Drug interactions
Elvitegravir + Quinidine
Severity: Moderate
Elvitegravir and Quinidine: 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
Quinidine is a CYP3A4 inhibitor and elvitegravir is a CYP3A4 substrate, but elvitegravir is nearly always given with cobicistat, which is a strong inhibitor. Cobicistat also raises quinidine levels, so the practical concern is higher quinidine exposure and arrhythmia risk in cobicistat-boosted regimens.
What this interaction means in plain words
Elvitegravir and Quinidine 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
CYP3A4 inhibition by quinidine may increase elvitegravir exposure, and cobicistat in the regimen can inhibit CYP3A and CYP2D6 metabolism of quinidine.
What to do
If the combination is needed, monitor ECG and quinidine concentrations when cobicistat-boosted elvitegravir is used. Reduce the quinidine dose or choose an alternative antiarrhythmic if levels or QTc rise.
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 Quinidine
- Adagrasib + Quinidine Contraindicated
- Arsenic trioxide + Quinidine Contraindicated
- Artemether / lumefantrine + Quinidine Contraindicated
- Chloroquine + Quinidine Contraindicated
- Dofetilide + Quinidine Contraindicated
- Dronedarone + Quinidine Contraindicated
Frequently asked questions
Can I take Elvitegravir with Quinidine?
MediHelp rates the interaction as moderate. Elvitegravir and Quinidine 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. Quinidine is a CYP3A4 inhibitor and elvitegravir is a CYP3A4 substrate, but elvitegravir is nearly always given with cobicistat, which is a strong inhibitor. Cobicistat also raises quinidine levels, so the practical concern is higher quinidine exposure and arrhythmia risk in cobicistat-boosted regimens.
How serious is the interaction between Elvitegravir and Quinidine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: If the combination is needed, monitor ECG and quinidine concentrations when cobicistat-boosted elvitegravir is used. Reduce the quinidine dose or choose an alternative antiarrhythmic if levels or QTc rise.
What other medicines interact with Quinidine?
MediHelp also lists interactions of Quinidine with, for example, Adagrasib, Arsenic trioxide, Artemether / lumefantrine. The full list is on the Quinidine page.
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