Drug interactions
Cyclophosphamide + Elvitegravir / cobicistat / emtricitabine / tenofovir df
Severity: Moderate
Cyclophosphamide 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 strongly inhibits CYP3A4, which may reduce conversion of cyclophosphamide to its active 4-hydroxy metabolite while altering exposure to toxic metabolites. The net effect on efficacy and toxicity is unpredictable. Cyclophosphamide is also not a classic sensitive substrate of cobicistat contraindications.
What this interaction means in plain words
Cyclophosphamide 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
Cobicistat inhibits CYP3A4, which participates in cyclophosphamide metabolism and activation.
What to do
Monitor for myelosuppression and reduced antitumour response, and consider an alternative non-boosted antiretroviral regimen if feasible.
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 Cyclophosphamide
Frequently asked questions
Can I take Cyclophosphamide with Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates the interaction as moderate. Cyclophosphamide 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 strongly inhibits CYP3A4, which may reduce conversion of cyclophosphamide to its active 4-hydroxy metabolite while altering exposure to toxic metabolites. The net effect on efficacy and toxicity is unpredictable. Cyclophosphamide is also not a classic sensitive substrate of cobicistat contraindications.
How serious is the interaction between Cyclophosphamide 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: Monitor for myelosuppression and reduced antitumour response, and consider an alternative non-boosted antiretroviral regimen if feasible.
What other medicines interact with Cyclophosphamide?
MediHelp also lists interactions of Cyclophosphamide with, for example, Adenovirus types 4 and 7 live, Belatacept, Bendamustine. The full list is on the Cyclophosphamide page.
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