Drug interactions
Amitriptyline + Elvitegravir / cobicistat / emtricitabine / tenofovir df
Severity: Moderate
Amitriptyline and Elvitegravir / cobicistat / emtricitabine / tenofovir df: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Cobicistat inhibits CYP2D6 and CYP3A4, which can raise amitriptyline concentrations and increase tricyclic toxicity. Possible effects include sedation, anticholinergic effects, hypotension and QT prolongation or arrhythmias.
What this interaction means in plain words
Amitriptyline and Elvitegravir / cobicistat / emtricitabine / tenofovir df can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Inhibition of CYP2D6 and CYP3A4 by cobicistat reduces amitriptyline metabolism.
What to do
Start with a lower amitriptyline dose and titrate based on response and tolerability. Consider monitoring amitriptyline levels and ECG in patients at cardiac risk.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Frequently asked questions
Can I take Amitriptyline with Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates the interaction as moderate. Amitriptyline and Elvitegravir / cobicistat / emtricitabine / tenofovir df can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Cobicistat inhibits CYP2D6 and CYP3A4, which can raise amitriptyline concentrations and increase tricyclic toxicity. Possible effects include sedation, anticholinergic effects, hypotension and QT prolongation or arrhythmias.
How serious is the interaction between Amitriptyline and Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with a lower amitriptyline dose and titrate based on response and tolerability. Consider monitoring amitriptyline levels and ECG in patients at cardiac risk.
What other medicines interact with Amitriptyline?
MediHelp also lists interactions of Amitriptyline with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Amitriptyline page.
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