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Drug Interactions between flecainide and Tybost

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

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Interactions between your drugs

Major

flecainide cobicistat

Applies to: flecainide and Tybost (cobicistat)

MONITOR CLOSELY: Coadministration with cobicistat may significantly increase the plasma concentrations of certain antiarrhythmic agents such as amiodarone, bepridil, disopyramide, flecainide, propafenone, and quinidine. The mechanism involves inhibition of CYP450 2D6 (flecainide, propafenone) and/or 3A4 (amiodarone, bepridil, disopyramide, quinidine) metabolism, as cobicistat is a potent inhibitor of both isoenzymes. The interaction has not been specifically studied, but could conceivably lead to serious and/or life-threatening reactions including cardiac arrhythmias and other toxicities if levels are significantly increased. The use of these antiarrhythmic agents has been associated with dose-related prolongation of the QT interval, thus elevated plasma levels may potentiate the risk of ventricular arrhythmias such as ventricular tachycardia and torsade de pointes as well as cardiac arrest and sudden death.

MANAGEMENT: Caution is advised if cobicistat must be used concomitantly with antiarrhythmic agents that are primarily metabolized by CYP450 2D6 and/or 3A4. Pharmacologic response and plasma antiarrhythmic drug levels should be monitored more closely whenever cobicistat is added to or withdrawn from therapy, and the antiarrhythmic dosage adjusted as necessary.

References

  1. (2012) "Product Information. Stribild (cobicistat/elvitegravir/emtricitabine/tenofov)." Gilead Sciences

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Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

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.

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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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