Drug interactions
Elvitegravir + Methadone
Severity: Moderate
Elvitegravir and Methadone: 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
Elvitegravir is given with the booster cobicistat, which inhibits CYP3A4 and can increase methadone exposure, although the legacy note describes the opposite. Clinical data with this combination suggest no major change in methadone effect, but individual responses vary.
What this interaction means in plain words
Elvitegravir and Methadone 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 and CYP2D6 and may raise methadone levels; elvitegravir itself has weak enzyme-inducing effects.
What to do
Monitor for sedation, respiratory depression, and QTc prolongation when starting the regimen, and for withdrawal if it is stopped. Adjust the methadone dose to clinical response.
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 Methadone
- Alvimopan + Methadone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Methadone Contraindicated
- Droperidol + Methadone Contraindicated
- Ibutilide + Methadone Contraindicated
- Isocarboxazid + Methadone Contraindicated
- Lefamulin + Methadone Contraindicated
Frequently asked questions
Can I take Elvitegravir with Methadone?
MediHelp rates the interaction as moderate. Elvitegravir and Methadone 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. Elvitegravir is given with the booster cobicistat, which inhibits CYP3A4 and can increase methadone exposure, although the legacy note describes the opposite. Clinical data with this combination suggest no major change in methadone effect, but individual responses vary.
How serious is the interaction between Elvitegravir and Methadone?
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 sedation, respiratory depression, and QTc prolongation when starting the regimen, and for withdrawal if it is stopped. Adjust the methadone dose to clinical response.
What other medicines interact with Methadone?
MediHelp also lists interactions of Methadone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Droperidol. The full list is on the Methadone page.
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