Drug interactions
Cariprazine + Elvitegravir / cobicistat / emtricitabine / tenofovir df
Severity: Major
Cariprazine and Elvitegravir / cobicistat / emtricitabine / tenofovir df: major interaction.
Last updated Sources: UK SmPC
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
The cobicistat component strongly inhibits CYP3A4 and can raise cariprazine and active metabolite levels. This increases the risk of akathisia, extrapyramidal symptoms and sedation.
What this interaction means in plain words
Cariprazine 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, the main metabolic pathway for cariprazine.
What to do
Halve the cariprazine dose when combined with a strong CYP3A4 inhibitor and monitor for adverse effects for several weeks. Restore the usual dose after the combination is stopped.
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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References
Other interactions of Cariprazine
Frequently asked questions
Can I take Cariprazine with Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates the interaction as major. Cariprazine 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. The cobicistat component strongly inhibits CYP3A4 and can raise cariprazine and active metabolite levels. This increases the risk of akathisia, extrapyramidal symptoms and sedation.
How serious is the interaction between Cariprazine 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: Halve the cariprazine dose when combined with a strong CYP3A4 inhibitor and monitor for adverse effects for several weeks. Restore the usual dose after the combination is stopped.
What other medicines interact with Cariprazine?
MediHelp also lists interactions of Cariprazine with, for example, Alfentanil, Amisulpride, Amobarbital. The full list is on the Cariprazine page.
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