Interactions between Elvitegravir and Erdafitinib
1 drug interaction and 8 additional warnings found for the following 2 drugs:
- elvitegravir
- erdafitinib
Drug interactions
Major drug interactions
Major:
elvitegravir erdafitinib
Applies to: elvitegravir and erdafitinib
Adjust dose
Coadministration with moderate inducers of CYP450 2C9 or 3A4 may decrease the plasma concentrations and therapeutic effects of erdafitinib. The mechanism is induction of CYP450 2C9- or 3A4-mediated metabolism of erdafitinib, which has been shown to be metabolized by these isoenzymes.
Management
According to the manufacturer, if a moderate CYP450 2C9 or 3A4 inducer is coadministered at the start of erdafitinib therapy, the recommended dose of erdafitinib should be administered. If a moderate CYP450 2C9 or 3A4 inducer is coadministered after the initial dose increase period, the dose of erdafitinib may be increased up to 9 mg once daily based on serum phosphate levels and tolerability. When a moderate CYP450 2C9 or 3A4 inducer is discontinued, the current dose of erdafitinib may be continued in the absence of erdafitinib toxicity.
References (1)
- (2019) "Product Information. Balversa (erdafitinib)." Janssen Products, LP
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
elvitegravir Food/Lifestyle
Applies to: elvitegravir
Adjust dosing interval
Food enhances the oral bioavailabilities of both elvitegravir and tenofovir. When a single dose of cobicistat/elvitegravir/emtricitabine/tenofovir (trade name Stribild) was given with a light meal (approximately 373 kcal; 20% fat), mean elvitegravir and tenofovir systemic exposures (AUCs) increased by 34% and 24%, respectively, relative to fasting conditions. When administered with a high-fat meal (approximately 800 kcal; 50% fat), the mean AUC of elvitegravir and tenofovir increased by 87% and 23%, respectively, relative to fasting conditions. The alterations in mean AUCs of cobicistat and emtricitabine were not clinically significant with either the light or high-fat meal.
Management
Cobicistat/elvitegravir/emtricitabine/tenofovir as a fixed-dose preparation should be administered once daily with food. Elvitegravir as a single-ingredient preparation should also be administered once daily with food.
References (2)
- (2012) "Product Information. Stribild (cobicistat/elvitegravir/emtricitabine/tenofovir)." Gilead Sciences
- (2014) "Product Information. Vitekta (elvitegravir)." Gilead Sciences
Moderate:
erdafitinib Food/Lifestyle
Applies to: erdafitinib
Generally avoid
Grapefruit or grapefruit juice may increase the plasma concentrations of erdafitinib. The proposed mechanism for the interaction is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Inhibition of hepatic CYP450 3A4 may also contribute. The interaction has not been studied with grapefruit juice but has been reported for other CYP450 3A4 inhibitors. When coadministered with itraconazole, a strong CYP450 3A4 inhibitor, erdafitinib mean ratios for the peak plasma concentration (Cmax) and systemic exposure (AUC) were 105% and 134%, respectively, relative to erdafitinib alone. Increased exposure of erdafitinib may heighten the risk of hyperphosphatemia and gastrointestinal, dermatologic, and ocular toxicities. In general, the effects of grapefruit products are concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit (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
Until further information is available, it may be advisable for patients to limit or avoid consumption of grapefruit, grapefruit juice, or Seville oranges during treatment with erdafitinib.
References (4)
- "Product Information. BALVERSA (erdafitinib)." JANSSEN-CILAG INTERNATIONAL N.V
- (2025) "Product Information. Balversa (erdafitinib)." Janssen-Cilag Ltd
- (2025) "Product Information. Balversa (erdafitinib)." Janssen Products, LP
- (2025) "Product Information. Balversa (erdafitinib)." Janssen Inc
Disease interactions
6 potential interactions Applies to: 4 conditions, including Liver Disease, Renal Dysfunction, Retinal Disorders, and Phosphate Imbalance.
Liver Disease
Major:
elvitegravir
Elvitegravir has a major potential interaction with Liver Disease.
The use of elvitegravir is not recommended for use in patients with severe hepatic impairment (Child-Pugh Class C). No dosage adjustment is required in patients with mild (Child-Pugh Class A) or moderate (Child-Pugh Class B) hepatic impairment.
Moderate:
erdafitinib
Erdafitinib has a moderate potential interaction with Liver Disease.
There are limited pharmacokinetic (PK) data on the use of erdafitinib in patients with severe renal impairment or severe hepatic impairment (Child-Pugh C). The PKs of erdafitinib in patients with renal impairment requiring dialysis are unknown.
Phosphate Imbalance
Moderate:
erdafitinib
Erdafitinib has a moderate potential interaction with Phosphate Imbalance.
Increases in phosphate levels are a pharmacodynamic effect of erdafitinib. Hyperphosphatemia was reported as adverse reaction in 76% of patients after initiating treatment, with 32% requiring phosphate binders during treatment. Caution and monitoring of phosphate levels is advised in all patients. Follow the manufacturer's dose modification guidelines if required.
Renal Dysfunction
Major:
elvitegravir
Elvitegravir has a major potential interaction with Renal Dysfunction.
The use of elvitegravir is not recommended in patients with severe renal impairment (estimated creatinine clearance below 30 mL per minute). No dosage adjustment is recommended in patients with estimated creatinine clearance greater than or equal to 30 mL per minute.
Moderate:
erdafitinib
Erdafitinib has a moderate potential interaction with Renal Dysfunction.
There are limited pharmacokinetic (PK) data on the use of erdafitinib in patients with severe renal impairment or severe hepatic impairment (Child-Pugh C). The PKs of erdafitinib in patients with renal impairment requiring dialysis are unknown.
Retinal Disorders
Moderate:
erdafitinib
Erdafitinib has a moderate potential interaction with Retinal Disorders.
Erdafitinib can cause ocular disorders, including central serous retinopathy/retinal pigment epithelial detachment (CSR/RPED) resulting in visual field defect. Perform monthly ophthalmological examinations during the first 4 months of treatment and every 3 months afterwards, and urgently at any time for visual symptoms. Ophthalmological examination should include assessment of visual acuity, slit lamp examination, fundoscopy, and optical coherence tomography. Follow manufacturers dose modification guidelines in patients at risk or with ocular adverse reactions.
Report options
More resources
elvitegravir
A total of 98 drugs are known to interact with elvitegravir.
- Elvitegravir is in the drug class integrase strand transfer inhibitor.
- Elvitegravir is used to treat HIV-1 Infection.
erdafitinib
A total of 483 drugs are known to interact with erdafitinib.
- Erdafitinib is in the drug class multikinase inhibitors.
- Erdafitinib is used to treat the following conditions:
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.