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Drug Interactions between aluminum hydroxide / magnesium hydroxide / simethicone and cobicistat / elvitegravir / emtricitabine / tenofovir alafenamide

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

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Interactions between your drugs

Moderate

aluminum hydroxide elvitegravir

Applies to: aluminum hydroxide / magnesium hydroxide / simethicone and cobicistat / elvitegravir / emtricitabine / tenofovir alafenamide

Aluminum hydroxide may decrease the absorption and blood levels of elvitegravir when taken at the same time. Therefore, aluminum hydroxide should be taken at least 2 hours before or 2 hours after you take elvitegravir. Consult with 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.

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Moderate

magnesium hydroxide elvitegravir

Applies to: aluminum hydroxide / magnesium hydroxide / simethicone and cobicistat / elvitegravir / emtricitabine / tenofovir alafenamide

Magnesium hydroxide may decrease the absorption and blood levels of elvitegravir when taken at the same time. Therefore, magnesium hydroxide should be taken at least 2 hours before or 2 hours after you take elvitegravir. Consult with 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.

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Moderate

tenofovir cobicistat

Applies to: cobicistat / elvitegravir / emtricitabine / tenofovir alafenamide and cobicistat / elvitegravir / emtricitabine / tenofovir alafenamide

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.

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Moderate

emtricitabine cobicistat

Applies to: cobicistat / elvitegravir / emtricitabine / tenofovir alafenamide and cobicistat / elvitegravir / emtricitabine / tenofovir alafenamide

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.

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Drug and food interactions

Major

aluminum hydroxide food

Applies to: aluminum hydroxide / magnesium hydroxide / simethicone

Citrate, or citric acid, can increase the absorption of aluminum hydroxide. This may lead to elevated blood levels of aluminum, particularly in individuals with reduced kidney function, since aluminum is primarily eliminated by the kidneys. Excess aluminum may deposit and cause problems in various tissues including bone, brain, heart, liver, muscles, and spleen. Over time, weak bones, bone pain, fractures, skeletal deformity, brain disorders, and anemia may develop. Talk to your doctor before using aluminum hydroxide if you have kidney impairment or are on hemodialysis. You should avoid or limit the consumption of citrate-containing foods and beverages (e.G., soft drinks, citrus fruits, fruit juices) during treatment with aluminum hydroxide. Be aware that some effervescent and dispersible drug formulations may also contain citrate and should be restricted as well. Even if you do not have kidney problems, it may be best to separate the dosing of aluminum hydroxide and citrate-containing products by 2 to 3 hours. Talk to a healthcare professional 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.

When aluminum hydroxide is taken during enteral nutrition therapy (tube feeding), the tube may get clogged. Therefore, aluminum hydroxide should not be mixed with or given after high-protein tube feedings. The dose should be separated from the feeding by as much as possible, and the tube should be thoroughly flushed before administration of the dose.

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Moderate

elvitegravir food

Applies to: cobicistat / elvitegravir / emtricitabine / tenofovir alafenamide

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.

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Minor

tenofovir food

Applies to: cobicistat / elvitegravir / emtricitabine / tenofovir alafenamide

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

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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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