Drug interactions
Dexamethasone + Elvitegravir / cobicistat / emtricitabine / tenofovir df
Severity: Major
Dexamethasone 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
Dexamethasone may lower elvitegravir and cobicistat concentrations through CYP3A induction, risking loss of virologic suppression and resistance. Cobicistat boosting may also increase dexamethasone exposure.
What this interaction means in plain words
Dexamethasone 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
Dexamethasone induces CYP3A, reducing elvitegravir and cobicistat exposure.
What to do
Avoid long-term systemic dexamethasone with this regimen, or use an alternative antiretroviral. If a short course is necessary, monitor HIV RNA.
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 Dexamethasone
- Bcg vaccine live + Dexamethasone Contraindicated
- Dexamethasone + Mifepristone Contraindicated
- Dexamethasone + Rilpivirine Contraindicated
- Dexamethasone + Smallpox vaccine live Contraindicated
- Dexamethasone + Varicella virus vaccine live Contraindicated
- Dexamethasone + Yellow fever vaccine Contraindicated
Frequently asked questions
Can I take Dexamethasone with Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates the interaction as major. Dexamethasone 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. Dexamethasone may lower elvitegravir and cobicistat concentrations through CYP3A induction, risking loss of virologic suppression and resistance. Cobicistat boosting may also increase dexamethasone exposure.
How serious is the interaction between Dexamethasone 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 long-term systemic dexamethasone with this regimen, or use an alternative antiretroviral. If a short course is necessary, monitor HIV RNA.
What other medicines interact with Dexamethasone?
MediHelp also lists interactions of Dexamethasone with, for example, Bcg vaccine live, Mifepristone, Rilpivirine. The full list is on the Dexamethasone page.
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