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Drug interactions

Elvitegravir / cobicistat / emtricitabine / tenofovir df + Entecavir

Severity: Moderate

Elvitegravir / cobicistat / emtricitabine / tenofovir df and Entecavir: moderate 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

Entecavir, emtricitabine and tenofovir are all eliminated by the kidney through filtration and active tubular secretion, and cobicistat can raise serum creatinine by inhibiting tubular secretion. Concurrent use may increase concentrations of the renally cleared drugs and the risk of renal adverse events. Entecavir is sometimes combined with tenofovir regimens in hepatitis B coinfection.

What this interaction means in plain words

Elvitegravir / cobicistat / emtricitabine / tenofovir df and Entecavir 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.

Evidence level: Low

Why it happens

Competition for renal tubular secretion and additive renal burden, which can decrease clearance of each drug.

What to do

Monitor serum creatinine, estimated clearance and phosphate regularly. Adjust the entecavir dose if creatinine clearance falls.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Entecavir?

MediHelp rates the interaction as moderate. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Entecavir 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. Entecavir, emtricitabine and tenofovir are all eliminated by the kidney through filtration and active tubular secretion, and cobicistat can raise serum creatinine by inhibiting tubular secretion. Concurrent use may increase concentrations of the renally cleared drugs and the risk of renal adverse events. Entecavir is sometimes combined with tenofovir regimens in hepatitis B coinfection.

How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Entecavir?

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 serum creatinine, estimated clearance and phosphate regularly. Adjust the entecavir dose if creatinine clearance falls.

What other medicines interact with Entecavir?

MediHelp also lists interactions of Entecavir with, for example, Alogliptin-metformin, Canagliflozin-metformin, Cidofovir. The full list is on the Entecavir page.

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