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Drug Interactions between Addamel N and elvitegravir

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

zinc sulfate elvitegravir

Applies to: Addamel N (trace elements with selenium and iodide) and elvitegravir

ADJUST DOSING INTERVAL: Coadministration with medications or supplements containing polyvalent cations such as zinc may decrease the plasma concentrations of integrase strand transfer inhibitors (INSTIs). The proposed mechanism involves chelation of the INSTI by polyvalent cations, forming a complex that is poorly absorbed from the gastrointestinal tract.

MANAGEMENT: If concomitant use is required, monitor for virologic efficacy and administer the INSTI at least 2 hours before or 6 hours after products containing polyvalent cations such as zinc.

References (3)
  1. (2013) "Product Information. Tivicay (dolutegravir)." ViiV Healthcare
  2. (2018) "Product Information. Biktarvy (bictegravir/emtricitabine/tenofovir)." Gilead Sciences
  3. US National Library of Medicine (2019) Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/287/insti-drug-interactions

Drug and food interactions

Moderate

elvitegravir food

Applies to: elvitegravir

ADJUST DOSING INTERVAL: Food enhances the oral bioavailabilities of both elvitegravir and tenofovir. When a single dose of cobicistat/elvitegravir/emtricitabine/tenofovir (trade name Stribild) was given with a light meal (approximately 373 kcal; 20% fat), mean elvitegravir and tenofovir systemic exposures (AUCs) increased by 34% and 24%, respectively, relative to fasting conditions. When administered with a high-fat meal (approximately 800 kcal; 50% fat), the mean AUC of elvitegravir and tenofovir increased by 87% and 23%, respectively, relative to fasting conditions. The alterations in mean AUCs of cobicistat and emtricitabine were not clinically significant with either the light or high-fat meal.

MANAGEMENT: Cobicistat/elvitegravir/emtricitabine/tenofovir as a fixed-dose preparation should be administered once daily with food. Elvitegravir as a single-ingredient preparation should also be administered once daily with food.

References (2)
  1. (2012) "Product Information. Stribild (cobicistat/elvitegravir/emtricitabine/tenofov)." Gilead Sciences
  2. (2014) "Product Information. Vitekta (elvitegravir)." Gilead Sciences

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

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown 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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