Drug interactions
Doxorubicin + Elvitegravir / cobicistat / emtricitabine / tenofovir df
Severity: Major
Doxorubicin and Elvitegravir / cobicistat / emtricitabine / tenofovir df: major interaction.
Last updated Sources: US FDA label
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 CYP3A4, CYP2D6 and P-glycoprotein, which may raise doxorubicin exposure. This may increase myelosuppression, mucositis and cardiotoxicity.
What this interaction means in plain words
Doxorubicin 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, CYP2D6 and P-glycoprotein, reducing doxorubicin clearance.
What to do
Where possible, use an antiretroviral regimen without a pharmacokinetic booster during doxorubicin therapy. If it must be combined, monitor blood counts and cardiac function closely and consider dose reduction.
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 Doxorubicin
Frequently asked questions
Can I take Doxorubicin with Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates the interaction as major. Doxorubicin 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 CYP3A4, CYP2D6 and P-glycoprotein, which may raise doxorubicin exposure. This may increase myelosuppression, mucositis and cardiotoxicity.
How serious is the interaction between Doxorubicin 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: Where possible, use an antiretroviral regimen without a pharmacokinetic booster during doxorubicin therapy. If it must be combined, monitor blood counts and cardiac function closely and consider dose reduction.
What other medicines interact with Doxorubicin?
MediHelp also lists interactions of Doxorubicin with, for example, Adenovirus types 4 and 7 live, Belatacept, Cobicistat. The full list is on the Doxorubicin page.
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