Drug Interactions between cobicistat / elvitegravir / emtricitabine / tenofovir and eplerenone
This report displays the potential drug interactions for the following 2 drugs:
- cobicistat/elvitegravir/emtricitabine/tenofovir
- eplerenone
Interactions between your drugs
eplerenone cobicistat
Applies to: eplerenone and cobicistat / elvitegravir / emtricitabine / tenofovir
Using eplerenone together with cobicistat is not recommended. Combining these medications may significantly increase the blood levels and effects of eplerenone. This can increase the risk of serious side effects including hyperkalemia (high blood potassium), which in severe cases can lead to kidney failure, muscle paralysis, irregular heart rhythm, and cardiac arrest. You may be more likely to develop hyperkalemia during treatment with eplerenone if you are elderly, dehydrated, or have kidney disease, diabetes, or advanced heart failure. 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.
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
eplerenone food
Applies to: eplerenone
Consumer information for this interaction is not currently available.
GENERALLY AVOID: Coadministration with grapefruit juice may increase the plasma concentrations of eplerenone. The primary mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. Inhibition of hepatic CYP450 3A4 may also contribute. In drug interaction studies, administration of a single 100 mg dose of eplerenone in combination with grapefruit juice resulted in a 25% increase in eplerenone systemic exposure (AUC). High blood levels of eplerenone can increase the risk of side effects including hyperkalemia. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition.
MANAGEMENT: It may be advisable for patients to avoid the consumption of grapefruit, grapefruit juice, or supplements that contain grapefruit during treatment with eplerenone.
References
- "Product Information. Inspra (eplerenone)." Searle (2002):
- "Product Information. Eplerenone (eplerenone)." MSN Laboratories Europe Ltd (2021):
- "Product Information. Eplerenone (Apotex) (eplerenone)." Apotex Pty Ltd (2023):
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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