Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Felodipine
Severity: Major
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Felodipine: 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
Felodipine is highly dependent on CYP3A4 for first-pass metabolism, so cobicistat can markedly raise its exposure. This can lead to marked hypotension, tachycardia, flushing and edema.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Felodipine 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
Cobicistat inhibition of intestinal and hepatic CYP3A4 metabolism of felodipine.
What to do
Use a reduced felodipine dose with close blood pressure monitoring, or switch to a calcium channel blocker less dependent on CYP3A4. Titrate cautiously.
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 Felodipine
- Felodipine + Itraconazole Contraindicated
- Aldesleukin + Felodipine Major
- Amifostine + Felodipine Major
- Apalutamide + Felodipine Major
- Atazanavir + Felodipine Major
- Carbamazepine + Felodipine Major
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Felodipine?
MediHelp rates the interaction as major. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Felodipine 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. Felodipine is highly dependent on CYP3A4 for first-pass metabolism, so cobicistat can markedly raise its exposure. This can lead to marked hypotension, tachycardia, flushing and edema.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Felodipine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a reduced felodipine dose with close blood pressure monitoring, or switch to a calcium channel blocker less dependent on CYP3A4. Titrate cautiously.
What other medicines interact with Felodipine?
MediHelp also lists interactions of Felodipine with, for example, Itraconazole, Aldesleukin, Amifostine. The full list is on the Felodipine page.
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