Drug interactions
Amlodipine-atorvastatin + Elvitegravir / cobicistat / emtricitabine / tenofovir df
Severity: Major
Amlodipine-atorvastatin and Elvitegravir / cobicistat / emtricitabine / tenofovir df: major 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 is a strong CYP3A4 inhibitor and raises exposure to both amlodipine and atorvastatin. This can cause hypotension, peripheral edema and, with atorvastatin, a higher risk of myopathy and rhabdomyolysis. The combination is not an absolute contraindication in labeling but needs dose control.
What this interaction means in plain words
Amlodipine-atorvastatin and Elvitegravir / cobicistat / emtricitabine / tenofovir df can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Cobicistat inhibits CYP3A4 (and intestinal transporters), reducing the metabolism of amlodipine and atorvastatin.
What to do
Start with the lowest atorvastatin dose and keep it at or below the labeled maximum for use with cobicistat, or switch to a statin less dependent on CYP3A4. Reduce the amlodipine dose if needed and monitor blood pressure, edema and muscle symptoms.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Amlodipine-atorvastatin
Frequently asked questions
Can I take Amlodipine-atorvastatin with Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates the interaction as major. Amlodipine-atorvastatin and Elvitegravir / cobicistat / emtricitabine / tenofovir df can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Cobicistat is a strong CYP3A4 inhibitor and raises exposure to both amlodipine and atorvastatin. This can cause hypotension, peripheral edema and, with atorvastatin, a higher risk of myopathy and rhabdomyolysis. The combination is not an absolute contraindication in labeling but needs dose control.
How serious is the interaction between Amlodipine-atorvastatin and Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with the lowest atorvastatin dose and keep it at or below the labeled maximum for use with cobicistat, or switch to a statin less dependent on CYP3A4. Reduce the amlodipine dose if needed and monitor blood pressure, edema and muscle symptoms.
What other medicines interact with Amlodipine-atorvastatin?
MediHelp also lists interactions of Amlodipine-atorvastatin with, for example, Amifostine, Apalutamide, Atazanavir. The full list is on the Amlodipine-atorvastatin page.
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