Drug interactions
Dabigatran etexilate + Elvitegravir / cobicistat / emtricitabine / tenofovir df
Severity: Major
Dabigatran etexilate and Elvitegravir / cobicistat / emtricitabine / tenofovir df: major interaction.
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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 intestinal P-glycoprotein, which can raise dabigatran absorption and plasma exposure. Higher exposure increases the risk of bleeding, particularly in patients with reduced renal function.
What this interaction means in plain words
Dabigatran etexilate 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 P-glycoprotein efflux of dabigatran etexilate in the gut, increasing its bioavailability.
What to do
Avoid the combination in patients with moderate or worse renal impairment; otherwise monitor closely for bleeding and consider reducing the dabigatran dose per local labeling. Consider an alternative anticoagulant if renal function is declining.
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 Dabigatran etexilate
- Dabigatran etexilate + Defibrotide Contraindicated
- Dabigatran etexilate + Ketorolac Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
- Abciximab + Dabigatran etexilate Major
- Alteplase + Dabigatran etexilate Major
- Amiodarone + Dabigatran etexilate Major
Frequently asked questions
Can I take Dabigatran etexilate with Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates the interaction as major. Dabigatran etexilate 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 inhibits intestinal P-glycoprotein, which can raise dabigatran absorption and plasma exposure. Higher exposure increases the risk of bleeding, particularly in patients with reduced renal function.
How serious is the interaction between Dabigatran etexilate 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: Avoid the combination in patients with moderate or worse renal impairment; otherwise monitor closely for bleeding and consider reducing the dabigatran dose per local labeling. Consider an alternative anticoagulant if renal function is declining.
What other medicines interact with Dabigatran etexilate?
MediHelp also lists interactions of Dabigatran etexilate with, for example, Defibrotide, Ketorolac, Mifepristone. The full list is on the Dabigatran etexilate page.
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