam Cmax by 3.1-fold and AUC by 31-fold; dextromethorphan Cmax by 1.7-fold and AUC by 2.4-fold; warfarin (a sensitive CYP450 2C9 substrate) Cmax by 1.1-fold and AUC by 2.9-fold; and digoxin (a P-gp substrate) Cmax by 1.9-fold and AUC by 1.5-fold. These results suggest that adagrasib is a potent inhibitor of CYP450 3A4 and may be a moderate inhibitor of CYP450 2D6 and 2C9 at the approved recommended dosage of 600 mg twice daily.
MANAGEMENT: Caution is advised when adagrasib is used concomitantly with drugs that are substrates of CYP450 3A4, CYP450 2D6, CYP450 2C9 and/or P-gp, particularly sensitive substrates or those with a narrow therapeutic range. Substitution for these medications is recommended when possible, or initiate with lower dosages and monitor patient clinical response/tolerance and titrate accordingly if coadministration is required. The prescribing information for concomitant medications should be consulted to assess the benefits versus risks of coadministration and for any dosage adjustments that may be required.
References
- "Product Information. Krazati (adagrasib)." Mirati Therapeutics, Inc. (2022):
emtricitabine cobicistat
Applies to: cobicistat / elvitegravir / emtricitabine / tenofovir and cobicistat / elvitegravir / emtricitabine / tenofovir
Cobicistat is a medication used to boost the effects of some medications that treat HIV infection. However, using cobicistat together with other HIV medications, such as emtricitabine, may alter the blood levels and effects of both medications. Using emtricitabine with cobicistat may reduce or increase blood levels of cobicistat. Reduced blood levels of cobicistat may make cobicistat less effective and may cause overall HIV treatment to be less effective. Cobicistat may increase blood levels of emtricitabine which may increase the risk of side effects. Talk to your doctor or pharmacist if you have any questions on how to use these medications properly. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Drug and food interactions
adagrasib food
Applies to: adagrasib
You should avoid consumption of grapefruit and grapefruit juice during approximately the first 8 days of treatment with adagrasib. During this time, grapefruit juice may increase the blood levels of adagrasib. This may increase the risk of side effects such as diarrhea, fatigue, musculoskeletal pain, hepatotoxicity, renal impairment, and an irregular heart rhythm that may be serious and potentially life-threatening. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with adagrasib. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
elvitegravir food
Applies to: cobicistat / elvitegravir / emtricitabine / tenofovir
Food significantly increases the absorption of elvitegravir. You should take each dose of elvitegravir with a meal. Taking it on an empty stomach may lead to inadequate blood levels and reduced effectiveness of the medication in treating HIV infection.
tenofovir food
Applies to: cobicistat / elvitegravir / emtricitabine / tenofovir
Information for this minor interaction is available on the professional version.
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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