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Drug Interactions between Biktarvy and dofetilide

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

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Interactions between your drugs

Major

dofetilide bictegravir

Applies to: dofetilide and Biktarvy (bictegravir / emtricitabine / tenofovir alafenamide)

CONTRAINDICATED: Coadministration with bictegravir may increase the plasma concentrations of dofetilide. The proposed mechanism is inhibition of organic cation transporter 2 (OCT2) and multidrug and toxin extrusion transporter 1 (MATE1) by bictegravir, resulting in decreased renal tubular secretion of dofetilide. Clinically, high plasma levels of dofetilide may increase the risk of QT interval prolongation, which has been associated with ventricular arrhythmias including torsade de pointes and sudden death.

MANAGEMENT: Given the risk for serious and/or life-threatening cardiovascular events associated with increased dofetilide plasma levels, concomitant use with bictegravir is considered contraindicated.

References (1)
  1. (2018) "Product Information. Biktarvy (bictegravir/emtricitabine/tenofovir)." Gilead Sciences

Drug and food interactions

Minor

dofetilide food

Applies to: dofetilide

In vitro data suggest that grapefruit juice may inhibit the CYP450 3A4 first-pass metabolism of dofetilide. Decreased first-pass metabolism may increase dofetilide concentrations and increase the risk of QT interval prolongation and arrhythmias. The clinical significance is unknown, since dofetilide has a high oral bioavailability and a low affinity for CYP450 3A4. The manufacturer recommends caution.

References (1)
  1. (2001) "Product Information. Tikosyn (dofetilide)." Pfizer U.S. Pharmaceuticals
Minor

tenofovir food

Applies to: Biktarvy (bictegravir / emtricitabine / tenofovir alafenamide)

Food enhances the oral absorption and bioavailability of tenofovir, the active entity of tenofovir disoproxil fumarate. According to the product labeling, administration of the drug following a high-fat meal increased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of tenofovir by approximately 14% and 40%, respectively, compared to administration in the fasting state. However, administration with a light meal did not significantly affect the pharmacokinetics of tenofovir compared to administration in the fasting state. Food delays the time to reach tenofovir Cmax by approximately 1 hour. Tenofovir disoproxil fumarate may be administered without regard to meals.

References (1)
  1. (2001) "Product Information. Viread (tenofovir)." 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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