Drug interactions
Cyclosporin + Elvitegravir / cobicistat / emtricitabine / tenofovir df
Severity: Major
Cyclosporin 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 strongly inhibits CYP3A4 and can raise cyclosporin concentrations substantially, increasing the risk of nephrotoxicity, hypertension and other toxicity. Tenofovir DF adds its own renal toxicity, further raising the risk of kidney injury.
What this interaction means in plain words
Cyclosporin 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 P-glycoprotein, reducing cyclosporin clearance, while both cyclosporin and tenofovir are nephrotoxic.
What to do
Prefer an antiretroviral regimen without a pharmacokinetic booster. If combined, reduce the cyclosporin dose, monitor cyclosporin trough levels closely, and check serum creatinine and renal function regularly.
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 Cyclosporin
- Adenovirus types 4 and 7 live + Cyclosporin Contraindicated
- Aliskiren + Cyclosporin Contraindicated
- Bcg vaccine live + Cyclosporin Contraindicated
- Bosentan + Cyclosporin Contraindicated
- Cidofovir + Cyclosporin Contraindicated
- Cyclosporin + Dengue vaccine Contraindicated
Frequently asked questions
Can I take Cyclosporin with Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates the interaction as major. Cyclosporin 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 strongly inhibits CYP3A4 and can raise cyclosporin concentrations substantially, increasing the risk of nephrotoxicity, hypertension and other toxicity. Tenofovir DF adds its own renal toxicity, further raising the risk of kidney injury.
How serious is the interaction between Cyclosporin 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: Prefer an antiretroviral regimen without a pharmacokinetic booster. If combined, reduce the cyclosporin dose, monitor cyclosporin trough levels closely, and check serum creatinine and renal function regularly.
What other medicines interact with Cyclosporin?
MediHelp also lists interactions of Cyclosporin with, for example, Adenovirus types 4 and 7 live, Aliskiren, Bcg vaccine live. The full list is on the Cyclosporin page.
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