Drug Interaction Report
9 potential interactions and/or warnings found for the following 2 drugs:
- cobicistat / elvitegravir / emtricitabine / tenofovir alafenamide
- betamethasone / iodixanol / lidocaine
Interactions between your drugs
iodixanol tenofovir
Applies to: betamethasone / iodixanol / lidocaine, cobicistat / elvitegravir / emtricitabine / tenofovir alafenamide
Before you undergo any imaging procedure where iodixanol may be given by injection, let your doctor know if you are currently being treated with tenofovir. Injection of iodixanol and similar contrast agents can sometimes cause kidney damage, and combining it with other medications that can also affect the kidney such as tenofovir may increase that risk. If you have been receiving tenofovir, your doctor may need to take special precautionary measures before, during and after the contrast injection, particularly if you also have other risk factors such as diabetes, preexisting kidney problems, dehydration, old age, congestive heart failure, low blood pressure, anemia, and multiple myeloma. Alternatively, if the risk is too great, your doctor may choose to perform a different imaging procedure where injection of a contrast is not needed. Following the procedure, you should drink plenty of fluids to keep yourself hydrated and to help flush the contrast agent out of your kidneys. Seek medical attention if you develop signs and symptoms that may suggest kidney damage such as nausea, vomiting, loss of appetite, increased or decreased urination, sudden weight gain or weight loss, fluid retention, swelling, shortness of breath, muscle cramps, tiredness, weakness, dizziness, confusion, and irregular heart rhythm. 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.
lidocaine cobicistat
Applies to: betamethasone / iodixanol / lidocaine, cobicistat / elvitegravir / emtricitabine / tenofovir alafenamide
Talk to your doctor before using lidocaine together with cobicistat. Combining these medications may increase the blood levels and effects of lidocaine. This can increase the risk of serious side effects such as irregular heart rhythm and other cardiovascular 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.
betamethasone cobicistat
Applies to: betamethasone / iodixanol / lidocaine, cobicistat / elvitegravir / emtricitabine / tenofovir alafenamide
Cobicistat may increase the blood levels of betamethasone. You may be more likely to experience side effects such as swelling, weight gain, high blood pressure, high blood glucose, muscle weakness, depression, acne, thinning skin, stretch marks, easy bruising, bone density loss, cataracts, menstrual irregularities, excessive growth of facial or body hair, and abnormal distribution of body fat, especially in the face, neck, back, and waist. 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 by your doctor to safely use both medications. Other side effects that may occur include decreased ability to fight infections, increased risk of developing infections, and inadequate response to stress such as infection, surgery, trauma, or a severe asthma attack. Children may experience a reduced growth rate due to excessive effects of betamethasone. 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 alafenamide, cobicistat / elvitegravir / emtricitabine / tenofovir alafenamide
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 alafenamide, cobicistat / elvitegravir / emtricitabine / tenofovir alafenamide
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
lidocaine food
Applies to: betamethasone / iodixanol / lidocaine
Grapefruit juice may increase the blood levels of lidocaine, which may increase the risk of side effects such as low blood pressure, slow heart rate, irregular heart rhythm, difficulty breathing and convulsions. Cigarette smoking may reduce the blood levels of lidocaine, which may make the medication less effective. It is best to avoid smoking during lidocaine therapy. Consuming cruciferous vegetables (e.G., broccoli, brussels sprouts) may also reduce the blood levels of lidocaine. Talk to a healthcare professional if you have any questions or concerns. 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.
elvitegravir food
Applies to: cobicistat / elvitegravir / emtricitabine / tenofovir alafenamide
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.
lidocaine food
Applies to: betamethasone / iodixanol / lidocaine
Consumer information for this interaction is not currently available.
MONITOR: Smoking cessation may lead to elevated plasma concentrations and enhanced pharmacologic effects of drugs that are substrates of CYP450 1A2 (and possibly CYP450 1A1) and/or certain drugs with a narrow therapeutic index (e.g., flecainide, pentazocine). One proposed mechanism is related to the loss of CYP450 1A2 and 1A1 induction by polycyclic aromatic hydrocarbons in tobacco smoke; when smoking cessation agents are initiated and smoking stops, the metabolism of certain drugs may decrease leading to increased plasma concentrations. The mechanism by which smoking cessation affects narrow therapeutic index drugs that are not known substrates of CYP450 1A2 or 1A1 is unknown. The clinical significance of this interaction is unknown as clinical data are lacking.
MANAGEMENT: Until more information is available, caution is advisable if smoking cessation agents are used concomitantly with drugs that are substrates of CYP450 1A2 or 1A1 and/or those with a narrow therapeutic range. Patients receiving smoking cessation agents may require periodic dose adjustments and closer clinical and laboratory monitoring of medications that are substrates of CYP450 1A2 or 1A1.
tenofovir food
Applies to: cobicistat / elvitegravir / emtricitabine / tenofovir alafenamide
Information for this minor interaction is available on the professional version.
Therapeutic duplication warnings
No duplication 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.
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. |
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Further information
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