Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Erythromycin
Severity: Moderate
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Erythromycin: 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
Cobicistat strongly inhibits CYP3A4, which can raise erythromycin concentrations and increase the risk of QT prolongation. Erythromycin may also increase elvitegravir and cobicistat exposure. Clinically this is a monitored interaction rather than a strict contraindication.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Erythromycin 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 P-glycoprotein, decreasing erythromycin clearance.
What to do
Consider azithromycin or another alternative; if erythromycin is used, monitor ECG and for adverse effects such as GI intolerance and arrhythmia.
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 Erythromycin
- Conivaptan + Erythromycin Contraindicated
- Dihydroergotamine intranasal + Erythromycin Contraindicated
- Dihydroergotamine + Erythromycin Contraindicated
- Domperidone + Erythromycin Contraindicated
- Dronedarone + Erythromycin Contraindicated
- Droperidol + Erythromycin Contraindicated
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Erythromycin?
MediHelp rates the interaction as moderate. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Erythromycin 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. Cobicistat strongly inhibits CYP3A4, which can raise erythromycin concentrations and increase the risk of QT prolongation. Erythromycin may also increase elvitegravir and cobicistat exposure. Clinically this is a monitored interaction rather than a strict contraindication.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Erythromycin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider azithromycin or another alternative; if erythromycin is used, monitor ECG and for adverse effects such as GI intolerance and arrhythmia.
What other medicines interact with Erythromycin?
MediHelp also lists interactions of Erythromycin with, for example, Conivaptan, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Erythromycin page.
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