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Drug Interactions between cobicistat / elvitegravir / emtricitabine / tenofovir and rifapentine

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

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Interactions between your drugs

Major

rifapentine tenofovir

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

Rifapentine may significantly reduce the blood levels of tenofovir from certain preparations, which may make it less effective in treating your condition. 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 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.

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Major

rifapentine cobicistat

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

Using cobicistat together with rifapentine is not recommended. Combining these medications may decrease the blood levels of cobicistat, which may reduce its effectiveness in treating HIV infection. Your doctor may be able to prescribe alternatives that do not interact. 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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Major

rifapentine elvitegravir

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

Using elvitegravir together with rifapentine is not recommended. Combining these medications may significantly decrease the blood levels of elvitegravir, which may reduce its effectiveness in treating HIV infection. Your doctor may be able to prescribe alternatives that do not interact. 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 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.

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Moderate

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.

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Drug and food interactions

Moderate

rifapentine food

Applies to: rifapentine

Consumer information for this interaction is not currently available.

ADJUST DOSING INTERVAL: Administration with food may increase the oral bioavailability of rifapentine and reduce the incidence of gastrointestinal adverse events. Administration with a high fat meal typically increases rifapentine's maximum concentration (Cmax) and systemic exposure (AUC) by approximately 40% to 50% over that observed when rifapentine is administered under fasting conditions. Rifapentine is often prescribed in combination with isoniazid. When single doses of rifapentine (900 mg) and isoniazid (900 mg) were administered with a low fat, high carbohydrate breakfast, the Cmax and AUC of rifapentine increased by 47% and 51%, respectively. On the other hand, isoniazid's Cmax and AUC decreased by 46% and 23%, respectively.

MANAGEMENT: Products containing oral rifapentine as the sole ingredient recommend administration with a meal to increase bioavailability and reduce the occurrence of gastrointestinal upset, nausea, and/or vomiting. Consultation of product labeling for combination products and/or relevant guidelines may be helpful if rifapentine is combined with a medication that is typically taken on an empty stomach.

References

  1. "Product Information. Isoniazid/Rifapentine 300 mg/300 mg (Macleods) (isoniazid-rifapentine)." Imported (India) 2 (2021):
  2. "Product Information. Priftin (rifapentine)." sanofi-aventis (2021):
Moderate

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.

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Minor

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

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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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