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

Consumer information for this interaction is not currently available.

ADJUST DOSE: Concomitant use with potent CYP450 3A4 inhibitors may increase the systemic concentrations and effects of zuranolone. The proposed mechanism is inhibition of the CYP450 3A4-mediated metabolism of zuranolone, which is primarily metabolized by this isoenzyme. Drug interaction studies have shown that coadministration with the potent CYP450 3A4 inhibitor itraconazole increased the systemic exposure (AUC) and peak plasma concentration (Cmax) by approximately 60% and 25%, respectively. Increased exposure to zuranolone may increase the risk of CNS-related adverse effects such as somnolence, confusion, dizziness and gait disturbances.

MANAGEMENT: If concomitant use with a potent CYP450 3A4 inhibitor is required, the manufacturer recommends that the dosage of zuranolone be reduced to 30 mg once daily for 14 days. No dosage adjustment is advised when used in combination with moderate CYP450 3A4 inhibitors.

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.

Switch to professional interaction data

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.

Switch to professional interaction data