Drug Interactions between cobicistat / darunavir / emtricitabine / tenofovir alafenamide and riociguat
This report displays the potential drug interactions for the following 2 drugs:
- cobicistat/darunavir/emtricitabine/tenofovir alafenamide
- riociguat
Interactions between your drugs
darunavir riociguat
Applies to: cobicistat / darunavir / emtricitabine / tenofovir alafenamide and riociguat
Consumer information for this interaction is not currently available.
ADJUST DOSE: Coadministration with drugs that are both potent multi-pathway CYP450 and P-glycoprotein/breast cancer resistant protein (P-gp/BCRP) inhibitors may significantly increase the plasma concentrations of riociguat, which is primarily metabolized by CYP450 1A1, 3A, 2C8 and 2J2, and is also a substrate of the P-gp/BCRP efflux transporter. Increased levels of riociguat may increase the risk for hypotension. According to the product labeling, administration of riociguat with the potent CYP450 and P-gp/BCRP inhibitor ketoconazole resulted in increases of riociguat peak plasma concentration (Cmax) and systemic exposure (AUC) by approximately 1.5- and 2.5-fold, respectively. The Cmax and AUC of the active metabolite, M1, which has 1/3 to 1/10 the pharmacologic activity of riociguat, were reduced by approximately 50% and 25%, respectively.
MANAGEMENT: The initiation of drugs that are both potent multi-pathway CYP450 and P-gp/BCRP inhibitors such as itraconazole, ketoconazole, and some HIV protease inhibitors in patients on stable doses of riociguat is not recommended. Some authorities recommend avoiding concomitant use of riociguat during and for 2 weeks after treatment with itraconazole. When riociguat is initiated in patients on stable doses of strong multi pathway CYP450 (especially CYP450 1A1 and CYP450 3A4) and P-gp/BCRP inhibitors, consider a starting dosage of riociguat of 0.5 mg three times a day and monitor these patients for signs and symptoms of hypotension.
cobicistat riociguat
Applies to: cobicistat / darunavir / emtricitabine / tenofovir alafenamide and riociguat
Cobicistat may significantly increase the blood levels of riociguat. You may be more likely to experience serious side effects such as low blood pressure and bleeding. The risk of other side effects such as dizziness, lightheadedness, fainting, headache, flushing, palpitation, nasal congestion, upset stomach, and constipation may also increase. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. 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 darunavir
Applies to: cobicistat / darunavir / emtricitabine / tenofovir alafenamide and cobicistat / darunavir / emtricitabine / tenofovir alafenamide
Using tenofovir together with darunavir may increase the plasma concentrations of both medicines. You may need a special test 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 such as kidney problems. 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 / darunavir / emtricitabine / tenofovir alafenamide and cobicistat / darunavir / 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.
emtricitabine cobicistat
Applies to: cobicistat / darunavir / emtricitabine / tenofovir alafenamide and cobicistat / darunavir / 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.
Drug and food interactions
darunavir food
Applies to: cobicistat / darunavir / emtricitabine / tenofovir alafenamide
Food can enhance the levels of darunavir in your body. Take darunavir with food. The type of food does not matter. This will make it easier for your body to absorb the medication. Swallow the whole tablets with a drink such as water or milk. Do not chew the tablets. Darunavir must be always be taken together at the same time as another medication called ritonavir (Norvir).
riociguat food
Applies to: riociguat
Chemical substances present in cigarette smoke may reduce the blood levels of riociguat. This means that the medication may be less effective if you smoke during treatment. Let your doctor know if you are a smoker, or if you start smoking or stop smoking during treatment with riociguat, because the dosage may need to be adjusted. 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 food
Applies to: cobicistat / darunavir / 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
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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