Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Enzalutamide
Severity: Major
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Enzalutamide: major 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
Enzalutamide's strong CYP3A induction can lower elvitegravir and cobicistat exposure, causing loss of virologic response and integrase resistance. Cobicistat inhibition of CYP3A may also raise enzalutamide levels.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Enzalutamide 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
CYP3A4 induction by enzalutamide reduces elvitegravir and cobicistat levels; cobicistat inhibits CYP3A4 and may increase enzalutamide.
What to do
Avoid the combination and use an antiretroviral regimen without a CYP3A-dependent booster. Monitor HIV RNA if it cannot be avoided.
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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Other interactions of Enzalutamide
- Doravirine + Enzalutamide Contraindicated
- Elbasvir / grazoprevir + Enzalutamide Contraindicated
- Ensitrelvir + Enzalutamide Contraindicated
- Enzalutamide + Fostemsavir Contraindicated
- Enzalutamide + Isavuconazonium Contraindicated
- Enzalutamide + Lenacapavir Contraindicated
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Enzalutamide?
MediHelp rates the interaction as major. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Enzalutamide 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. Enzalutamide's strong CYP3A induction can lower elvitegravir and cobicistat exposure, causing loss of virologic response and integrase resistance. Cobicistat inhibition of CYP3A may also raise enzalutamide levels.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Enzalutamide?
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 the combination and use an antiretroviral regimen without a CYP3A-dependent booster. Monitor HIV RNA if it cannot be avoided.
What other medicines interact with Enzalutamide?
MediHelp also lists interactions of Enzalutamide with, for example, Doravirine, Elbasvir / grazoprevir, Ensitrelvir. The full list is on the Enzalutamide page.
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